The Colorado All Payer Claims Database (CO APCD) is a state-legislated, secure health care claims database compliant with all federal privacy laws. The complexity and scale of the database continually grows with millions of claims submitted by payers each month, reflecting over 4.5 million lives. It contains nearly 920 million claims for approximately 65 percent of insured lives in Colorado, with information from 42 commercial health insurance plans, including Medicare Advantage as well as voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS) claims. For more information regarding the number of lives, payers, and more that are in the CO APCD, and how it has changed over time, visit the CO APCD Insights Dashboard.
Due to a 2016 ruling by the United States Supreme Court, states cannot mandate submission of claims data from self-insured ERISA plans to APCDs. Self-insured claims are estimated to represent half of the total commercially insured lives in Colorado and CIVHC estimates that the CO APCD currently contains approximately a quarter of those lives. The CO APCD also does not contain claims for people covered by Federal health insurance programs such as the Veterans Administration, TRICARE, or Indian Health Services, and does not include information for uninsured Coloradans.
CO APCD 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; and public information on civhc.org designed to foster decision-making at all levels of the health care system, from consumers to state agencies.
Non-Public Data Releases
CIVHC provides custom data sets and reports to organizations and researchers seeking to advance the Triple Aim. Every release of data must benefit Colorado, as mandated by CO APCD regulations, as well as adhere to federal privacy and anti-trust laws.
There are several ways non-public CO APCD data is provided, depending on the question the requestor is hoping to answer and their sophistication with claims data analysis. For stakeholders who do not have time or the expertise to analyze data on their own, CIVHC can provide a Custom or Standard report in a business intelligence or data visualization tool like Tableau or Excel. When partners are interested in performing their own analyses using tools of their choosing and have a strong analysis background, CIVHC provides them with a Custom or Standard Data Set. Depending on the level of personal health information (PHI) required, data sets are De-Identified, Limited, or Fully Identifiable. Every request containing any element of PHI is reviewed in detail by the Data Release and Review Committee to ensure they meet all state and federal privacy regulations prior to moving into production.
Public Data Releases
Increasing access to transparent health care data for all stakeholders is foundational to the original legislative vision of the CO APCD, CIVHC’s mission, and to Colorado’s ability to make informed decisions that will have lasting benefit to the state. Making public analyses and interactive tools available on civhc.org is one of the methods CIVHC employs to bring transparency to the health care marketplace. The Shop for Care tool is available to help patients identify where they can go to receive the best care at the lowest price for procedures and services.
Public releases of CO APCD data are used widely in Colorado and across the nation and, in some cases, are provided as in-kind donations to help stakeholders who do not have the resources for a full non-public release access information. View our Focus Areas page and Publication Library on civhc.org to access all publicly available reports, and contact us at email@example.com to see if your project qualifies for an in-kind public release.