Overview

The CO APCD contains millions of claims across all health plans for multiple years. Health insurance payers submit data monthly and the entire database is refreshed every other month, so the CO ACPD is continually evolving and being enhanced.

Data Warehouse Refresh Resources

The CO APCD Data Warehouse is refreshed every other month, incorporating new years of data while also improving the quality of the existing data by implementing new business rules, adding previously missing files, or correcting concerns. The breakdown of paid-through dates by business line for the most recent refresh is available here.

The Release Notes for the most recent refresh is now available for download and provides important information regarding the length of time between the service date and paid date (‘claims lag’) for medical and pharmacy claims in the CO APCD. This analysis helps answer several key questions including how long it takes to achieve “completeness,” how lag time varies by payer type (commercial, Medicaid, etc), and by claim type (medical, pharmacy, inpatient, outpatient, etc).

The Data Discovery Log documents data quality items identified following file submission and processing, enhancement and loading of data into the CO APCD following each refresh of the warehouse.

Query: CO APCD Data Quality

The Query: CO APCD Data Quality series is designed to:

  • explain the foundations of how CIVHC approaches data quality as administrator of the CO APCD,
  • detail the processes and systems that bring the data into the warehouse, and
  • define what steps are taken before data is released.

Commercial Data in the CO APCD

As of June 2022, the Colorado All Payer Claims Database (CO APCD) contained over 870 million claims spanning 2013 through 2021. These claims were submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Read more…

What to Expect with Claims Data

A previous query defined the different nuances encompassed under the term “data quality” to help shed light on the myriad factors that can impact the contents of an output from the Colorado All Payer Claims Database (CO APCD). This piece will outline some baseline expectations for users who are new Read more…

Defining Data Quality in the CO APCD

Claims data is very different than other types of data typically encountered by actuaries, accountants, analysts, and researchers. If not prepared for the unique challenges it presents, it is easy to conclude that something is wrong with a data set. The phrase “data quality” is frequently used as a catch-all Read more…

Non-Claims Data in the CO APCD

The CO APCD contains nearly 800 million claims representing approximately 65 percent of lives in Colorado, including medical, dental, and pharmacy claims. However, claims data only shows a portion of how the health care system functions. There are numerous behind-the-scenes factors that impact an individual’s health or cost of their Read more…

In Warehouse Quality Checks and Processing

An earlier Query detailed the submission and intake stages for data sent each month to the Colorado All Payer Claims Database (CO APCD). During these stages, each batch of data moves through several cycles of testing to determine the accuracy and validity of the information in relation to previously submitted Read more…

Data Submission, Intake, and Warehouse Refreshes

Each month health insurance payers submit millions of medical, professional, pharmacy, and dental claims for inclusion in the Colorado All Payer Claims Database (CO APCD). Ensuring that the data in the CO APCD is the most credible and highest quality begins before the files are sent. CIVHC and data manager, Read more…

Medicare Data in the CO APCD

As of June 2020, the Colorado All Payer Claims Database (CO APCD) contained nearly 920 million claims for approximately 65 percent of insured individuals in Colorado with medical coverage, reflecting over 3.4 million lives. When those with dental and pharmacy coverage are added, the CO APCD spans over 5 million Read more…

Medicaid Data in the CO APCD

As of June 2020, the Colorado All Payer Claims Database (CO APCD) contained nearly 920 million claims for approximately 65 percent of insured individuals in Colorado with medical coverage, reflecting over 3.4 million lives. When those with dental and pharmacy coverage are added, the CO APCD spans 4.5 million unique Read more…

Query: CO APCD Data Analytics

The Query: CO APCD Data Analytics series is designed to:

  • provide insight into CIVHC's approach and philosophy of data analytics,
  • outline the what is possible and what is not with the data, and
  • demystify the process of CO APCD data release.

Limitations of CO APCD Data

With a resource the size of the Colorado All Payer Claims Database (CO APCD), it is easy to presume that the possibilities for exploration are endless. In some senses, it is true, that comprehending the potential combinations of data elements from over 870 million claims is nearly impossible. However, the Read more…

Rules Governing CO APCD Data Use

In 2010, the Colorado General Assembly saw the opportunities an immense repository of data such as the Colorado All Payer Claims Database (CO APCD) could afford – they also saw the possibilities for exploitation and built safeguards into the use of the CO APCD. When drafting the legislation that shaped Read more…

Contents of The CO APCD and How Data Is Released

The CO APCD is a state-legislated, secure health care claims database compliant with all federal privacy and antitrust laws. It is the only claims repository in the state that represents the vast majority of insured lives in Colorado, with more than ten years of data from commercial health insurance payers, Read more…

Public 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, or public data releases on civhc.org designed to foster decision-making at all levels of the health care system. Increasing access to transparent health care data for all stakeholders Read more…

Data Element Request Form

Once someone has decided to use a non-public data set from the Colorado All Payer Claims Database (CO APCD) for their investigation, it is crucial that they request the right information to answers to the questions being asked. While that sounds like it would be a relatively straight-forward determination, in Read more…

Non-Public Release Application and Data Use Agreement

When requestors begin the process of accessing non-public data from the Colorado All Payer Claims Database (CO APCD), CIVHC’s Health Data Solutions Consultants work closely with them to determine what data would meet their needs and what path the request will follow. Once the project goals are established, and they Read more…

Non-Public Data Release Process

If the request meets all necessary criteria, non-public data from the Colorado All Payer Claims Database (CO APCD) is available to “state agencies and private entities in Colorado engaged in efforts to improve health care.” These requests are categorized by CIVHC as non-public as the data will go to one Read more…

HIPAA & Personal Health Information

Protecting health information is the highest priority for the Colorado All Payer Claims Database CO APCD). Colorado statute CRS 25.5-1-204 requires the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the ability to analyze data and share with providers and payers Read more…

Data Security and the CO APCD

When designing how the Colorado All Payer Claims Database (CO APCD) was to be built and administered, protecting health information was the highest priority. Colorado statute CRS 25.5-1-204 requires the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the ability to Read more…