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 $5,517
Yearly Healthcare Cost Per Public Employee Program Enrollee (PEBB)
(Enrollee Cost per Year)
$6,231 No ResultNo Result
Emergency Room Visits Per 1,000 Persons 135.25 134.23 582.5

Good Treatment Results

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Return to Hospital
(Lower Return to Hospital Rate is Better)
0.94 0.97 No Result
Avoid Return to Hospital for Mental Health Condition
(Lower Return to Hospital Rate is Better)
No ResultNo Result 11%
Controlling High Blood Pressure 53% No Result 59%
Blood Sugar in Poor Control - Diabetes 38% No Result 39%
Blood Pressure in Good Control - Diabetes 63% No Result 66%

Keeping Patients Safe

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Wrong Medication for Bronchitis 44% 48% 45%
Avoidable Emergency Room Visits 12.47 11.41 No Result
Checking Patients on Blood Pressure Medications 80% 82% 85%
Testing for Cause of Back Pain 83% 82% 75%
Treating Children with Throat Infections 85% 85% 78%

Get the Right Care

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Diabetes Care
Blood Sugar Testing 89% 90% 85%
Check for Kidney Disease 87% 86% 87%
Eye Exam to Check for Vision Loss 50% 45% 43%
Getting Medications to Control Blood Sugar 66% 72% 61%
Mental Health Care
Follow-up Visit After Hospital Stay 54% 54% 81%
Getting Anti-depressant Medications 62% 63% 51%
Getting Care for Attention Deficit/Hyperactivity Disorder 47% 44% 45%
Asthma and Lung Care
Testing for Lung Disease 34% 41% 25%
Getting the Right Medications for Asthma 30% 33% 33%
Fewer Hospital Stays Due to Good Lung Care
(Hospital Stays per 1,000 Persons, Lower Rate is Better)
0.26 0.5 3.63
Heart Care
Getting and Taking Medications for Heart Disease 80% 66% 78%
Getting Medications to Lower Blood Pressure 62% 63% 52%
Getting Medications to Lower Cholesterol 68% 67% 60%

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 86% 88% 91%
Regular Check-Ups for 3-6 Year-Olds 65% 67% 63%
Well-Child Visits in the First 15 Months of Life 66% 63% 49%
Getting Substance Abuse Services - MedicaidNo ResultNo Result 33%
Getting Mental Health Services 62% 60% 63%
Adults Get Care
Access to Care for Adults 94% 93% 77%
Getting Mental Health Services 37% 33% 46%
Getting Mental Health Services - Commercial 39% 34% No Result
Getting Substance Abuse Services - MedicaidNo ResultNo Result 30%

Preventing Illness

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Help Children Stay Healthy
Checking if Weight is a Health Problem - Children 60% No Result 67%
Care to Prevent CavitiesNo ResultNo ResultNo Result
Checking for Cancer
Breast Cancer Screening 70% 68% 51%
Cervical Cancer Screening 68% 66% 55%
Checking for Colorectal Cancer No ResultNo Result 32%
Right Care to Prevent Illness
Checking if Weight is a Health Problem - Adults 77% No Result 88%
Chlamydia Screening in Women 44% 48% 53%