Defining Data Quality in the CO APCD
Claims data is very different than other types of data typically encountered by actuaries, accountants, analysts, and researchers. If not prepared for the unique challenges it presents, it is easy to conclude that something is wrong with a data set. The phrase “data quality” is frequently used as a catch-all Read more
Non-Claims Data in the CO APCD
Non-Claims Data in the CO APCD The Colorado All Payer Claims Database (CO APCD) contains medical, dental, vision, and pharmacy claims from the majority of insured individuals in the state. However, claims data highlights only a portion of how the health care system functions. There are numerous other non-claims components Read more
Pharmacy and Drug Rebate Data in the CO APCD
Previous queries have outlined that the CO APCD contains medical, dental, vision, and pharmacy claims for the majority of insured individuals in Colorado, roughly 74 percent of covered lives in the state. However, numerous other behind-the-scenes factors provide insight into how an individual interacts with the health care system. One Read more
Behavioral Health and Substance Use Disorder Claims in the CO APCD
The Colorado All Payer Claims Database (CO APCD) contains over 1.1 billion claims, representing over 5 million insured lives in Colorado, with more added every month. Of these claims, there are over 75 million behavioral health claims contained in the CO APCD, representing over 10 million unique Coloradans who have Read more
Race, Ethnicity, and Demographic Data in the CO APCD
Collecting reliable and complete patient demographic data, especially race and ethnicity information, is a challenge most health data organizations, including other state All Payer Claims Databases (APCDs), have grappled with for years. However, all agree that this data is essential to help communities understand drivers, inform solutions and assess progress Read more
In-Warehouse Quality Checks and Data Processing
Once payer-submitted data has successfully passed the extensive initial validation and quality tests performed by CIVHC and data manager Human Services Research Institute (HSRI) and NORC at the University of Chicago, the data are ready to be ingested into the warehouse. Previous queries have detailed the process for the monthly submission and intake Read more
Data Refreshes, Intake, and the Submitter Quality Index (SQI)
Each month, health insurance payers submit millions of medical, professional, pharmacy, dental, and vision claims for inclusion in the Colorado All Payer Claims Database (CO APCD). CIVHC continuously works closely with submitters to ensure they understand the submission requirements and that the process is as smooth as possible. After submissions pass Read more
Understanding the Data Submission Guide (DSG) and Data Submission Validation
As administrator of the Colorado All Payer Claims Database (CO APCD), CIVHC is required by statute not only to maintain the database, but to continually improve the quality and utility of the CO APCD. One of the most essential activities to enhancing the CO APCD is annually updating the CO APCD Rule and Data Submission Read more
Phasegate
In fiscal year 2023-2024, CIVHC’s Data Operations team implemented a new project management process, PhaseGate, to ensure projects moving through CIVHC’s teams are successful. The process divides development into distinct stages, or phases, separated by decision points, known as gates. The PhaseGate process is effective because it helps teams break Read more
Medicare Data in the CO APCD
As of June 2023, the Colorado All Payer Claims Database (CO APCD) contained over one billion claims spanning 2013 through 2022. These claims were submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO Read more
Contents of The CO APCD and How Data Is Released
The Colorado All Payer Claims Database (CO APCD) is a state-legislated, secure health care claims database compliant with all federal privacy and antitrust laws. It is the only claims repository in the state that represents most insured lives in Colorado, with more than ten years of data from commercial health Read more
Specialized Analytics in Public Reporting
The Colorado All Payer Claims Database (CO APCD) contains medical, pharmacy, vision, and dental claims from the majority of insured individuals in the state and collects non-claims data on additional components that impact individual health and cost of care. However, collecting all this data is only the beginning for those Read more
Geocoding the CO APCD and Health Equity Analytics
It is estimated that 80% of a person’s health outcomes are related to social factors outside of their control. These social determinants of health are the nonmedical factors that influence a person’s health, including the conditions in which they are born, live, work, and age. In 2021, CIVHC took a big step to enhance the Read more
Public Data Releases
As discussed in a previous Query, CIVHC releases data from the Colorado All Payer Claims Database (CO APCD) in two ways: Non-public releases, for individuals or organizations to use to improve care for Coloradans Public data, for anyone to use to help make data-driven health decisions A different query addressed the process required Read more
Non-Public Release Application and Data Use Agreement
As discussed in a previous Query, individuals or organizations can request non-public data releases from the Colorado All Payer Claims Database (CO APCD) to help answer questions or solve problems around health and health care in Colorado. Today, we continue exploring the steps requestors must take to apply for a Read more
The Data Element Selection Form (DESF)
Once an organization or an individual has decided to use a non-public data set from the Colorado All Payer Claims Database (CO APCD), it’s crucial they request the right information to answer their questions. That sounds relatively straightforward, but when there are nearly 500 options to choose from, often it Read more
Non-Public Data Release Process
As discussed in a previous Query, CIVHC releases data from the Colorado All Payer Claims Database (CO APCD) in two ways: Non-public releases, for individuals or organizations to use to improve care for Coloradans. Public data, for anyone to use to help make data-driven health decisions. Today, we are exploring how Read more
HIPAA & Personal Health Information
Protecting health information is the highest priority for Center for Improving Value in Health Care, administrator of the Colorado All Payer Claims Database (CO APCD). Colorado statute CRS 25.5-1-204 requires the administrator of the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the Read more
Capabilities and Limitations of CO APCD Data
With a resource the size of the Colorado All Payer Claims Database (CO APCD), it is easy to presume that the possibilities for exploration are endless. In some senses, it is true that comprehending the potential combinations of data elements from over one billion claims is nearly impossible. However, the scale of Read more
Data Security and the CO APCD
When designing how the Colorado All Payer Claims Database (CO APCD) was to be built and administered, protecting health information was the highest priority. Colorado statute CRS 25.5-1-204 requires the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the ability to analyze data Read more