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Friday, December 7, 2012

CIVHC Answers Frequently Asked Questions About the APCD

Colorado’s All Payer Claims Database (APCD) went live on November 1st at www.cohealthdata.org. The APCD is a secure database that includes claims data from commercial health plans, Medicare and Medicaid. The APCD was created by legislation in 2010 and administered by the Center for Improving Value in Health Care (CIVHC). Since the launch, CIVHC received some common questions which they've answered below. For the complete list of APCD Frequently Asked Questions, click here.

Question: When will it be possible to see more detailed data and reports like cost and quality reporting at the medical group, clinic or physician level?

Answer: We expect to begin reporting comparative cost and utilization information at the level of named facilities, payers and provider groups beginning in late 2013. We are currently developing processes and procedures to share and vet information with affected groups.

Question: Will data or reports eventually be available for individual diagnoses?
Answer: We expect to begin reporting on the incidence/prevalence and costs to treat common chronic diseases beginning in mid-2013. Entities with an interest in a specific diagnosis or set of diagnoses can request a specialized report through the Data Release Process.
Question: Will you eventually capture and report on quality metrics?

Answer: Yes, we are currently working with stakeholder groups both locally and nationally as well as APCDs in other states to identify appropriate and meaningful quality metrics to include in APCD cost and utilization reporting. We anticipate adding quality metrics by the end of 2013.

Question: Will www.cohealthdata.org eventually provide information that allows consumers to make more informed choices regarding their health care?

Answer: Yes, by the end of 2013 we anticipate releasing a consumer focused section www.cohealthdata.org that will provide comparative cost, quality and value information. One of APCD’s core goals is to provide information that allows consumers to better manage resources and make value based decisions regarding their health care. Information based on the APCD will allow consumers, for the first time, to meaningfully shop for health services and better manage their own care.

Question: Are there plans to link the Colorado APCD to other data such as clinical information maintained by the Colorado Regional Health Information Organization (CORHIO) or Quality Health Network (QHN)?

Answer: Finding ways to link together cost and utilization information from the APCD with clinical information systems will eventually provide for a fuller picture of cost, quality and value. However, combining data sources from Health Information Exchanges and the APCD present numerous technical, privacy and resource challenges. No timetable has been established for this work.

Question: Will the Colorado APCD provide data and reports by payer type?

Answer: Yes, once data from additional payers is added, users will be able to view data and reports by payer type, e.g., Medicare, Medicaid, commercial plans, etc. Click here for payers currently included in the APCD and the timeline for adding additional payers.
Question: Will risk adjustment be based on the same methodology used by Medicare?

Answer: The Colorado APCD will begin generating reports based on risk-adjusted data mid-2013. Initially, risk adjustment of Colorado APCD data will be performed using tools developed by 3M. The Colorado APCD has the ability to use other tools for risk adjustment as well, including the Hierarchical Condition Categories (HCCs) currently used by the Centers for Medicare & Medicaid Services (CMS).

Question: Currently, I cannot see who the providers, facilities or counties are in the snapshot reports on imaging services, routine deliveries or knee arthroscopy. Will I be able to see data on a named facility or provider basis in future releases?

Answer: Yes. As we add additional payers and the APCD becomes more representative of Colorado’s insured population, we plan to provide results at finer levels of detail. We anticipate providing cost and utilization data at the level of named facilities, payers and provider groups beginning in late 2013.

Question: I can’t see the interactive maps on my iPad or iPhone, will this be possible in future releases?                

Answer: We hope to address this issue in future releases but in the meantime, those without Flash capability can access the underlying data in the maps by clicking on the Data Sheet within the Maps Tab, or on the Reports Tab