APCD Cost-Sharing Reconciliation — README What this project does Reconciles patient cost-sharing in All-Payer Claims Databases (APCDs) by linking secondary/tertiary payments to under-paid primary claims, yielding accurate member-level liability and a full audit trail from claim → day → episode → member.

Language: SAS (9.4M5+ or Viya) Primary script: code/cost_sharing_reconciliation.sas Scope: Medical + pharmacy claims; eligibility; primary/secondary/tertiary coordination; Part A/B deductible logic; diagnostics/QA.

Why it matters Naïve APCD analyses that ignore secondary payments overstate patient liability. This repo provides a transparent, reproducible algorithm and validation suite to correct that bias and document each allocation decision.

Contact

Maintainer: Rick DeVoss Email: rick.devoss@cuanschutz.edu Dept: Health Systems, Management & Policy, University of Colorado Anschutz