Public Health in the Rockies 2026

Learning Objective:
To assess differences in health care utilization, documented social needs, and spending among Black populations in Colorado using Colorado All Payer Claims Database (CO APCD) data.

Background/Purpose:
Black populations in Colorado continue to experience disparities in health outcomes and health care utilization. This study evaluated differences in emergency department (ED) use, inpatient admissions, readmissions, follow-up care, documented social needs, and spending across insurance types and Black population subgroups.

Methods:
Researchers conducted a retrospective claims-based analysis using CO APCD data from 2018–2025 across commercial, Medicaid, Medicare Advantage, and Traditional Medicare populations. Outcomes included ED visits, inpatient admissions, 30-day readmissions, 7-day follow-up visits, ICD-10 Z-code utilization, and total health care spending. Measures were standardized as rates per member per year (PMPY).

Results:
The largest differences were observed in ED utilization. In Traditional Medicare, Black, Hispanic or Latino members experienced 1.99 ED visits PMPY compared to 0.74 among All Other Public Health Fields Race populations. Similar patterns were observed across Medicaid, Medicare Advantage, and commercial coverage. Inpatient admissions were also higher among Black populations, reaching 0.21 PMPY in Traditional Medicare compared to 0.14 among All Other Public Health Fields Race populations. Thirty-day readmission rates reached 0.09 PMPY among Black, Hispanic or Latino members compared to 0.03 among All Other Public Health Fields Race populations. Documented social needs, measured using ICD-10 Z-codes, were consistently higher among Black populations across insurance types.

Implications:
Findings highlight consistent, system-wide differences in health care utilization across Black populations in Colorado and support collaborative, community-based outreach, care navigation, and prevention strategies to advance health equity statewide.