Scroll below to compare the cost and quality of healthcare for Washingtonians -- organized by three major insurance markets in the state: Medicaid Apple Health, the Health Exchange, and those with private commercial insurance. 

Click on the left-hand tab above to see performance results organized by nine areas of the state in which organizations, called Accountable Communities for Health (ACH), are working to improve the health and quality of life for everyone living there.

Cost and Value

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Yearly Healthcare Cost Per Medicaid Enrollee
(Enrollee Cost per Year)
No ResultNo Result $6,441
Yearly Healthcare Cost Per Public Employee Program Enrollee (PEBB)
(Enrollee Cost per Year)
$6,712 No ResultNo Result
Emergency Room Visits Per 1,000 Persons 109.2 82.03 367.11

Good Treatment Results

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Readmissions to Hospital
(Lower Return Rate is Better)
0.85 0.76 No Result
Avoid Return to Hospital for Mental Health Condition
(Lower Percentage is Better)
No ResultNo Result 16%
Controlling High Blood Pressure 53% No Result 58%
Blood Sugar in Poor Control - Diabetes 34% No Result 40%
Blood Pressure in Good Control - Diabetes 57% No Result 66%

Keeping Patients Safe

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Wrong Medication for Bronchitis 54% 55% 66%
Appropriate Testing for Cause of Back Pain 79% 77% 72%
Avoidable Emergency Room Visits 8.62 5.87 44.08
Checking Patients on Blood Pressure Medications 75% 77% 78%
Getting Prescriptions for Both Opioids and Sedatives
(Rate per 1,000 Persons)
No ResultNo Result 15%
Testing Children with Throat Infections 77% 72% 78%

Get the Right Care

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Diabetes Care
Blood Sugar Testing 84% 85% 79%
Check for Kidney Disease 84% 85% 39%
Eye Exam to Check for Vision Loss 42% 39% 38%
Getting Medications to Control Blood Sugar 72% 78% 64%
Mental Health Care
Follow-up Visit After Hospital Stay 44% 41% 70%
Getting Anti-depressant Medications 73% 71% 56%
Getting Care for Attention Deficit/Hyperactivity Disorder 40% 40% 47%
Asthma and Lung Care
Testing for Lung Disease 13% 14% 10%
Getting the Right Medications for Asthma 38% 36% 26%
Fewer Hospital Stays Due to Good Lung Care
(Hospital Stays per 1,000 Persons, Lower Rate is Better)
0.1 0.08 1.93
Heart Care
Getting and Taking Medications for Heart Disease 86% 84% 84%
Getting Medications to Lower Blood Pressure 79% 81% 60%
Getting Medications to Lower Cholesterol 75% 77% 59%

Getting In to See the Doctor

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Children Get Care
Having a Primary Care Visit Yearly: Children and Adolescents 77% 74% 70%
Regular Check-Ups for 3-6 Year-Olds 56% 53% 43%
Well-Child Visits in the First 15 Months of Life 63% 65% 49%
Getting Substance Abuse Services - MedicaidNo ResultNo Result 25%
Getting Mental Health Services 61% 56% 64%
Adults Get Care
Access to Care for Adults 90% 92% 71%
Getting Mental Health Services 36% 27% 50%
Getting Substance Abuse Services - MedicaidNo ResultNo Result 40%

Preventing Illness

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Help Children Stay Healthy
Checking if Weight is a Health Problem - ChildrenNo ResultNo Result 70%
Checking for Cancer
Breast Cancer Screening 65% 65% 45%
Cervical Cancer Screening 63% 65% 50%
Checking for Colorectal Cancer 61% No ResultNo Result
Right Care to Prevent Illness
Chlamydia Screening in Women 40% 40% 47%