In the fall of 2022, Center for Improving Value in Health Care (CIVHC) implemented a new Submitter Quality Index (SQI), a benchmark step in CIVHC’s overall workplan to continually improve data completeness and accuracy.
The SQI is a tool that helps CIVHC assess the quality of data submitted to the Colorado All Payer Claims Database (CO APCD) by health insurance payers. Equipped with this information, CIVHC works collaboratively with payers to identify opportunities to continuously improve their individual submissions. The SQI also gives an assessment of the overall health of data submitted to the CO APCD and allows CIVHC to track continued progress to enhance the quality of the entire database.
Identifying Quality of Submitted Data
Since the creation of the CO APCD in 2012, CIVHC has strategically developed and revised data quality control processes to ensure the data is reliable and useful. While we use “data quality” as a catch-all term, it actually encompasses several different components under CIVHC’s definition. Implementation of the SQI is one of most recent strategic steps taken to further develop the first phase of the data quality process – completeness and accuracy of data submission.
The SQI assigns a numerical score to data submitted by payers, assessing over 25 common data fields for each type of file submitted (Eligibility Files, Medical Claims, and Pharmacy Claims), a total of over 75 total common data elements. In each field, analysts check the accuracy and completeness of the submission, looking for errors such as an invalid field or one left blank.
When all fields have been evaluated and scored, submitters receive a score from 0 (lowest) to 5 (highest possible), which evaluates the completeness and accuracy of these major submission fields and the overall quality of their submission.
CIVHC is also able to combine the scores to assign a number on a scale of 0 (lowest) to 10 (highest possible), representing the total health of data submitted into the CO APCD. This assessment is completed every other month in conjunction with the bi-monthly data warehouse refreshes and will be made available to individual submitters by CIVHC. The percentage will also be made publicly viewable on CIVHC’s website in the interest of transparency. For January of 2023, the SQI percentage was 9.19% out of a possible 10, indicating there were very few errors in the data submitted.
Collaborating with Submitters
CIVHC is currently developing a methodology to submit payers’ scores back to them, allowing them to identify areas where they can improve and see how they compare to other data submitters. This will give CIVHC the opportunity to provide each submitter direct, customized feedback and work with them individually to uplift the quality and completeness of data in the CO APCD.
If you have questions about data submissions, the Submitter Quality Index, or want to suggest a topic for a Query CO APCD: Data Analytics, please email us at email@example.com.