All-payer health care claims
Washington All-Payer Health Care Claims Database Program
RCW 43.371.020, directs the Office of Financial Management (OFM) to establish a statewide all payer health care claims database (WA-APCD) to support transparent public reporting of health care information. The purpose of the database is to improve health care price transparency and to:
- Assist patients, providers, and hospitals to make informed choices about care
- Enable providers, hospitals, and communities to improve by benchmarking their performance against that of others by focusing on best practice
- Enable purchasers to identify value, build expectations into their purchasing strategy, and reward improvements over time
- Promote competition based on quality and cost
The database will systematically collect all medical claims, pharmacy claims, and dental claims from private and public payers, with data from all settings of care that permit the systematic analysis of health care delivery.
The law also required OFM to use a competitive procurement process to select a lead organization to coordinate and manage the database, and a data vendor who is subcontracted to the lead organization to establish and operate the WA-APCD system. In July 2016 OFM selected Oregon Health and Science University’s (OHSU) Center for Health Systems Effectiveness (CHSE) as the lead organization and Onpoint Health Data as the data vendor.
Ted von Glahn is serving as the program director for OHSU.
See the Washington State All-Payer Health Care Claims Database (WA-APCD) overview for additional information.
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Rule-making for the WA-APCD
Phase 3 Rule-Making
CR 103P - historical data submission
Rules - historical data submission
CR 103P - data security and data privacy
Rules - data security and data privacy
CES data security and data privacy rule
Written comments submitted for March 7, 2017 hearing
CR 103P - format for the calculation and display of aggregate cost data
Rules - format for the calculation and display of aggregate cost data
CES format for the calculation and display of aggregate cost data
Written comments submitted for October 10, 2017 hearing
CR 101 - chemical dependency/substance use disorder treatment claims
CR 101 – procedures for establishing fees and penalties for inappropriate disclosure of data
Background paper 7: Penalties for the Inappropriate Disclosures or uses of Direct Patient Identifiers, Indirect Patient Identifiers and Proprietary Financial Information
Implementation of Chapter 43.371 RCW
Deadline for data suppliers to register with the WA-APCD is December 2, 2016.
Data Access Under Chapter 43.371 RCW: Statewide Health Care Claims Data
Apparently Successful Bidder Press Release - July 27, 2016
Report to Legislature - December 1, 2016
Report to Legislature - December 1, 2017
Other health care transparency websites and information
Washington State MONAHRQ – an information system of hospital inpatient care utilization, quality and potentially avoidable stays in Washington state’s community hospitals and by Washington residents.
Last updated: November 30, 2017