Types of Reports on the APCD Website
1. Disease Diagnoses Report
This report shows the number of people diagnosed with a particular disease or condition from claims data for a partial segment of Connecticut’s commercially insured population. These reports do not include Medicaid and Medicare populations in the state. We used multiple years of claims data to identify people with select conditions1. Unique, member-specific identifiers were created from non-duplicative claims data to estimate the number of people with a select disease/condition. It is common in reporting from insurance claims data to refer to individuals as “members.” This allows us to report on diagnosed rates for a select group of people in the database. The criteria for selection relied upon claims-based identification criteria found in NCQA (National Committee for Quality Assurance), CMS (Center for Medicare & Medicaid Services), American Academy of Pediatrics and National Initiative for Children’s Healthcare Quality2. There are other sources of information on various aspects of population prevalence reports available on the State of Connecticut Department of Public Health (DPH) website3.
The following are the criteria for selecting diseases for this report:
- Most commonly diagnosed disease/condition
- Diseases/conditions that affect various age groups or gender differently, e.g., under 18 versus other age groups, gender, etc.
- Focus on chronic diseases/conditions
- Diseases/conditions where preventive care is effective
- Disease diagnoses were reported based on using claims data only
For some conditions the population was restricted to the gender most appropriate for the condition: e.g., females for breast, cervical, and endometrial cancer and males for prostate cancer.
Although many conditions have high diagnoses rates in adults and much lower rates in children (e.g., congestive heart failure, diabetes), the Connecticut summary rates were not restricted to adults. Because of this the summary rates which combine all age groups cannot be directly compared to summary rates of disease that may be reported by the Center for Disease Control or other organizations where the rates are specific to the adult population. They are useful for understanding relative variation by geographical area or health reference groups.
2. Population Coverage Report
The Population Coverage report provides users an in-depth understanding of various characteristics of the eligibility data in the APCD warehouse. Using the filters appropriately one can look at various features of population characteristics including Insurance Type / Product, Coverage Type, Group Size, Employee Type, Coverage Level, Maximum Deductible, Family Size and Marital Status. These reports are based on a partial segment of Connecticut’s commercially insured population, including Fully-Insured, Small Group, and Individual Market plans. Collection of complete commercial claims data is an ongoing process.
One type of reports for population coverage will be based on the number of unique lives in the APCD database by ZIP code compared to the total payer-specific population as determined by American Community Survey. For example, if we are analyzing the commercial carriers’ population, we compare total commercial population in a given geographic entity compared to the data that has been submitted to the APCD. We know that currently self-insured commercial plans do not submit their data. It is thus helpful to understand what percent (%) of the commercial population is submitting data to the APCD and those (self-funded employers) plans that are not submitting data. The intent of this report to provide researchers and consumers with a better and more in-depth understanding of the population attributes and what portion of the payer segment data is in the warehouse.
This report will display various characteristics of the reported population from eligibility perspective. We intend to capture the proportions of the population in the APCD database for the following variables:
- Insurance type/product
- Self Funded
- Group Size
- Employee Type
- Coverage Level
- Maximum Deductible
- Family Size
- Marital Status
1 See Appendix A on the Details tab of the Diseases Diagnoses report.
2 Details of diagnoses codes and identification logic can be obtained from Connecticut’s APCD by special request.
3 The link to the DPH population-based Cancer statistics page is http://www.ct.gov/dph/cwp/view.asp?a=3129&q=576918&dphNav=|&dphNav_GID=2196
The CT DPH Behavioral Risk Factor Surveillance System provides information on the prevalence of a variety of chronic conditions, and those data can be found here http://www.ct.gov/dph/cwp/view.asp?a=3132&q=388096&dphNav_GID=1832%20