Publications

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.

Quality Measures: Diabetes A1c Testing and Breast Cancer Screening

Updated: August 2020
Download the Quality Measures Summary
Download the Methodology

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.

Behavioral Health and Substance Use Disorder Claims

Released: August 2020
Download the data

Understanding opportunities to enhance behavioral health and treatment for substance use disorders is essential to achieving CIVHC’s mission to improve the health of Coloradans. Behavioral health claims, including some substance use disorder claims (with the exception of those covered under 42 CFR Part 2), are available in the CO APCD and offer researchers and other stakeholders an opportunity to find ways to improve these services across the state. This new analysis shows that claims volume and paid amounts increased from 2017-2019 across all payers for both types of claims.

Potential Impact of COVID-19 Temporary Cessation of Elective Procedures

Released: July 2020
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Download the infographic

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
Download the full report
Download the infographic

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
Download the underlying data
Download the infographic

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.

Data Byte: Emergency Department Facility Payments

Released: August 2019
Download here

This Data Byte identifies how much commercial health insurance payers and patients pay for the Evaluation and Management (E&M) facility portion of an Emergency Department (ED) visit.  ED visits typically include an E&M facility component that corresponds to the severity level of the visit – ranked from low to high. These payments only represent a portion of what is billed for an ED visit and do not include amounts for other services which may be performed during the visit such as lab tests, imaging services, surgical procedures, or other fees that may be billed directly by the ED physician or provider.