Guest Blogger: Douglas McCarthy

In my role as a health policy researcher, I’ve worked with many national health care data sources throughout the years. My service on the boards of the Center for Improving Value in Health Care (CIVHC) and the Peak Health Alliance have given me insight into what a valuable resource the Colorado All Payer Claims Database (CO APCD) is for Colorado.

However, it wasn’t until I conducted research on state APCDs across the country (How States Establish an APCD and Make It Functional and The Uses and Benefits of State APCDs), and the subsequent onset of the COVID-19 pandemic, that I fully understood how the CO APCD’s design and governance structure enables rapid adaptation in support of an ever-changing health care landscape.

In the 10 years since being appointed as the administrator of CO APCD, CIVHC has been a leader in the use of claims data to improve lives in Colorado and across the nation. CIVHC’s staff exemplify agility, ingenuity, and a pioneering spirit in generating public and non-public reports that address timely issues, like informing Colorado’s work to minimize the impact of COVID-19, and providing insights into long-term solutions to reduce costs and improve care.

As COVID-19 created national uncertainty, CIVHC developed analyses to support the efforts of state agencies, health care providers, and public health officials to stem the tide of the pandemic. These reports allowed state and community partners to identify populations at risk for serious illness across Colorado, estimate the potential financial impact of the temporary cessation of elective procedures, and understand trends in telehealth services and in-person service use before and throughout the pandemic. CO APCD data also helped state and community leaders pinpoint areas for vaccine distribution.

CIVHC packages its data analyses in innovative ways including infographics and interactive online reports that make CO APCD data understandable and actionable for communities, policymakers, and other Change Agents to transform how care is paid for and delivered. These include the consumer-focused Shop for Care tool, which highlights variation in the cost and quality of services, Medicare Reference Based Price Report, which supports purchasing alliances, analysis of low value care services and associated spending to identify opportunities for eliminating waste, and a synthesis of community-level data on health care cost, quality, access and utilization in the Community Dashboard.

Over the last year, CIVHC also took steps to address health equity by geocoding the CO APCD with demographic and socioeconomic information. Such data linkages are vital to ensuring that the system is working for everyone, no matter their circumstance. In 2018, CIVHC also began collecting data on alternative payment models and prescription drug rebates to supplement the CO APCD. Analyses of these data is helping policymakers and other stakeholders identify additional ways to improve the health care system through payment reform and addressing rising prescription drug costs.

Altogether, these accomplishments make CIVHC and the CO APCD stand out as a leader in health care transparency and a model for other states. It’s my privilege to be a part of this organization and support their mission to improve health, increase the quality of care, and reduce the cost burden of health care for all Coloradans.

Douglas McCarthy is the President of Issues Research, Inc. and serves as the board president of CIVHC. He lives in Durango. Email him at dm@issuesresearch.com.