General
What does the CO APCD do?
Last Updated: August 11, 2017The CO APCD provides Coloradans access to aggregate claims information (cost, diagnosis, location, provider type) to identify the costs, utilization and quality of health care services provided in Colorado. By aggregating, analyzing and reporting these claims data, the CO APCD helps consumers, providers, state agencies, researchers, health plans and other...
Why do we need an APCD in Colorado?
Last Updated: August 11, 2017We cannot manage what we cannot measure. Every state throughout the country is struggling with increasing health care costs and it is estimated that 30-40% of the care provided is not contributing to better health. Without a firm understanding of how, where and how much health care spending occurs, Colorado...
What can be done with claims data?
Last Updated: August 11, 2017Claims data includes information such as costs, facility type and diagnosis that allow us to identify areas for improvement across our health care system. The CO APCD has the ability to inform opportunities to improve health, improve quality of care and lower costs. A wide variety of stakeholders can and...
How is this information useful to patients?
Last Updated: August 11, 2017Imagine buying a car without being able to compare its features or consumer satisfaction ratings compared to other brands. Now imagine having no idea what the car will cost you until you receive a bill in the mail. CO APCD data can allow you to find the best care at...
Do other states have APCDs and how is Colorado’s different?
Last Updated: August 11, 2017More than 15 states have implemented an APCD or are in the process of doing so, and many others express strong interest, according to the national APCD Council. Implementation of an APCD is seen as one of the most important steps a state can take to improve the care and lower...
Will this information go into some sort of national database?
Last Updated: August 11, 2017There is no national APCD database nor is there any known basis upon which the federal government could compel states to contribute to such a database.
Will the CO APCD bring about competition that lowers costs?
Last Updated: August 11, 2017We do expect increased competition to be just one of the many outcomes of the CO APCD. As transparency of cost and quality grows, it is expected that purchasers of health care services will go to those providers who provide the highest value. This same cost and quality data will...
What if providing transparent prices actually encourages hospitals and physicians with lower costs than their peers to raise their rates?
Last Updated: August 11, 2017That’s certainly a potential unintended consequence. Experience in other states that have had APCDs for longer than Colorado, however, demonstrates that purchasers and consumers migrate toward the providers who demonstrate high quality and low costs in the APCD—we’ve seen that happen in Massachusetts, for example, as consumers have used the...
If Colorado does indeed move toward more integrated, Kaiser-like health systems—which don’t process “claims” in the same fashion as other health plans—won’t that make the CO APCD obsolete?
Last Updated: August 11, 2017Not at all. The majority of the information collected from payers is the same regardless of the payment mechanism and will allow understanding of utilization, effectiveness, quality and overall costs. The CO APCD will allow services and their costs to be aggregated so that appropriate comparisons can be made. Over...
How do hospitals and providers feel about having their prices publicized?
Last Updated: August 11, 2017CIVHC can’t speak for any industry group. But Colorado’s hospitals have embraced the notion of transparency for some time, with the hospital report card that shows charges and some quality information. They themselves are not able to provide the kind of data the CO APCD gathers, and it is useful...
Will the detailed health history and family health questionnaire that I filled out for my doctor or insurance company be stored in the CO APCD?
Last Updated: August 11, 2017The CO APCD isn’t a medical record, and doesn’t capture information from questionnaires or your doctor’s notes. It only includes the information from insurance claims, such as what services were received and how much was paid for those.