The Washington All-Payer Health Care Claims Database (WA-APCD) is the state’s most complete source of health and dental insurance data. It contains claims from more than 30 commercial health care payers; the Medicaid program, including its five managed care plans; and Medicare Advantage, the HMO products for Medicare members. The WA-APCD has historical claims data beginning with 2013 and the database is systematically updated each calendar quarter with the most current claims data. Data from Washington's workers' compensation program is now included and Medicare fee-for-service was added in 2019.
In 2014, the Washington State Legislature enacted the all-payer statute (Chapter 43.371 RCW) directing the Washington State Office of Financial Management (OFM) to establish the WA-APCD to improve transparency to:
- Assist patients providers, and hospitals to make informed choices about health care
- Enable providers, hospitals and communities to improve by benchmarking their performance against that of others by focusing on best practices
- Enable purchasers to identify value, build expectations into their purchasing strategy, and reward improvements over time
- Promote competition based on quality and cost.
OFM received funding to implement the WA-APCD from Federal Rate Review and State Innovation Model grants. These grants help states improve price transparency in health care — and work with the array of health care stakeholders — to improve health by transforming the delivery of health and human services. A number of other states operate all-payer programs, and more states are in the process of implementing them. The national APCD Council has more information about APCDs across the United States.
Data from the WA-APCD is available to consumers and other interested parties through Washington HealthCareCompare. The website allows searches to find high-quality doctor groups and hospitals, and to compare prices for common medical procedures and treatment at nearby hospitals, ambulatory surgery and other outpatient health centers. The site also contains the Washington Statewide Common Measure Set.
Using a competitive bidding process, OFM contracted with the Center for Health Systems Effectiveness (CHSE) at Oregon Health & Science University as the lead organization to manage the WA-APCD. CHSE partnered with Onpoint Health Dataand Forum One to implement the program. Together, these groups ensure stakeholder input in the governance of the WA-APCD, securely collect and validate data submissions, and make the information available and meaningful to consumers, researchers, policy makers and other agencies and interested individuals.
Lead Organization: Center for Health Systems Effectiveness
The Center for Health Systems Effectiveness (CHSE) at Oregon Health & Science University uses data to improve the value of health care. Their team of health economists and policy researchers have decades of experience in designing and evaluating large-scale health-system reforms. CHSE is working under OFM's direction to coordinate governance for the WA-APCD, including recruitment of Washington stakeholders for two advisory committees, performance oversight of our data vendor, and appropriate and secure release of data in conformance with state regulation.
Data Vendor: Onpoint Health Data
Onpoint has four decades of experience designing, constructing, managing, and analyzing a wide array of health care databases, including development of half of the nation’s established APCDs. With coordination from OFM and the lead organization, Onpoint works directly with Washington data suppliers to collect, validate, secure, and analyze Washington health care data.
Website and Communications: Forum One
To maximize the WA-APCD's value to Washington health care consumers, the team recruited the Seattle office of Forum One, a communications and digital agency, to design and build the WA-APCD website. A key purpose of the site is to assist consumers in shopping for health care services and providers. Forum One specializes in creating web solutions for mission-driven organizations to extend their influence and impact the world. Their team brings deep experience to tackle the challenge of engaging consumers in their health care decisions.