Every CIVHC publication is aimed at serving, engaging, educating, or amplifying Change Agents, thereby highlighting their good work and providing necessary information and tools to help them move forward.

Anesthesiology, Radiology and Emergency Physician Payments

Released: May 2021
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This analysis provides median and 25th-75th percentile payment ranges for Anesthesiologists, Radiologists and Emergency Physicians for calendar year 2019. Claim counts and percent of claims and payments less than $3,000 are also available.

Top 300 Dental Procedures by Volume in the CO APCD

Released: April 2021
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The CO APCD contains dental claims submitted by payers who provide coverage in Colorado. This report identifies the top 300 dental procedures by volume from 2012-2020 that are available in the database. For more information on number of dental claims and people covered with dental insurance by payer, visit our CO APCD Insights Dashboard.


Race and Ethnicity Data in the CO APCD

Released: April 2021
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Two fields - Race and Hispanic Indicator -  became required for payers to submit to the CO APCD in September 2019. This file describes the state of data collection and capture of required and voluntary race and ethnicity information in the CO APCD. Please note that the data does not yet fully represent the race/ethnicity distribution in the CO APCD as all payers (public and private) are working on improving their data collection and submission. CIVHC continues to work with payers to improve these fields and is also working to bring in external sources of race, ethnicity and socioeconomic data into the data warehouse to enable more extensive analysis of health equity.

Top 100 Brand and Generic Commercial Prescription Drugs

Released: March 2021
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This analysis provides information on the top 100 generic and top 100 brand commercial prescription drugs from 2019 based on highest spend (total allowed amount) in the Colorado All Payer Claims Database (CO APCD).  Breakouts by plan and patient paid amounts are also available as well as price and utilization trend information for the top 100 drugs from 2016-2018.

End Stage Renal Disease and Dialysis Dependence

Released: December 2020
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This analysis provides information on the number of Coloradans with End Stage Renal Disease (ESRD) and Dependence on dialysis, and the number of dialysis facilities by county. The population with ESRD and dependence of dialysis is described by age group (under 50, 50 and over), payer type (Commercial, Medicaid, Medicare FFS, Medicare Advantage), county, and by urban/rural regions for calendar years 2018-2019. The dataset also describes the number of dialysis facilities by Colorado county.

Nurse Midwife Payment Evaluation

Released: December 2020
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The Nurse Midwife Payment Evaluation data set provides payment comparisons for common procedures provided by Nurse Midwives, OB/GYNs, Primary Care Providers, Nurse Practitioners and Physician Assistants. The data is available by payer (Medicaid, Medicare Advantage and commercial) and shows median and average paid amounts and 25th to 75th percentile paid amounts to allow users to understand variation in payments.

Colon Cancer Screening and Colonoscopy Billing

Released: December 2020
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Most individuals being screened for colon cancer have a two-step process, the fecal screener and, if positive, a colonoscopy. According to the United States Preventive Services Task Force (USPSTF), both of these are considered screening procedures and should be covered as preventive care at $0 for the member. This analysis helps to answer, of the people who have a fecal screener: 1. How many insured lives in Colorado have a colonoscopy within a year?, and, 2. How many of those who have a colonoscopy pay a co-pay or co-insurance?

Quality Measures: Diabetes A1c Testing and Breast Cancer Screening

Updated: August 2020
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As part of the Qualified Entity Certification Program (QECP), CIVHC has developed information for Breast Cancer Screening and Diabetes A1c testing using Medicare Fee for Service (FFS), Medicaid, Commercial and Medicare Advantage claims data from the Colorado All Payer Claims Database (CO APCD). The two quality measures are based on nationally endorsed specifications, and can be used by public health agencies, providers and others to understand variation in quality and improve care for Coloradans.

Potential Impact of COVID-19 Temporary Cessation of Elective Procedures

Released: July 2020
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On March 23, 2020, Governor Polis issued an order for temporary cessation of elective health care services. This analysis using commercial claims in the Colorado All Payer Claims Database (CO APCD) supports the Division of Insurance, payers, providers and others seeking to understand the financial impact the cessation will have on cost and utilization. Procedures identified as elective include inpatient and outpatient surgical operations and diagnostic procedures such as gastrointestinal endoscopies.


Low Value Care in Colorado

Released: March 2020
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Low value health care refers to certain treatments, diagnostic tests, and screenings where the risk of harm or cost exceeds the likely benefit for patients. This analysis of claims in the CO APCD from 2015-2017 identifies the top 13 low value care services according to national guidelines, and identifies associated spending and volume across Medicare, Medicaid and Commercial health insurance claims for different regions across the state.

Emergency Department Use for Mental Health Reasons

Released: December 2019
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The Emergency Department (ED) Mental Health-Related report provides stakeholders the opportunity to compare utilization and cost metrics for ED visits with a primary diagnosis of mental health among Medicaid, Medicare Advantage and Commercial payer eligible populations for Division of Insurance regions and Colorado as a whole. Coloradans living with mental illness don’t always have access to comprehensive services or seek timely care to support their needs. In spite of excellent work across the state to reverse that trend, the Emergency Department (ED) remains a source of support for many suffering from potentially preventable mental health crisis.

CO APCD Annual Reports