Pricing

WA-APCD Data Product Fee Schedule

In creating the WA-APCD, the Washington Legislature instructed the program to help support itself by generating revenues through data-product sales. At the same time, the program aims to make data available and affordable to stakeholders working to improve the state's health care systems, including researchers, non-profits, data suppliers, and providers.

The fee schedules below describe costs of the four different WA-APCD data products for different categories of data-users. Potential data requesters are always encouraged to contact the WA-APCD program office to discuss proposed projects and costs involved before submitting applications.

For product details, see Data File Extract Product Overview.pdf

Pricing Key Features

The WA-APCD offers four types of products:

  1. Data File Extract
  2. Analytic Enclave: Cloud-based Data and Analytics Platform
  3. Standard Report: Per Person Cost and Utilization
  4. Custom Analytics Report

The fee structure is organized by covered lives; it is not organized by “data types” like inpatient, outpatient, or prescription drug. Generally, though not always, a covered-lives dataset includes the eligibility, medical claims and prescription drug claims data. Other data, such as health care provider roster and demographics data, also are available in certain products.

The four-year historical data period (2014-2017)* is a single product – increments are not charged for each year of historical data. An incremental fee is charged for each data year past the historical data period. The incremental fee for data later than the historical period is determined on a per-client basis.

This fee schedule applies to health insurance data only; the availability and pricing of dental and workers compensation data will be determined at a later date, because they are not yet available for use.

*2013 historical data is available but is incomplete for a subset of data submitters.

WA-APCD Data Applicant Categories

The WA-APCD distinguishes between different categories of data applicants in its data-release fee structure. Fees are tiered by applicants’ organizational status, proposed data uses, financial resources and any WA-APCD program role. Data applicants are grouped in these categories:

Reduced Fee Tier

  • Public Benefit/Non-Profit:  Data use is for a public benefit and the output is available to the public at no cost. The “reduced fee” is available to an applicant that is a non-profit entity and has limited financial resources.  If the applicant has the financial resources – such as funding from a commercial entity or a grant – then the standard fee applies. In limited circumstances, like a student conducting research, the fee may be waived.
  • State and Local Government Agencies:  Data use is for state or local government agency activities, whether performed directly by the agency or by a contracted vendor.

Standard Fee Tier

  • WA-APCD Data Suppliers:  The data use accrues to the benefit of the applicant only; no data or derivative products are released to third-parties for direct financial gain. Data Supplier fee category applies to any payer that is a WA-APCD data submitter and to the payer’s submissions by insurance product type(s): i) health, ii) prescription drug, iii) dental, and iv) workers compensation. For example, a dental data submitter is not eligible for the standard fee for non-dental data; rather the premium fee schedule applies.
  • WA-APCD Provider/Reportable Entity:  The data use accrues to the benefit of the applicant only; no data or derivative products are released to third-parties for direct financial gain. Provider association fee tier categorization depends on the proposed data use (e.g. public policy use vs. reseller use) Provider reportable entity means any provider licensed by the state of Washington that rendered services to patients per the WA-APCD claims data for the requested data product period.

Premium Fee Tier

  • General, Own Single User:  Benefit from the data use accrues to the applicant only; no data or derivative products are released to third parties.

Premium+ Fee Tier

  • General, Reseller, Multiple Users:  The data use is to create derivative data products that will be available for sale or release to third parties.

Data Product Fees by Applicant Categories

For product details see Data File Extract Product Overview.pdf

I. Data File Extract

Per Member Per Year (PMPY) charge is assessed for each unique person in the dataset for the calendar year or other designated period. Data components include eligibility files, medical claims and prescription drug claims. The four-year historical data period (2014-2017) is a single time period for the purpose of applying the per person fee; a discounted per-person fee is charged for each annual period thereafter (e.g., 2018, 2019 etc.). Fees are for one of the three standard WA-APCD datasets. A higher fee is charged to customize a standard dataset. Minimum fee is $7,500. 

 Data Client CategoryFee per covered person
(Per member per year)
Reduced fee tier$.01
Standard fee tier$.02 
Premium fee tier$.04
Premium+ fee tier$.06

II. Analytic Enclave

The Analytic Enclave product is a managed, cloud-based analytic environment that enables secure access to the all-payer data, added-value data augmentation services and a set of analytic tools; refreshed quarterly with the newest data submissions. Access is by annual seat license.

 Data Client Category1-seat annual license*2-seat annual license*
Reduced fee tier$40,000$47,500
Standard fee tier$60,000 $67,500
Premium fee tier$100,000$107,500
Premium+ fee tierClient-specificClient-specific

* $5,000 per seat license for each license beyond the initial 2 licenses. Fees are for one of the three standard WA-APCD datasets; higher fee is charged to customize a standard dataset

III. Standard Report

This Per Person Cost and Utilization product is a standard dataset that is delivered to the client via secure file transfer protocol. The Product serves the needs of organizations interested in a pre-defined set of per person cost and utilization metrics for a patient population of interest. 

The fee is based on the number of primary care practitioners assigned to the practice location per the WA-APCD roster. The per person costs and utilization is derived from eligibility, medical claims, and prescription drug claims. Separate results are included by market sector (e.g. commercial, Medicaid, Medicare Advantage) if applicable. Report is generated on a calendar year basis; data can be selected for 12-month period beginning with CY2017.

Pricing for this WA-APCD standard report is split into two categories of data clients:  physician organizations clients, and all others.

Fee Schedule for Physician Organizations Clients

 Number of practitionersPer-practice* standard report fee
5 or fewer$4,000
6-9$6,000 
10-25$8,500
25+$12,000

*Practice fees are discounted for physician organizations comprised of multi-practices (e.g. discrete locations)

Fee Schedule for Clients Excluding Physician Organizations

The fee is based on number of unique persons with medical coverage assigned to the healthcare entity or geographic area (e.g. person location, market segment, product type etc.). Per person costs and utilization is derived from eligibility, medical claims and prescription drug claims. Data can be reported by one or more market sectors (e.g. commercial, Medicaid, Medicare Advantage). Report is generated on a calendar year basis; data can be selected for 12 month period beginning with CY2017.

Data Client Category

<50,000 Enrollees

50,000-100,000 Enrollees

100,001-500,000 Enrollees

500,001+ Enrollees

Reduced fee tier

$8,000

$12,000

$15,000

$20,000

Standard fee tier*

$9,600

$14,400

$18,000

$24,000

All others

$11,520

$17,280

$21,600

$28,800

*Excluding Physician Organizations

IV. Custom Analytic Report

Typically, the custom analytic report fee ranges from $7,500 to $17,500 based on a $175 hourly rate for report development. Following client request submission, a flat fee (e.g. $1,200) is charged for the report design and development – this fee is credited to the client and deducted from the total cost of the report. If the client business requirements are sufficiently defined in its report request and a subsequent 1-2 hour design session then no up-front report design and development fee is assessed. The report design and development fee is not assessed if the client chooses not to proceed with the product purchase at the close of this initial 1-2 hour design session. The client must pay the full design and development fee if the product development work proceeds beyond the initial design session regardless of the client’s product purchase decision.

These fees will be based on the client’s data product requirements – the data client category fee tiering that is used for other WA-APCD products do not apply to custom analytic products.

 

Data Release Resources

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