Colorado’s APCD: Policy, Reform and Reporting

NAHDO Conference

October 25, 2012

• Backbone Organization for Collective Impact• Improve the Health Care Payment System

– Develop a “Framework” – analyze alternative payment models, set a path and make the case

• Improve the Health Care Delivery System– Palliative Care, Care Transitions/Readmissions and

System Integration initiatives

• Increase Data Transparency and Accountability– Triple-Aim Metrics and Dashboard– All Payer Claims Database (APCD)

• Engage Business to change Market Dynamics

Key CIVHC Initiatives

Colorado APCD Timeline

• Recommendation of Blue Ribbon (208) Commission for Health Care Reform – 2008

• CIVHC becomes an independent non-profit – 2010• CIVHC named APCD Administrator by the Executive

Director of HCPF – 2011• Grant funding to establish the APCD – 2011 • Contract with Treo Solutions – December 2011• Test data submissions begin – March 2012• Historical data submissions begin – June 2012• Colorado APCD goes “Live” on November 1, 2012• www.cohealthdata.org

3

Initial Public Facing Reports (Tier 1)

• Interactive or Dynamic Reports– Provide Map and Tabular views of variation in:

• Total Cost of Care and Utilization Rates• Inpatient Utilization by Service Line• Provider Access Comparison• Clinically-linked Readmissions

• Static or Snapshot Reports– Total and High-Cost Imaging, Knee MRI, Knee

Arthroscopy and Routine/Uncomplicated Delivery– Variation in average paid amounts and utilization rates

by blinded payer and facility

Priorities based on Stakeholder Outreach

• Chronic Disease – variation in incidence/prevalence, costs to treat and standards of care

• Prescription drug utilization and spending • Variation in utilization rates and allowed/paid amounts

by named Payer and Provider Group• Incorporate quality and clinical outcome measures • Compare the impacts of alternative payment and

delivery system models• Provide data to support public health initiatives

6

APCD Enhancements – Coming Soon

• Risk and Severity Adjusted data will be available beginning in 2013

• Public reporting in Fall 2013 will identify provider groups and plans; developing processes for pre-release review

• Align analytics with additional data sources including disease registries and vital statistics

• Data Release: Colorado APCD data will be available through a data release process aligned with CIVHC’s Triple-Aim mandate