Publications

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.

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.

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 25^th to 75^th percentile paid amounts to allow users to understand variation in payments.

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?

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.

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.

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.

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 Prescription Drug Spending and the Impact of Drug Rebates
• Regional Price Variation for Common Procedures
• Common Procedure Episode Price Breakdown
• Imaging Services Price Variation
• Prescribing Opioids in CO - Supplemental Data File
• Common Procedure Price Variation
• Cancer Prevalence in Colorado
• Chronic Conditions in Colorado
• Quality Measures in Colorado
• Total Cost of Care
• Health Care Utilization in Colorado
• Drug Cost Savings Potential - Vimovo and Duexis
• Cost of Care in Colorado
• SIM Measures
• Regional Payment Variation
• Free Standing Emergency Departments
• Infographic: Hepatitis C
• Payment Variation by Payer
• Avoidable Emergency Department Use
• Average Paid Amounts for Common Health Conditions
• C-Section Reduction Cost Savings Analysis 

• Behavioral Health and Substance Use Disorder Claims
• Emergency Dept. Facility Payments
• Advance Care Planning Code Volumes
• Legislative District Medical and Pharmacy Total Spend, 2017 & 2018
• Low Birthweight and Birth Outcomes
• Respite Care Volume and Total Spend in CO
• In/Out of Network Costs
• Firearm Injury Trends and Costs
• Top 25 CPTs by Volume in CO
• Intraoperative Neuromonitoring
• Prescription Trends of Opioid Drug Subsys
• Coloradans with Pre-Existing Conditions
• Medicaid/Frostbite Claims 
• ED Severity Levels by Payer
• High Risk Pool Costs 
• EpiPen Cost Trends
• Medicaid Teen Pregnancy Rate Trends