April 30, 2012 – DENVER – Colorado’s All Payer Claims Database (APCD) – a groundbreaking tool for measuring health care costs and utilization throughout Colorado – has achieved a major implementation milestone by securing $4.5 million in joint funding from The Colorado Trust and the Colorado Health Foundation.
The APCD is a secure, encrypted data warehouse that will include claims information from all commercial health insurers operating in Colorado, as well as Medicaid and Medicare. Scheduled to launch in Colorado by the end of the year, this important resource will give consumers and employers across the state comparative data to make informed choices about purchasing health care and coverage. It will enable hospitals and other health care facilities to identify high-cost and often misused patient services, such as unnecessary emergency room visits, and validate where alternative care solutions and prevention are having an impact. Physicians and other clinicians will be able to compare cost and quality performance across payers. The APCD also will provide policymakers and researchers an in-depth picture of health care spending and quality trends to inform policy and public health initiatives.
The Center for Improving Value in Health Care (CIVHC), a non-profit, nonpartisan organization, administers the APCD. “Health care costs are increasing exponentially, and approximately 30 percent of the money spent is wasteful and doesn’t add any real value to the patient,” said CIVHC CEO Phil Kalin. “In this age of technology when consumers can evaluate cost and ratings of just about any product on the market, health care is the exception, and that’s about to change. The APCD provides the transparency of pricing and quality that our health care system currently lacks and that all of us need to make good decisions about our care.”
“If we are to make substantial improvements in how health care is delivered while enhancing quality and reducing cost, we must have easy access to reliable and comprehensive data,” stated Anne Warhover, President and CEO of the Colorado Health Foundation. “The information provided by the All Payer Claims Database will be essential to meeting the state’s primary health care goals and to helping make Colorado the healthiest state in the nation.”
“The claims and costs data that the APCD will make available, as well as specific measures of quality, will provide an integral missing part of the spectrum of data needed to inform our decisions on health care. Together with other sources, including our Colorado Health Access Survey of coverage, access and utilization of health care, the APCD will help to inform policymakers and business leaders in supporting better access to care in our state” said Ned Calonge, MD, President and CEO of The Colorado Trust. “We know that a critical component of finding solutions that work is having robust data to pinpoint challenges and confirm improvements.”
Colorado has evidence that thoughtful use of focused data makes a difference. For more than a decade, Mesa County’s providers and payers have used claims data to identify new ways of delivering and paying for health care that have resulted in better outcomes and lower costs for Medicare patients in Mesa County than in almost any other part of the country.
In 2008, Colorado’s Blue Ribbon Commission on Health Care recommended that Colorado create an APCD, arguing that transparent data regarding costs and quality were necessary for Colorado to take control of spiraling health care costs. The APCD was enabled by legislation in 2010, and CIVHC was appointed administrator of the APCD. The planning phase was supported through a grant from The Colorado Trust. The additional $4.5 million in funding from the Colorado Health Foundation ($2.5 million) and The Colorado Trust ($2 million) will support development, implementation and management of the APCD.
All information in the APCD is encoded to maintain security, and all APCD data releases will comply with the privacy requirements of the Health Insurance Portability and Accountability Act (HIPAA). The first APCD reports, available at the end of the year, will provide statewide, aggregated overviews of health care costs and utilization. As additional data comes into the APCD over the next two years, more detailed analyses of costs and quality by facility and provider type will be generated. Eventually, consumers will be able to view this type of comparative information on a public website, while researchers and others may request access to more detailed datasets, subject to compliance with HIPAA regulations.
“As an example, if you need hip surgery, you will be able to use a website that will show you how much that surgery would cost at various locations in your area and you will be able to compare that with quality information, such as infection rates,” explains Kalin. “No one would take their car to a repair shop with the worst consumer ratings and the highest costs, and it’s about time consumers had the same opportunity to shop around for health care.”
With the launch of the APCD, Colorado will join nine other states across the U.S., including neighboring Utah, that already have a similar database in place to identify variations in cost and to address disparities in price where the quality and services do not justify a higher bill. For more information about Colorado’s APCD, visit www.civhc.org.
About CIVHC. The Center for Improving Value in Health Care is a nonprofit, nonpartisan organization committed to identifying and advancing initiatives across Colorado that enhance consumers’ health care experiences, contain costs and improve the health of Coloradans by creating an efficient, high quality and transparent health care system. For more information about the Center for Improving Value in Health Care, visit www.civhc.org.
About the Colorado Health Foundation. The Colorado Health Foundation works to make Colorado the healthiest state in the nation by investing in grants and initiatives to health-related nonprofits that focus on increasing the number of Coloradans with health insurance, ensuring they have access to quality, coordinated primary care and encouraging healthy living. For more information, please visit www.ColoradoHealth.org.
About The Colorado Trust. The Colorado Trust is a grantmaking foundation dedicated to achieving access to health for all Coloradans. Trust grant support focuses on the development and implementation of policies, programs and services that expand health coverage and improve the health care system. For mor information, please visit www.coloradotrust.org.