FINANCIAL MODEL 03
APCD-Calibrated Payer Mix & Revenue by RETAC
This model uses All Payer Claims Database (APCD) data to estimate payer mix and gross revenue potential by RETAC region across Colorado. APCD is Colorado’s statewide claims dataset compiled by the Center for Improving Value in Health Care (CIVHC) and captures a more complete picture of payer distribution than billing records alone — particularly for agencies with high uncompensated care or out-of-area transports.
The model breaks revenue down by payer category — Medicare, Medicaid, commercial insurance, and self-pay — and shows estimated gross revenue per transport at regional and county levels. APCD calibration allows comparisons across all 11 RETAC regions rather than a single agency’s billing history.
This model works alongside the Payer Mix & Revenue Analysis and Colorado County EMS Cost Baseline Index models to give agencies a fuller picture of financial position relative to regional peers.
Data source: CIVHC Colorado APCD. Model developed by NCRETAC.
Revenue vs. deficit by RETAC
RETAC detail
Commercial rates: CIVHC CO APCD FY25 (A0427, 2023), network-weighted by DOI region. Medicare: CMS Colorado Public Use File ($532.63 urban, $537.85 rural). Medicaid: 80% of Medicare (CO HCPF FFS standard). Payer mix: Urban/Rural/Frontier tiers calibrated from Colorado Ambulance Financial Model and CO demographic data. APCD covers commercial insurance only — Medicare FFS and Medicaid rates are from CMS/HCPF directly. Call volumes: CDPHE ePCR 2023–2024, annualized, distributed by vehicle share within RETAC. Source: GAL registry May 2025.