CO Medical Price Compare

Current Payers: Data Vintage: COAPCDQ42013 This Data Vintage stamp reflects indicates which payer data is included in this report, along with any special conditions and data submission waivers associated with the payer data. Current payers include the 12 largest commercial payers in Colorado (large-group and individual fully insured lines of business) and Medicaid. Small group, self-insured commercial payers and Medicare is not included. Please visit the Glossary in the Resources tab at http://www.cohealthdata.org for the full Data Vintage information, and visit the Current Data/Future Milestones link on the Resources tab to see the timeline for adding additional payers to the database. Data Completeness Score The data completeness score is an indicator of how comprehensive the coverage of lives in the database reflects the population. It is represented as a Quartile score of C1-C4 with C1 being the lowest score. The lower the score, the greater the degree of caution should be used in interpreting the results. - C1 indicates that 25% of the population or less are included in the data. - C2 represents that between 25% and 50% of the population are included in the data. - C3 represents that between 50% and 75% of the population are included in the data. - C4, the upper range, represents at least 75% of the population are included in the data. Completeness scores are approximate estimations based on data sources internal and external to the APCD. They are designed to provide an appropriate level of caution to users of the APCD. It’s important to keep in mind that caution needs to be exercised when reviewing data from C1 and C2 and that data becomes more reliable as you move from C3 to C4. 3M Technology "3M™ Health Information Systems provides grouping technology used in the creation of the data in this report. 3M™ APR-DRG Software (All Patient Refined Diagnoses Related Groups) is a classification system to categorize hospital stays based on diagnoses and procedures performed. 3M™ Clinical Risk Grouping Software (CRGs) categorize a population based on health status and use of health care services from claims submitted over a calendar year. 3M™ EAPG Software (Enhanced Ambulatory Patient Groups) is a patient classification system designed to explain the amount and type of resources used in an ambulatory visit. 3M™ Potentially Preventable Readmissions Software (PPR) identifies those admissions in an acute care setting that have subsequent readmissions, within 30 days that are both clinically related and are deemed potentially preventable. Please reference the following link for more information on 3M Health Information Systems grouping technology: http://solutions.3m.com/wps/portal/3M/en_US/Health-Information-Systems/HIS/Products-and-Services/Classification-and-Grouping/" Illness Burden The Illness Burden for a population is a number used to measure the relative health of that group based upon the number and types of healthcare services used. A higher number (above the 1.0 average) indicates that the population uses more and/or costlier services relative to the rest of the population in the database and is often a result of a higher number of people with chronic diseases like diabetes or asthma. Likewise, smaller numbers (below the 1.0 average), indicate a relatively healthier population using less health care services. Compared to Expected Compared to Expected (C2E) values indicate how different the actual observed data in an area is from an expected value (an average based upon the type of people that live in that area). The C2E is always represented as a percentage. Numbers in red represent those “compared to expected” values that are in excess of 25%, indicating a higher than average expected cost or use of services. Likewise, numbers in green represent those “compared to expected” values that are below -25% indicating a lower than average expected cost or use of services. BETOS Categories BETOS is an acronym for Berenson-Eggers Type of Service. BETOS Categories are groupings of professional services based on the HCPCS (Health Care Procedure Coding System, including CPT codes) used by the provider to identify the services rendered at the time of service. Please see the following link for additional information: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareFeeforSvcPartsAB/Downloads/BETOSDescCodes.pdf CPT Codes CPT is an acronym for Current Procedural Terminology and is a registered trademark of the American Medical Association. For more information on CPT codes, please refer to the following location: http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt.page Terms & Conditions of Use This report and any data made available on or obtained through the APCD website is subject to our current Terms of Use and Privacy Policy available at: http://www.cohealthdata.org. Data Note Data (particularly rates and percentages) from Colorado counties with fewer than 5,000 people are more volatile than data from counties with larger populations. Readers should exercise caution when interpreting results from counties with small populations. This includes: Baca, Cheyenne, Costilla, Custer, Dolores, Gilpin, Hinsdale, Jackson, Kiowa, Lincoln, Mineral, Ouray, Phillips, San Juan, Sedgwick, Saguache, and Washington counties.