Connecting state and local government leaders
Washington's HealthCareCompare, created by a state agency, allows residents to research the cost and quality of hundreds of medical, dental and pharmacy services and procedures.
Having your knee replaced in Washington state costs an average of $33,539, but fees can range from $26,791 to $41,576.
At one hospital in Olympia, the procedure costs an average of $24,745. Less than 6 miles away at a different hospital, the same operation usually runs around $36,414.
Those price estimates are courtesy of Washington HealthCareCompare, a new website created by the state that allows residents to research the cost and quality of hundreds of medical, dental and pharmacy services and procedures. The site, which goes live Friday, also contains information on health-care providers.
“This is Washington state’s big step forward in providing consumers information to make informed choices on health care,” Thea Mounts, director of the Washington State Statistical Analysis Center, said on a media call Thursday.
The website’s data comes from the Washington All-Payer Claims Database, an “effort that’s been underway for the last several years to collect health, dental and pharmacy claims as well as eligibility information from health carriers in Washington,” Mounts said.
The database was created in 2014 when the Washington State Legislature passed a bill requiring the state to collect the health information and make it accessible to the public, allowing consumers to “find and use the data to make better-informed decisions about the health care they choose and use,” according to the Washington State Office of Financial Management.
The database holds health and dental insurance claims information from both private insurance companies and government-sponsored programs, including Medicare and Medicaid. It currently contains information from more than 4 million Washington residents, all of it aggregated for anonymity.
As of December 2016, at least 18 states had enacted all-payer claims databases, or APCDs, according to the National Conference of State Legislatures. Sixteen are currently operational, and more than a dozen other states have since considered similar laws or programs.
To use the new website, Washington residents log onto www.wahealthcarecompare.com, click on the “find local prices of a treatment or visit” tab, and type in the name of a procedure or treatment and the ZIP code where they’d like to receive the care. Cost results can be tailored to include a user’s insurance information, including co-pay and deductible.
Cost information is simply an estimate, Mounts said, and users should contact their insurance companies to ensure coverage.
Residents can also use the website to research quality metrics that rate health-care providers, and to peruse ratings for different facilities, as well as high and low-cost estimates for specific procedures in specific offices.
The greatest asset for the consumer, Mounts said, is the ability to ask questions and receive cost information ahead of office visits. It’s especially helpful for lower-cost procedures, where a patient will not meet his or her entire deductible in one appointment and may have to pay more out-of-pocket, she said.
“For something like a knee replacement surgery where it’s very expensive and might meet anyone’s deductible for the year, maybe that’s not the example that would be the most salient for people,” she said. “But for procedures that are less expensive … they would have an opportunity to drill into the cost for those.”
The database can also be used for research purposes, though the legislation limits access to certain kinds of data for certain people. The state’s Office of Financial Management has already received requests from research teams, Mounts said.
“The first state agencies accessing the data will be able to start doing analyses in mid-July, and our hope is to have at least some preliminary looks at the work done using the Washington APCD data for the January legislative session,” she said. “They won’t be really complex given the time, but we hope to have things that demonstrate the value of the data.”
Kate Elizabeth Queram is a Staff Correspondent for Government Executive’s Route Fifty and is based in Washington, D.C.