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USE CASE: Testing CO APCD Data with Advanced Analytics

Health Care Incentives Improvement Institute (HCI3) aims to improve health care quality and value with evidence-based incentive programs and a fair and powerful model for payment reform.

Project Summary: HCI3’s multi-tiered analytics system starts with analysis of individual patients and the episodes they trigger, then rolls up the results to the population level, allowing for both individual drill-downs and estimation of overall trends. At each level of analysis, it is possible to distinguish between costs associated with typical or necessary care vs. costs resulting from unnecessary or inadequate treatment.

The analysis of CO APCD data had two prongs:

1) Test the applicability of the cost-of-care metrics to Colorado data

2) Test the applicability of certain quality metrics (i.e. NQF-endorsed rates of potentially avoidable complications for certain chronic conditions and acute medical events)

Benefit to Colorado: HCI3 was able to demonstrate similar patterns of variation in price, frequency, and mix per episode that they have observed in other parts of the country. Additionally they established that the analytics are applicable to CO APCD data and to support payment reform projects in Colorado.