The Colorado All Payer Claims Database (CO APCD) contains over 63 million claims for over three million unique Coloradans who have received services or have a diagnosis for a behavioral health condition, including mental health conditions or substance use disorder (SUD).
Behavioral health services is an umbrella term for behavioral factors that can impact health, including mental health conditions, stress-linked physical conditions, and substance abuse conditions. Claims for behavioral health services are identified in the CO APCD through admitting, principal or secondary diagnoses and procedure codes on claims. To learn more about behavioral health data available in the CO APCD, read our fact sheet, or download our Excel file listing all codes related to behavioral health and claims volume.
The CO APCD Insights Dashboard shows that claims for behavioral health services have steadily increased since 2013 across all payer types. From 2013 to 2020, behavioral health claims increased by 6% or more. Claims for behavioral health have also supported a Data Byte on Emergency Department use for mental health. There is also potential to pair behavioral health claims with “geocoded” socio-economic background (GSB) data in the CO APCD. Geocoded data allows us to overlay American Community Survey data with claims data to account for socio-economic factors including housing status, income level, education level, and preferred language. Tying this data with behavioral health claims would provide a deeper layer of analysis on the intersection of social needs, behavioral health and health equity in Colorado.
SUD Claims in the CO APCD
While the number of people living with substance use disorder (SUD) is a serious cause for concern, the collection of data related to SUDs in Colorado has been limited due to strict federal rules in part two of item 42 in the Code of Federal Regulations (CFR). With these restrictions, CIVHC could only collect SUD claims provided through programs and facilities not federally funded. However, with the passage of recent legislation, the rules around collection and use of SUD claims have been loosened enabling certain use cases of collection and analysis.
Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), passed in March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) significantly expanded the use of SUD data. While the CARES Act does not define use for SUD claims as broadly as other claims collected in the CO APCD, it does make SUD claims data much more accessible.
CIVHC has worked through the last year to create a unique claims flag for SUD data, which is on track to be included in the July 2022 refresh of the Data Warehouse. CIVHC compiled identifiers from Medicaid and Medicare, as well as a variety of other sources, to create a comprehensive list of SUD identifiers. This will give CIVHC a standard definition of SUD claims and ensure easy inclusion and exclusion to ensure all releases of SUD are appropriate.
For a breakout of SUD vs Behavioral Health codes currently in the CO APCD, please download our Behavioral Health and Substance Abuse Volume Excel file (please note this document is based on a previous data warehouse refresh and will not match the current Insights Dashboard). In the coming months, SUD data collection in the CO ACPD will expand and allow opportunity for new analyses on behavioral health and social determinants of health in Colorado.
As CIVHC continues to learn about the appropriate uses for collection and release of SUD data, we will share more information. In the meantime, please contact us at firstname.lastname@example.org for questions.