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 $6,671
Yearly Healthcare Cost Per Public Employee Program Enrollee (PEBB)
(Enrollee Cost per Year)
$7,418 No ResultNo Result
Emergency Room Visits Per 1,000 Persons 128.98 121.99 439.84

Good Treatment Results

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Readmissions to Hospital
(Lower Return Rate is Better)
0.25 0.26 0.19
Avoid Return to Hospital for Mental Health Condition
(Lower Percentage is Better)
No ResultNo Result 16%
Statin Therapy for Patients With Cardiovascular Disease - Adherence 0.72 0.67 0.57
Blood Sugar in Poor Control - Diabetes 98% No Result 94%
Blood Pressure in Good Control - Diabetes 3% No Result 8%

Keeping Patients Safe

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Avoid Wrong Medication for Bronchitis 43% 46% 29%
Appropriate Testing for Cause of Back Pain 83% 84% 76%
Follow-up After Emergency Department Visit for Substance Use 15% 14% 24%
Testing Children with Throat Infections 72% 70% 77%

Get the Right Care

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Diabetes Care
Blood Sugar Testing 87% 88% 71%
Eye Exam to Check for Vision Loss 63% 66% 66%
Mental Health Care
Antidepressant Medication Management: Effective Acute Phase Treatment 0.59 0.62 0.44
Follow-up After Emergency Department Visit for Mental Health Illness 69% 62% 51%
Getting Anti-depressant Medications 77% 77% 62%
Asthma and Lung Care
Testing for Lung Disease 30% 30% 19%
Getting the Right Medications for Asthma 82% 82% 63%
Heart Care
Getting and Taking Medications for Heart Disease 86% 86% 69%

Getting In to See the Doctor

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Children Get Care
Child and Adolescent Well-Care Visit 50% 41% 41%
Follow-up Care for Children Prescribed ADHD Medication: Continuation 42% 40% 42%
Follow-up Care for Children Prescribed ADHD Medication: Initiation 38% 36% 38%
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents 16% 13% 23%
Getting Substance Abuse Services - MedicaidNo ResultNo Result 24%
Adults Get Care
Access to Care for Adults 92% 86% 70%
Getting Substance Abuse Services - MedicaidNo ResultNo Result 39%
Prenatal and Postpartum Care: Postpartum Care 56% 53% 59%
Prenatal and Postpartum Care: Timeliness of Prenatal Care 34% 31% 44%

Preventing Illness

How is this measured?
Commercial CoverageHealth Exchange CoverageMedicaid Coverage
Checking for Cancer
Breast Cancer Screening 68% 61% 38%
Cervical Cancer Screening 64% 56% 47%
Right Care to Prevent Illness
Chlamydia Screening in Women 41% 39% 48%