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).

    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.

    In-Warehouse Quality Checks and Data Processing

    Previous queries have detailed the process for the monthly submission and intake of claims data to the Colorado All Payer Claims Database (CO APCD). This query explores the steps the data undergo after being accepted into the warehouse. Once payer-submitted data has successfully passed the extensive initial validation and quality Read more…

    Data Refreshes, Intake, and the SQI

    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). CIVHC along with data managers, Human Services Research Institute (HSRI) and NORC at the University of Chicago, continually work closely with submitters to ensure they Read more…

    Phasegate

    In fiscal year 2023-2024, CIVHC’s Data Operations team is implementing 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 Read more…

    Understanding Data Submission and the DSG

    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 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…

    Commercial Data in the CO APCD

    As of June 2023, the Colorado All Payer Claims Database (CO APCD) contained over 1 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…

    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 to claims 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.

    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 to ensure 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…

    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…

    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 the database, 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…