Georgia APCD Snapshot

Introduction

The intent of this snapshot is to provide users with a succinct summary of the population of the GA APCD as well as a comparison between the GA APCD population and the actual Georgia population as reflected by the U.S. census. This snapshot also includes a summary of the most common claims procedures recorded in the GA APCD. The Snapshot is designed for use on full-screen devices. See Methods and Limitations below for additional information on Snapshot metric design.

Methods

Member Counts

Member counts indicate the total number of unique individuals with medical, dental, and/or pharmacy coverage. Individuals with coverage for at least one month of a given year are counted. There are individuals who now live outside of Georgia but have Georgia-based insurance and are thus represented in the GA APCD. These patients are counted in this population snapshot but excluded in analyses of disease prevalence at the state or county level.

Procedure Counts

Medical procedures have been aggregated into groups via the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) Clinical Classifications Software for Services and Procedures (CSS-Services and Procedures) classification system. Specifically, CSS-Services and Procedures collapses more than 10,000 Current Procedural Terminology (CPT, e.g. HCPCS Level I) codes and 6,000 HCPCS Level II codes into over 240 categories useful for data summarization.

Census Data

The U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates were used to gauge how accurately the GA APCD reflects Georgia’s insured population. The relevant figures show population percentages from each data source computed by year across age, sex, urban-rural classification, and social vulnerability index (SVI). This comparison is intended to assess gaps and evaluate the generalizability of the GA APCD to the population of Georgia.
The GA APCD percentages are based on individuals with medical coverage and do not include individuals that have only pharmacy and/or dental coverage.

Urban-Rural Classification

The CDC’s National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties is a six-level measure of urbanicity based on the Office of Management and Budget’s (OMB) county divisions for metropolitan and micropolitan statistical areas. Urbanicity has also been a useful tool in identifying geographic health disparities, specifically across urban and rural populations.
The percentages of the ACS insured population and the GA APCD population with medical coverage are calculated and plotted for six urban-rural classifications: Non-core, Micropolitan, Small Metro, Medium Metro, Large Fringe Metro, and Large Central Metro.

Social Vulnerability Index

The CDC’s Social Vulnerability Index is an aggregate index of 16 variables from the U.S. census created to assess geographic areas that may be vulnerable to emergent stresses like natural disasters or disease outbreaks. It has also been used as a tool to highlight geographic health disparities, including disease-specific outcomes and risks.
The percentages of the ACS insured population and the GA APCD population with medical coverage are calculated and plotted for each SVI quartile. The lowest SVI quartile represents those who are least vulnerable against external stresses. Therefore, the lowest SVI quartile is named Low Risk and then moves to Medium-Low Risk, Medium-High Risk, and High Risk for the highest quartile.

Caveats and Limitations

Missing Data

This Snapshot is based on data present in the Georgia All Payer Claims Database as of November 2023. The GA APCD is still missing important payer data that will be added in the coming year. Georgia Medicaid and Medicare parts A and B data are not included in this Snapshot. Metrics may thus change in subsequent releases as these data and additional historical data are added.

Limited Data Elements

The APCD has limited or no information on certain key demographic data including race, ethnicity, income, and education status, which hinders analyzing disease disparities on an individual level and adjusting estimates based on these variables.

Data Suppression and De-Identification

Reported metrics that are derived from patient counts less than 11 individuals are suppressed and will not be included in dashboards or data. APCD data is de-identified, used, and disclosed with guidance from the US Department of Health and Human Services in accordance with section 164.514(a) of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.