Methodology

The measures are drawn from the Washington State Common Measures Set – the State performance dashboard that guides work being done by many organizations to improve the health of Washingtonians.   

The Common Measures Set is comprised of more than 55 measures of healthcare quality and value. In this section of the website, the performance results are reported by the nine Accountable Communities for Health (ACH) regions and by the major health insurance market sectors. Patients, based on residence, are grouped into the nine ACHs to produce the regional results.  Similarly, patients, based on their insurance coverage, are grouped by their insurance coverage -- commercial, Medicaid and the Washington Health Benefits Exchange -- to produce results by these three insurance market sectors.

Most of these measures are part of national measurement systems sponsored by the National Committee for Quality Assurance (NCQA) and the Centers for Medicare and Medicaid (CMS).  Additionally, Washington state agencies have authored select measures to tailor indicators for the State.

Performance results are computed separately for the commercial and Medicaid populations. For a few measures, only Medicaid results are reported as the commercial population data is not available.  Some of the hospital measures are based on patients across all insurance programs -- Medicare, commercial, and Medicaid; other hospital measures include care and experiences for Medicare patients only.

The measure results mainly are based on patients who got care during 2015 and 2016. See details on the individual measures.

The WA-APCD scored the approximately 30 measures that were calculated using claims data. The measures that are based on other data sources – including clinical records and patient surveys – were scored by a number of organizations including several government agencies (Washington Department of Health, Washington Department of Social and Human Services, Washington Health Care Authority, and the federal Centers for Medicare and Medicaid Services) along with the Washington State Hospital Association. 

The price information for hospital inpatient services was produced using proprietary computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3M APR™ Software, 3M APR™ DRG classification system, the 3M CRG™ Software, and 3M CRG™ (including the selection, coordination and arrangement of all codes) are owned by 3M. All rights reserved.