Publications

Released: November 2024

Using data from the Colorado All Payer Claims Database (CO APCD), this analysis provides insights to legislators and the public about in-network and out-of-network ambulance service costs and utilization rates for Coloradans with commercial health insurance. The report also includes data on how commercial health insurance payments compare to Medicare Fee-for-Service (FFS) rates, showing the percentage paid above or below the Medicare baseline (100).

Released: June 2024

This study examined end-of-life (EOL) health care utilization, medical, and pharmacy costs among Coloradans who died during the COVID-19 pandemic years 2020-2021. The findings are based on 2020-2021 claims data in the Colorado All Payer Claims Database (CO APCD) and death registry information from the Colorado Department of Public Health and Environment (CDPHE). Amidst the pandemic, managing EOL care posed significant challenges, with disparities in care intensity and hospice utilization across insurance types. This research aimed to highlight these disparities and assess the impact of COVID-19 on EOL care, considering demographic variables.

Released: May 2024

The intent of this report is to understand the volume of members with recorded Z codes to identify health-related social needs in the Colorado All Claims Database (CO APCD) from 2016-2022. This analysis explores the volume and percentage of these members with claims by year, payer type, and by claim type for all payers (Medicaid, Medicare, and commercial payers). Z Codes, which are codes that identify non-medical factors that may influence a patient's health status were evaluated for this analysis. Z codes became available for providers to use in 2016.

Released: April 2024

This data provides a snapshot of race and ethnicity information that payers submit to the Colorado All Payer Claims Database (CO APCD) for individual members. Race and Hispanic indicators became required submission fields in September 2019. The remaining race and ethnicity fields are voluntary. Note: The data in this analysis may not fully represent the race and ethnicity distribution for members in the CO APCD as all payers (public and private) are working on improving their data collection and submissions to the CO APCD. To view the requirements for payers, please refer to the most current Data Submission Guide categories ME021 – ME027.

Released: April 2024

In 2021, firearm related violence in Colorado hit a 40 year high according to an analysis of Colorado Department of Public Health and Environment mortality data. Additionally, the American Public Health Association and the Centers for Disease Control classify firearm injury and death as a significant public health issue. This data analysis, using claims from the Colorado All Payer Claims Database (CO APCD) provides a snapshot of the types of firearm injuries that are occurring in the state by volume, rate per person, health care cost, geographic variation, and trends over time.

Released: April 2024

Using data from the EPA (Environmental Protection Agency) and the Colorado All Payer Claims Database (CO APCD), this analysis evaluates the impact of Wildfire and Ozone on Emergency Department (ED) visits for respiratory and circulatory diseases. The analysis provides the maximum mean for the fine particulate matter (PM2.5) concentrations (a metric for assessing air quality during wildfires), maximum 8-hour parts per million (PPM) ozone concentrations, and ED utilization and cost in select Colorado counties by month.

Released: February 2023

Coloradans living with mental illness don’t always have access to comprehensive services or seek timely care to support their needs. Many efforts are underway in Colorado to improve diagnosis and treatment of mental health conditions, reduce stigma related to seeking care, and expand coverage and access to services for those living with mental illness. Despite these efforts, across the state, the Emergency Departments (ED) remain a source of support for many suffering from potentially preventable mental health crises. This custom data set from the Colorado All Payer Claims Database (CO APCD) provides a snapshot of utilization, cost and trends for visits to the ED with mental health or potential self-harm as a primary diagnosis.

Released: November 2022

This analysis provides a snapshot of utilization, cost, and trends for vasectomies and oral and non-oral contraception in Colorado from 2018-2021. The data set includes plan paid, patient responsibility, and total allowed amounts (plan paid and patient responsibility combined), in addition to the total number of procedures or prescriptions and the rate of people receiving care per 1,000 covered lives by payer. Results indicate that vasectomies decreased slightly during the height of the pandemic (2020), while use of oral contraception and non-oral contraception (provider administration portion) has remained consistent. There has been a decrease in use of non-oral contraceptives (prescription portion only), due to a decrease in the prescription fill rate for the vaginal ring.

Released: September 2022

This analysis was conducted to understand the utilization of gender affirming care among transgender, gender diverse, and non-binary (TGDNB) youth and young adults over time. In 2017, the Colorado Department of Health Care Policy and Financing’s (HCPF) Medical Services Board passed a statute for a comprehensive Medicaid transition-related care benefit. Through legislation passed in 2021, Colorado became the first state in the nation to require comprehensive gender-affirming care as part of minimum, or “benchmark,” health care plans sold on the individual and small group markets, which accounts for about a quarter of the state’s insured population. Plans must comply beginning in 2023.

Released: February 2022

This analysis shows the frequency of women receiving an additional Emergency Department (ED) charge with a normal labor and delivery. The data provides the volume and percentage of normal, routine vaginal deliveries with an additional ED charge, and provides breakouts by payer type (Medicaid or commercial), trends over time, and by ED facility severity level code. Average allowed amounts (patient and plan paid) for vaginal delivery in CO with and without an ED charge are also included.

Released: August 2021

As coronavirus continues to spread across the state, this analysis of Coloradans at high risk of severe illness from COVID-19 helps the state and communities understand the impact that infection may have in certain areas.

Released: March 2021

This analysis provides information on the top 100 generic and top 100 brand commercial prescription drugs from 2019 based on highest spend (total allowed amount) in the Colorado All Payer Claims Database (CO APCD).  Breakouts by plan and patient paid amounts are also available as well as price and utilization trend information for the top 100 drugs from 2016-2018.

Released: December 2020

The Nurse Midwife Payment Evaluation data set provides payment comparisons for common procedures provided by Nurse Midwives, OB/GYNs, Primary Care Providers, Nurse Practitioners and Physician Assistants. The data is available by payer (Medicaid, Medicare Advantage and commercial) and shows median and average paid amounts and 25^th to 75^th percentile paid amounts to allow users to understand variation in payments.

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