Past Data Requests

This program evaluation aims to inform Washington State public health and Hepatitis C virus (HCV) implementing organizations about state-wide progress towards HCV elimination and inform priority investments for the next phase of ‘Hepatitis C Free Washington' implementation. Outcomes of interest include HCV screening, linkage, and treatment completion rates over time as well as cost to the State of Washington and patients. We plan to merge APCD data with WDRS data to estimate linkage to treatment rates.

The Physician and Physician Practice Research Database (3P-RD) is intended to be a prototype database that captures information on physician and physician practice characteristics to help address current data gaps within health services research. NORC will be using available administrative data and provider databases to capture the universe of active physicians and physician practices to develop the 3P-RD database. This prototype will be for AHRQ's internal research purposes, and will also include a design that can be potentially used to create public release research databases. The 3P-RD prototype will contain data for 13 states and include data elements related to physicians and physician practices' characteristics pertinent to analyzing health services research and policy questions. This prototype is part of the feasibility study NORC is conducting that will identify options and provide recommendations for AHRQ’s consideration of how to establish a program that regularly creates and maintains these databases. Examples of possible health research or policy questions the database will be useful for answering include, but are not limited to: 1) How many unique physicians holding a current license to practice medicine in the state are actively providing services? 2) Of the physicians who actively provide services, what percent provide services to patients full-time versus part-time? 3) What are the patient population characteristics for practicing physicians (i.e. % commercial vs Medicaid vs Medicare as well as gender / age characteristics)? 4) How does the mix of provider types within a physician practice change over time? 5) How are physician practice migration patterns changing over time? 6) What factors are associated with physicians’ practice behaviors?

This amendment adds a use case to the University of Washington, Department of Epidemiology Data Use Agreement. The use case title is "Use of Extreme Risk Protection Orders in Washington." The use case involves linking a cohort of approximately 500 participants involved as a Respondent or Petitioner in Extreme Risk Protection Orders (ERPO) filed in the State of Washington from December 1st, 2016 through September 30th. 2020 and approximately 4,500 participants admitted to the Psychiatric Emergency Service at Harborview Medical Center from January 1st, 2012 through November 30th, 2016 with WA-APCD medical claims records to identify medical utilization patterns. This DUA amendment does not add any new data elements

Researchers at the RAND Corporation will reprice commercial medical claims from MHDO using Medicare's groupers and pricing algorithms and will release a public research report that includes commercial prices as a percent of Medicare prices for hospitals and hospital systems identified by name. This research report will update and expand on the findings in a RAND reports released in May, 2019 (https://www.rand.org/pubs/research_reports/RR3033.html) and September 2020 (https://www.rand.org/pubs/research_reports/RR4394.html). The public research report will include hospitals from around the country and will be created using claims data from three sources: selfinsured employers, state-based all payer claims databases (APCDs), and health plans. Benefit to Citizens of Washington: This project will benefit the people of Washington by providing them with a detailed hospital price report for hospitals in Washington, as well as comparisons among hospitals in Washington versus hospitals in other states. Key audiences for the report will be (1) self-insured employers that participate in the study and that are assessing the reasonableness of the prices they are paying for hospital care, (2) other employers that are struggling with high and rising health care costs and that want to better understand patterns and trends in hospital prices, and (3) policymakers and researchers who are concerned with hospital pricing and price transparency. 

Estimating impact of ARR on HIE enrollees: The Auto-Reenrollment and Renewal (ARR) policy on the Health Insurance Exchanges (HIEs) was designed to prevent unintentional discontinuous enrollment among HIE enrollees by automatically reenrolling enrollees in their default health plan if an active selection was not made during open enrollment. However, in the five years since ARR was implemented, policymakers have become concerned that ARR is enhancing consumer inertia that is then distorting market signals on the HIEs and increasing premiums, and have considered modifying ARR. The purpose of this research is to establish the impact of ARR on consumer inertia and consumer welfare within HIEs.

This study seeks to identify racial and geographic disparities in the care of Parkinson’s disease (PD) in Washington State, particularly King County. The study will use medical records (Medicare, Medicaid, and commercial) to characterize PD-related diagnoses, treatment, and specialty care in WA zip codes and to then determine how zip code or African American, Asian American, Latino American, and American/Alaskan Indian race/ethnicity may influence PD care. Using findings from these analyses, a pilot program will be designed to target underserved communities and help them better access specialist care and community services. More particularly, the pilot will identify and assess barriers to people with PD accessing specialized care (e.g., transportation, location and hours of medical facilities, marketing) and design access programs and interventions that address those barriers, including mechanisms that incentivize community doctors and primary care physicians to refer PD patients on to Movement Disorder Specialists. The study and pilot will initially address disparities within the African-American population of SE Seattle and South King County in contrast to the African American population of NW and North King County, with the idea that other population groups can be addressed in a future phase 2 project. By completing both the initial study and the pilot program, patients diagnosed with PD may be better served so that they can live healthier and longer lives, while reducing costs to the health-care system as a whole.

The main purpose of this project is to support the WSMA’s role on the Surprise Billing Workgroup created by 2HSB 1065 with a goal of reducing healthcare costs for Washington’s patients. We will analyze the WA-APCD data to assess variations in costs by procedure and geography to identify differentials in utilization of out-of-network providers. The Surprise Billing Workgroup is responsible for advising how best to use the WA-APCD to establish commercially reasonable reimbursement. Specifically, our aims are to 1) support the determination of a commercially reasonable reimbursement from the WA-APCD data, 2) have data-driven awareness of ways in which WSMA can implement best practices to support legislature’s efforts around this bill. These two aims enable us to drive toward our mission to “Provide strong physician leadership and advocacy to shape the future of medicine and advance quality care for all Washingtonians.” We would like a fully-formed understanding of the bill’s impact on Washington State’s healthcare ecosystem, as our association plays an important role representing the physicians and physician assistants in our state. The results will not be used for commercial purposes.

Currently due to improved screening, earlier detection, and advanced cancer therapy, two thirds U.S. cancer patients can live longer than five years. There were more than 15.5 million U.S. cancer survivors alive in 2016. However, cancer patients have eight times higher risk of developing cardiovascular disease (CVD) than non-cancer patients, due to the cardio-toxic cancer therapies and shared risk factors. Since multisystem comorbidity requires care from multiple specialties, an effective relationship between oncologists and cardiologists may be essential to achieving optimal care. However, the question of how to build such an effective relationship between oncologists and cardiologists to obtain optimal outcomes remains unanswered. To assist decision making of cancer patients, providers and communities, Zhi Pan’s proposed PhD dissertation aims to provide an understanding of the oncologist-cardiologist relationship and thereby facilitate better design of more effective approaches for pursuing optimal prevention, treatment, and population health of adult cancer patients at high risk of developing CVD. This study has three aims: (1) Identify distinct patterns of the oncologist cardiologist relationship in caring for the target population. (2) Determine the impact of oncologist cardiologist relationship on outcomes and quality of care for the target population. (3) Test whether payer status and coverage, provider features, patient demography, and community characteristics affect the oncologist-cardiologist relationship and patient outcomes for the target population.

DUA amendment to add a use case and file linkage fee. This study focuses on a cohort of Washington State children between zero to three years’ old who participated in Early Support for Infants & Toddlers (ESIT) program. We will follow their education paths in pre-K and Kindergarten and investigate the role of health factors in children’s education outcomes. Particularly, we profile the population by their eligibility for early learning intervention services due to specific developmental delays or disability. In addition, by connecting with Washington State All Payers Claims Database (APCD), using linkage data elements (i.e., internal_member_id, first name, last name, middle name, gender, date of birth, and ssn) we will investigate what medical diagnosis and procedures these children have received and cluster condition specific sub-populations.

Each year there are about 4 million births in the US. About 70% of women take at least one prescription medication in pregnancy, and for many of these medications, there is inadequate safety data. Large observational studies are instrumental in closing this evidence gap because pregnant women are routinely excluded from clinical trials. Our team has had many successes in generating evidence on the safety of medications used in pregnancy including antibiotics, antihypertensive medications, and antidepressants. To study an even wider range of medications and evaluate more important but rarer outcomes, we will need to draw on larger data resources, such as WA-APCD, to identify large populations of pregnant women and their infants. The objective of this research proposal is to carry out feasibility work to investigate whether the Washington State All-Payer Database can be used to study medication use in pregnancy. Specifically, we will investigate means to identify pregnancies and to link mothers’ data to their babies. Once we can establish this data linkage, we will conduct descriptive analyses to support grant applications. For instance, we’ll count the number of mom-baby pairs contained in WA-APCD and describe their characteristics, examine frequency of use of various medication classes in pregnancy, and describe the prevalence of outcomes of interest such as birth defects. We may submit a conference abstract and a manuscript describing methods we used to link moms and babies with aggregated data as described above. Ultimately, results from future research based on the WA-APCD data could help pregnant women and their clinicians make informed decisions about medication treatment in pregnancy.