Overview

The CO APCD contains millions of claims across all health plans for multiple years. Health insurance payers submit data monthly and the entire database is refreshed every other month, so the CO ACPD is continually evolving and being enhanced.

Data Warehouse Refresh Resources

The CO APCD Data Warehouse is refreshed every other month, incorporating new years of data while also improving the quality of the existing data by implementing new business rules, adding previously missing files, or correcting concerns. The breakdown of paid-through dates by business line for the most recent refresh is available here.

The Release Notes for the most recent refresh is now available for download and provides important information regarding the length of time between the service date and paid date (‘claims lag’) for medical and pharmacy claims in the CO APCD. This analysis helps answer several key questions including how long it takes to achieve “completeness,” how lag time varies by payer type (commercial, Medicaid, etc), and by claim type (medical, pharmacy, inpatient, outpatient, etc).

The Data Discovery Log documents data quality items identified following file submission and processing, enhancement and loading of data into the CO APCD following each refresh of the warehouse.

Query: CO APCD Data Quality

The Query: CO APCD Data Quality series is designed to:

  • explain the foundations of how CIVHC approaches data quality as administrator of the CO APCD,
  • detail the processes and systems that bring the data into the warehouse, and
  • define what steps are taken before data is released.

The Submitter Quality Index

In the fall of 2022, Center for Improving Value in Health Care (CIVHC) implemented a new Submitter Quality Index (SQI), a benchmark step in CIVHC’s overall workplan to continually improve data completeness and accuracy. The SQI is a tool that helps CIVHC assess the quality of data submitted to the Read more…

Data Submission, Intake, and Warehouse Refreshes

Each month health insurance payers submit millions of medical, professional, pharmacy, and dental claims for inclusion in the Colorado All Payer Claims Database (CO APCD). Work to ensure that this data coming into the CO APCD is the most credible and highest quality begins before the files are sent. CIVHC Read more…

Medicare Data in the CO APCD

As of June 2022, the Colorado All Payer Claims Database (CO APCD) contained over 870 million claims spanning 2013 through 2021. 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 Read more…

Medicaid Data in the CO APCD

As of June 2022, the Colorado All Payer Claims Database (CO APCD) contained over 870 million claims spanning 2013 through 2021. 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 Read more…

Commercial Data in the CO APCD

As of June 2022, the Colorado All Payer Claims Database (CO APCD) contained over 870 million claims spanning 2013 through 2021. 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 Read more…

What to Expect with Claims Data

A previous query defined the different nuances encompassed under the term “data quality” to help shed light on the myriad factors that can impact the contents of an output from the Colorado All Payer Claims Database (CO APCD). This piece will outline some baseline expectations for users who are new Read more…

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…

Query: CO APCD Data Analytics

The Query: CO APCD Data Analytics series is designed to:

  • provide insight into CIVHC's approach and philosophy of data analytics,
  • outline the what is possible and what is not with the data, and
  • demystify the process of CO APCD data release.

Specialized Analytics in Public Reporting

The Colorado All Payer Claims Database (CO APCD) contains medical, pharmacy, 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 of 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 Read more…

Public Data Releases

CIVHC releases CO APCD data in two ways: non-public custom releases, licensed by Change Agents working on specific projects to improve care for Coloradans, or public data releases on civhc.org designed to foster decision-making at all levels of the health care system. Increasing access to transparent health care data for all Change Read more…

Data Element Request Form

Once someone has decided to use a non-public data set from the Colorado All Payer Claims Database (CO APCD), it is crucial that they request the right information to answer their questions. While that sounds like a relatively straight-forward determination, in many cases it is not. The Data Element Request Read more…

Non-Public Release Application and Data Use Agreement

When requestors begin the process of accessing non-public data from the Colorado All Payer Claims Database (CO APCD), CIVHC’s Health Data Solutions Consultants work closely with them to determine what data would meet their needs and what path the request will follow. Once the project goals are established, and they meet the Read more…

Non-Public Data Release Process

If the request meets all necessary criteria, non-public data from the Colorado All Payer Claims Database (CO APCD) is available to “state agencies and private entities in Colorado engaged in efforts to improve health care.” These requests are categorized by CIVHC as non-public, as the data will go to one person or organization, Read more…

HIPAA & Personal Health Information

Protecting health information is the highest priority for the Colorado All Payer Claims Database (CO APCD). 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 and share with providers and payers 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 Read more…

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 870 million claims is nearly impossible. However, the Read more…

Rules Governing CO APCD Data Use

In 2010, the Colorado General Assembly saw the opportunities an immense repository of data such as the Colorado All Payer Claims Database (CO APCD) could afford – they also saw the possibilities for exploitation and built safeguards into the use of the CO APCD. When drafting the legislation that shaped Read more…