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Colorado’s APCD: Policy, Reform and Reporting

Colorado’s APCD: Policy, Reform and Reporting. NAHDO Conference October 25, 2012. Key CIVHC Initiatives. 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

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Colorado’s APCD: Policy, Reform and Reporting

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  1. Colorado’s APCD: Policy, Reform and Reporting NAHDO Conference October 25, 2012

  2. Key CIVHC Initiatives • 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

  3. 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

  4. 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

  5. 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

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