2016 COMMUNITY CHECKUP REPORT

Chart Pack: Graphs and Figures

www.WACommunityCheckup.org

DECEMBER 2016 Variation among Accountable Communities of Health for Mental Health Services for Commercially Insured Adults, Ages 18–64

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 28% 29% Cascade Pacific Action Alliance 28% Greater Columbia 26% King 30% North Central 24% North Sound 28% Olympic 27% Pierce 27% SW WA Regional Health Alliance 44% 0% 20% 40% 60% 80% 100% Variation among Counties for Mental Health Services for Commercially Insured Adults, Ages 18–64

STATE AVERAGE: 29%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 31 % Pend 24% Okanogan Oreille Skagit 22% Ferry Stevens 19% Island 27% 18% 21% 27% Clallam Snohomish 21% 27% Chelan Jefferson 28% 26% Douglas Kitsap Lincoln Spokane King 25% 30% 19% 29% Grays Mason 30% Harbor 27% 22% Kittitas Grant Thurston Pierce 23% 22% Adams 27% Whitman 28% 17% 23% Pacific Lewis 21% 24% Franklin Garfield Yakima 26% Wahkiakum 25% 15% Cowlitz Benton Walla Columbia 27% Walla 39% 30% 16% Asotin Skamania 27% 20% 31 % Clark Klickitat 44% 19% Variation among Accountable Communities of Health for Mental Health Services for Medicaid Insured Adults, Ages 18–64

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 45% 46% Cascade Pacific Action Alliance 45% Greater Columbia 45% King 51% North Central 45% North Sound 47% Olympic 48% Pierce 43% SW WA Regional Health Alliance 42% 0% 20% 40% 60% 80% 100% Variation among Counties for Mental Health Services for Medicaid Insured Adults, Ages 18–64

STATE AVERAGE: 46%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 51% Pend 43% Okanogan Oreille Skagit 46% Ferry Stevens 40% Island 47% 48% 43% 46% Clallam Snohomish 47% 46% Chelan Jefferson 48% 49% Douglas Kitsap Lincoln Spokane King 48% 48% 36% 46% Grays Mason 51% Harbor 41% 44% Kittitas Grant Thurston Pierce 47% 41% Adams 43% Whitman 45% 35% 48% Pacific Lewis 45% 45% Franklin Garfield Yakima 41% Wahkiakum 44% 40% Walla 49% Cowlitz Benton Columbia Walla Asotin 49% Skamania 50% 35% 52% 46% 51% Clark Klickitat 41% 46% Variation among Medical Groups for Cardiovascular Disease Care for Commercially Insured

NCQA 90TH PERCENTILE STATE AVERAGE MEDICAL GROUP RATE

100%

92% 90% 86% 82% 82% 80% 79% 76%

70%

60%

50%

40%

30%

20%

10%

Cholesterol-lowering Medication safety: Statin therapy for Taking Taking hypertension medication generic monitoring patients patients with cholesterol-lowering medications as directed prescriptions on high-blood cardiovascular disease medications as directed pressure medications Commercial Health Plan Results for Blood Pressure Control for People with Cardiovascular Disease

STATE AVERAGE: 57% NCQA 90TH PERCENTILE RATE

Kaiser Permanente NW 84% Group Health Cooperative 75% Group Health Options 61% Asuris Northwest Health 54% Cigna 52% LifeWise Health Plan of 52% Regence BlueShield 52% UnitedHealthcare 52% Aetna 43% 33%

0% 20% 40% 60% 80% 100% Commercial Health Plan Results for Medication Safety: Monitoring Patients on High-Blood Pressure Medication

STATE AVERAGE: 81% NCQA 90TH PERCENTILE RATE

Kaiser Permanente NW 86% Group Health Cooperative 84% Group Health Options 82% Asuris Northwest Health 80% Cigna 81% Regence BlueShield 80% UnitedHealthcare 81% Aetna 81%

0% 20% 40% 60% 80% 100% Medicaid Health Plan Results for Blood Pressure Control for People with Cardiovascular Disease

STATE AVERAGE: 53% NCQA 90TH PERCENTILE RATE

Community Health Plan of Washington 59% Molina Healthcare of Washington 57% Amerigroup Washington 53% UnitedHealthcare Community Plan 49%

0% 20% 40% 60% 80% 100% Medicaid Health Plan Results for Medication Safety: Monitoring Patients on High-Blood Pressure Medication

STATE AVERAGE: N/A NCQA 90TH PERCENTILE RATE

Molina Healthcare of Washington 87% Amerigroup Washington 86%

0% 20% 40% 60% 80% 100% Medicaid per Enrollee Annual Spending, 2010–2015

MEDICAID PER ENROLLEE ANNUAL SPENDING

$7,800

$7,600

$7,544 $7,400

$7,200 $7,253 $7,270 $7,177

$7,000

$6,800

$6,721 $6,600 $6,671

$6,400

$6,200 2010 2011 2012 2013 2014 2015 Medicaid per Enrollee Spending in Washington State, 2010–2015

Medicaid Expenditures Medicaid Average Member Enrollment Medicaid per Enrollee Annual Spending

2010 $7,347,364,307 1,012,990 $7,253 2011 $7,599,043,607 3% Change 1,058,863 5% Change $7,177 -1% Change 2012 $7,771,270,669 2% Change 1,068,886 1% Change $7,270 1% Change 2013 $8,111,259,183 4% Change 1,075,221 1% Change $7,544 4% Change 2014 $10,283,214,733 27% Change 1,530,091 42% Change $6,721 -11% Change 2015 $11,538,184,702 12% Change 1,729,578 13% Change $6,671 -1% Change Public Employee Benefi t per Enrollee Annual Spending, 2010–2015

PEB PER ENROLLEE ANNUAL SPENDING

$8,000

$7,000

$6,000

$5,425 $5,000 $5,355 $4,904 $5,024 $5,032 $4,706 $4,000

$3,000

$2,000

$1,000

$0 2010 2011 2012 2013 2014 2015 Public Employee per Enrollee Spending in Washington State, 2010–2015

PEB Expenditures PEB Average Monthly Enrollment PEB per Enrollee Annual Spending

2010 $1,644,909,877 335,422 $4,904 2011 $1,707,158,938 4% Change 339,829 1% Change $5,024 2% Change 2012 $1,592,252,228 -7% Change 338,371 0% Change $4,706 -6% Change 2013 $1,730,484,626 9% Change 343,884 2% Change $5,032 7% Change 2014 $1,877,997,903 9% Change 350,709 2% Change $5,355 6% Change 2015 $1,928,976,921 3% Change 355,578 1% Change $5,425 1% Change Washington State-Purchased Health Care Spending as a Percentage of State GDP and Total Average Monthly Eligible Members for State-Purchased Health Care

STATEPURCHASED HEALTH CARE SPENDING AS A PERCENTAGE OF STATE GDP

WA STATE HEALTH CARE AVG MONTHLY ELIGIBLE MEMBERS (MEDICAID AND PEB)

3.50% 2,500,000 3.04% 2.88% 3.00% 2,000,000 2,085,156 2.48% 2.50% 2.40% 2.44% 2.50% 1,880,800

1,500,000 2.00% 1,398,692 1,407,257 1,419,106 1,348,412

1.50% 1,000,000

1.00% 500,000

0.50%

2010 2011 2012 2013 2014 2015 Heath Care Spending Growth Related to the Washington State Gross Domestic Product, 2010–2015

WA State-Purchased Health WA State Health Care Avg WA State GDP State-Purchased Health Care Annual Spending Monthly Eligible Members Care Spending as a (includes Medicaid and PEB) (Medicaid and PEB) Percentage of State GDP 2010 $8,992,274,184 1,348,412 $362,114,000,000 2.48% 2011 $9,306,202,545 3% Change 1,398,692 4% Change $372,287,000,000 3% Change 2.50% 1% Change 2012 $9,363,522,897 1% Change 1,407,257 1% Change $390,154,000,000 5% Change 2.40% -4% Change 2013 $9,841,743,810 5% Change 1,419,106 1% Change $402,789,000,000 3% Change 2.44% 2% Change 2014 $12,161,212,636 24% Change 1,880,800 33% Change $422,767,000,000 5% Change 2.88% 18% Change 2015 $13,467,161,622 11% Change 2,085,156 11% Change $443,665,000,000 5% Change 3.04% 6% Change Variation among Medical Groups for Diabetes Care for Commercially Insured

NCQA 90TH PERCENTILE STATE AVERAGE MEDICAL GROUP RATE

100% 94% 90% 90% 90% 86%

80% 75% 70% 70%

60%

50%

40%

30%

20%

10%

Blood sugar (HbA1c) testing Eye exam for people with diabetes Kidney disease screening for for people with diabetes people with diabetes Variation among Accountable Communities of Health for Childhood Immunization Status by Age 13

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 48% 60% Cascade Pacific Action Alliance 59% Greater Columbia 65% King 67% North Central 71% North Sound 59% Olympic 57% Pierce 59% SW WA Regional Health Alliance 53% 0% 20% 40% 60% 80% 100% Variation among Counties for Childhood Immunization Status by Age 13

STATE AVERAGE: 60%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 63% Pend 30% Okanogan Oreille Skagit 56% Ferry Stevens 10% Island 46% 34% 31 % 36% Clallam Snohomish 45% 63% Chelan Jefferson 74% 52% Douglas Kitsap Lincoln Spokane King 74% 60% 54% 49% Grays Mason 67% Harbor 45% 62% Kittitas Grant Thurston Pierce 54% 72% Adams 59% Whitman 61% 71% 46% Pacific Lewis 38% 62% Franklin Garfield Yakima 68% Wahkiakum 73% Walla 67% Cowlitz Benton Columbia Walla Asotin 60% Skamania 64% 63% 61% 36% 28% Clark Klickitat 53% 18% Variation among Accountable Communities of Health for Childhood Immunization Status by Age 2

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 21% 33% Cascade Pacific Action Alliance 28% Greater Columbia 35% King 43% North Central 36% North Sound 31 % Olympic 25% Pierce 26% SW WA Regional Health Alliance 27% 0% 20% 40% 60% 80% 100% Variation among Counties for Childhood Immunization Status by Age 2

STATE AVERAGE: 33%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 23% Pend Okanogan Oreille Skagit 30% Ferry Stevens Island 19% 8% 17% Clallam Snohomish 14% 37% Chelan Jefferson 37% 23% Douglas Kitsap Lincoln Spokane King 38% 27% 19% 20% Grays Mason 43% Harbor 19% 26% Kittitas Grant Thurston Pierce 18% 37% Adams 26% Whitman 31 % 40% 26% Pacific Lewis 15% 30% Franklin Garfield Yakima 35% Wahkiakum 43% Walla Cowlitz Benton Columbia Walla Asotin 27% Skamania 35% 23% 6%

Clark Klickitat 27% Variation among Accountable Communities of Health for HPV Vaccination Rates for Boys

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 11 % 17% Cascade Pacific Action Alliance 15% Greater Columbia 22% King 20% North Central 21% North Sound 14% Olympic 14% Pierce 17% SW WA Regional Health Alliance 15% 0% 20% 40% 60% 80% 100% Variation among Counties for HPV Vaccination Rates for Boys

STATE AVERAGE: 17%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 11 % Pend Okanogan Oreille Skagit 13% Ferry Stevens Island 12 % 6% 7% Clallam Snohomish 10% 15% Chelan Jefferson 23% 12 % Douglas Kitsap Lincoln Spokane King 21% 15% 14% 11 % Grays Mason 20% Harbor 11 % 13% Kittitas Grant Thurston Pierce 13% 22% Adams 17% Whitman 18% 23% 12 % Pacific Lewis 9% 16% Franklin Garfield Yakima 28% Wahkiakum 26% Cowlitz Benton Walla Columbia Walla 10% 20% Asotin Skamania 20%

Clark Klickitat 15% Variation among Accountable Communities of Health for HPV Vaccination Rates for Girls

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 14% 22% Cascade Pacific Action Alliance 20% Greater Columbia 27% King 26% North Central 25% North Sound 18% Olympic 19% Pierce 20% SW WA Regional Health Alliance 19% 0% 20% 40% 60% 80% 100% Variation among Counties for HPV Vaccination Rates for Girls

STATE AVERAGE: 22%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 17% Pend Okanogan Oreille Skagit 14% Ferry Stevens Island 17% 11 % 11 % Clallam Snohomish 12 % 19% Chelan Jefferson 26% 15% Douglas Kitsap Lincoln Spokane King 23% 20% 17% 14% Grays Mason 26% Harbor 16% 21% Kittitas Grant Thurston Pierce 19% 28% Adams 20% Whitman 23% 17% 16% Pacific Lewis 16% 24% Franklin Garfield Yakima 32% Wahkiakum 32% Cowlitz Benton Walla Columbia Walla 15% 23% Asotin Skamania 23%

Clark Klickitat 19% 11 % Variation among Medical Groups for Medication Management for Commercially Insured

NCQA 90TH PERCENTILE STATE AVERAGE MEDICAL GROUP RATE

100%

90%

80% 75% 72% 70% 67%

60% 60% 56%

50%

40%

30%

20%

10%

Managing medications for Staying on antidepressant Staying on antidepressant people with asthma medication (6 months) medication (12 weeks) Mental Health Services for Adults, Ages 18–64

RESULTS FOR HEALTH PLANS RESULTS FOR COUNTIES

Medicaid Managed Care Washington Counties, Washington Counties, Commercial Health Plans Organizations Commercially Insured Medicaid Insured

State Average = 29% State Average = 46% State Average = 29% State Average = 46%

Lowest Highest Lowest Highest Lowest Highest Lowest Highest performance performance performance performance performance performance performance performance

16% 53% 42% 48% 15% 44% 35% 52% Mental Health Services for Children, Ages 6–17

RESULTS FOR HEALTH PLANS RESULTS FOR COUNTIES

Medicaid Managed Care Washington Counties, Washington Counties, Commercial Health Plans Organizations Commercially Insured Medicaid Insured

State Average = 35% State Average = 63% State Average = 35% State Average = 63%

Lowest Highest Lowest Highest Lowest Highest Lowest Highest performance performance performance performance performance performance performance performance

15% 68% 56% 64% 11% 55% 53% 71% Washington State Performance for Commercially Insured as Compared to NCQA National Benchmarks

National 90th National Benchmarks Measure State Average Percentile Above National 90th Percentile Eye exam for people with diabetes 75% 70% Avoiding antibiotics for adults with acute bronchitis 34% 38% Between National 75th and Avoiding X-ray, MRI and CT scan for low-back pain 80% 83% 90th Percentile Staying on antidepressant medication (6 months) 56% 60% Staying on antidepressant medication (12 weeks) 72% 75% Access to primary care (ages 12–19 years) 90% 95% Access to primary care (ages 45–64) 96% 97% Access to primary care (ages 65+) 98% 99% Between National 50th and Blood sugar (HbA1c) testing for people with diabetes 90% 94% 75th Percentile Breast cancer screening 75% 80% Colon cancer screening 63% 72% Kidney disease screening for people with diabetes 86% 90% Medication safety: monitoring patients on high-blood pressure medications 82% 86% Access to primary care (ages 2–6 years) 89% 96% Access to primary care (ages 7–11 years) 90% 97% Access to primary care (ages 12–24 months) 98% 99% Access to primary care (ages 20–44) 92% 95% Between National 25th and Appropriate testing for children with sore throat 77% 92% 50th Percentile Cervical cancer screening 75% 82% Chlamydia screening 39% 60% Spirometry testing to assess and diagnose COPD 40% 52% Well-child visits (ages 3–6 years) 73% 87%

National 90th percentile is based upon national benchmarks computed by the National Committee for Quality Assurance (NCQA). This refl ects the top 10 percent of performance across the nation. The source for this benchmark data contained in this publication is Quality Compass® 2015 and is used with the permission of the National Committee for Quality Assurance (“NCQA”). Any analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifi cally disclaims responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. Washington State Performance for Medicaid Insured as Compared to NCQA National Benchmarks

National 90th National Benchmarks Measure State Average Percentile Between National 75th and Staying on antidepressant medication (6 months) 42% 48% 90th Percentile Staying on antidepressant medication (12 weeks) 58% 63% Avoiding antibiotics for adults with acute bronchitis 30% 40% Between National 50th and Avoiding X-ray, MRI and CT scan for low-back pain 77% 83% 75th Percentile Eye exam for people with diabetes 63% 68% Access to primary care (ages 65+) 84% 92% Between National 25th and Appropriate testing for children with sore throat 66% 85% 50th Percentile Cervical cancer screening 55% 73% Chlamydia screening 51% 69% Access to primary care (ages 2–6 years) 75% 93% Access to primary care (ages 7–11 years) 86% 96% Access to primary care (ages 12–19 years) 86% 95% Access to primary care (ages 12–24 months) 89% 98% Access to primary care (ages 20–44) 71% 87% Access to primary care (ages 45–64) 75% 92% Below National 25th Percentile Blood sugar (HbA1c) testing for people with diabetes 63% 92% Breast cancer screening 27% 71% Kidney disease screening for people with diabetes 71% 88% Medication safety: monitoring patients on high-blood pressure medications 82% 92% Spirometry testing to assess and diagnose COPD 22% 41% Well-child visits (ages 3–6 years) 58% 84%

National 90th percentile is based upon national benchmarks computed by the National Committee for Quality Assurance (NCQA). This refl ects the top 10 percent of performance across the nation. The source for this benchmark data contained in this publication is Quality Compass® 2015 and is used with the permission of the National Committee for Quality Assurance (“NCQA”). Any analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifi cally disclaims responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. Variation among Medical Groups for Cancer Screenings for Medicaid Insured

NCQA 90TH PERCENTILE STATE AVERAGE MEDICAL GROUP RATE

100%

90%

80% 73% 71% 70% 69%

60% 55% 51% 50% 43% 40%

30% 27%

20%

10%

Breast cancer screening Cervical cancer screening Chlamydia screening Colon cancer screening Variation among Accountable Communities of Health for Substance Use Disorder Services for Medicaid Insured Adults, Ages 18–64

STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 26% 28% Cascade Pacific Action Alliance 27% Greater Columbia 26% King 32% North Central 24% North Sound 33% Olympic 31 % Pierce 22% SW WA Regional Health Alliance 29% 0% 20% 40% 60% 80% 100% Variation among Counties for Substance Use Disorder Services for Medicaid Insured Adults, Ages 18–64

STATE AVERAGE: 28%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 38% Pend 38% Okanogan Oreille Skagit 26% Ferry Stevens 28% Island 37% 32% 26% 25% Clallam Snohomish 40% 31 % Chelan Jefferson 28% 28% Douglas Kitsap Lincoln Spokane King 24% 27% 24% 26% Grays Mason 32% Harbor 30% 32% Kittitas Grant Thurston Pierce 30% 20% Adams 22% Whitman 26% 17% 21% Pacific Lewis 31 % 20% Franklin Garfield Yakima 27% Wahkiakum 29% Walla 25% Cowlitz Benton Columbia Walla Asotin 28% Skamania 26% 20% 19% 23% 32% Clark Klickitat 29% 24% Variation among Accountable Communities of Health for Substance Use Disorder Services for Medicaid Insured Children, Ages 6–17

STATE AVERAGE BETTER AVERAGE WORSE 36% Better Health Together 31 % Cascade Pacific Action Alliance 46% Greater Columbia 27% King 37% North Central 34% North Sound 44% Olympic 47% Pierce 32% SW WA Regional Health Alliance 41% 0% 20% 40% 60% 80% 100% Variation among Counties for Substance Use Disorder Services for Medicaid Insured Children, Ages 6–17

STATE AVERAGE: 36%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 52% Pend Okanogan Oreille Skagit 46% Ferry Stevens Island 49% 28% 37% Clallam Snohomish 61% 40% Chelan Jefferson 30% Douglas Kitsap Lincoln Spokane King 42% 40% 32% Grays Mason 37% Harbor 44% 52% Kittitas Grant Thurston Pierce 36% 25% Adams 32% Whitman 43% 21% Pacific Lewis 47% 44% Franklin Garfield Yakima 29% Wahkiakum 24% Cowlitz Benton Walla Columbia Walla 49% 32% Asotin Skamania 30%

Clark Klickitat 40% 34% Variation among Accountable Communities of Health for Well-Child Visits for Medicaid Insured

90TH PERCENTILE STATE AVERAGE BETTER AVERAGE WORSE

Better Health Together 61% Cascade Pacific Action Alliance 61% Greater Columbia 58% King 56% 58% 84% North Central 45% North Sound 60% Olympic 58% Pierce 62% SW WA Regional Health Alliance 42% 0% 20% 40% 60% 80% 100% Variation among Counties for Well-Child Visits for Medicaid Insured

STATE AVERAGE: 58%

BETTER AVERAGE WORSE UNRATED

Whatcom San Juan 59% Pend Okanogan Oreille 42% Skagit 46% Ferry Stevens 59% Island 61% 52% 49% 58% Clallam Snohomish 58% 61% Chelan Jefferson 52% 62% Douglas Kitsap Lincoln Spokane King 55% 58% 52% 62% Grays Mason 56% Harbor 59% Grant 52% Kittitas Thurston Pierce 54% 38% Adams 62% Whitman 64% 64% 60% Pacific Lewis Franklin 44% 61% Garfield Yakima 58% Wahkiakum 59% Walla Cowlitz Benton Columbia Walla Asotin 64% Skamania 57% 55% 66% 59% 67% Clark Klickitat 41% 52% Variation among Medical Groups for Well-Child Visits for Medicaid Insured

NCQA 90TH PERCENTILE STATE AVERAGE MEDICAL GROUP RATE

100%

90% 84% 80%

70% 67%

60% 58%

50%

41% 40%

30%

20%

10%

Adolescent well-care visits Well-child visits (ages 3–6 years) Ranking Medical Group Performance for Commercially Insured: Medical Groups That Have Results for 15 or More Measures

Medical Group WORSE AVERAGE BETTER

Group Health Cooperative 1 4 23 Virginia Mason Medical Center 2 9 17 The Everett Clinic 2 13 13 Pacific Medical Centers 1 16 10 Swedish Medical Group 2 16 10 Edmonds Family Medicine 2 13 11 UW Neighborhood Clinics 23 4 The Polyclinic 3 12 12 UW Medicine - Valley Medical Group 2 16 9 Medical Center 2 13 10 Rockwood Clinic* 2 20 6 Lakeshore Clinics 2 18 6 Confluence Health 4 15 8 Harborview Medical Center* 11 6 Family Care Network 5 12 10 Kittitas Valley Healthcare 1 14 4 Women's & Family Health Specialists 14 3 Capital Medical Center 1 15 3 Hall Health Primary Care Center 2 13 5 Three Rivers Family Medicine 2 17 3 MultiCare Health System 5 16 6 Providence Medical Group - Spokane* 5 16 6 Lourdes Medical Center * 2 13 4 Memorial Physicians, PLLC 5 17 5 PeaceHealth Medical Group * 4 20 2 Southlake Clinic 3 11 5 Providence Medical Group- Southeast 1 16 Pullman Family Medicine 2 12 3 The Vancouver Clinic 4 15 3 North Olympic Healthcare Network 2 10 3 Providence Physicians Group 6 18 3 EvergreenHealth Medical Group 6 17 3 Family Medicine Of Grays Harbor 2 13 1 Kadlec Clinic* 7 17 4 Cascade Family Medical Clinic 3 8 4 Columbia Medical Associates 6 16 3 Island Hospital 3 10 3 Whidbey General Hospital and Clinics 3 12 2 Palouse Medical 4 9 4 Providence Medical Group - Southwest 5 11 4 Summit View Clinic 5 16 1 The Doctors Clinic 7 18 2 Pioneer Family Practice, PLLC 4 9 3 Tumwater Family Practice Clinic 7 9 6 Overlake Medical Clinics 7 14 3 Walla Walla Clinic 5 16 Northwest Physicians Network 8 17 2 Olympic Medical Center 6 7 5 Yelm Family Medicine 5 9 3 Community Health of Central Washington* 5 10 2 Columbia Basin Health Association* 5 7 3 Lake Serene Clinic 5 9 2 Neighborcare Health* 5 9 2 Trios Medical Group* 8 9 5 Samaritan Healthcare 5 10 1 Jefferson Healthcare 5 11 Skagit Regional Health* 9 11 4 Sound Family Medicine 9 17 1 Steck Medical Group 5 9 1 Western Washington Medical Group 10 13 4 Cascade Valley Hospital and Clinics* 6 11 Adventist Health Medical Group 6 10 Sunnyside Community Hospital & Clinics* 7 6 3 HealthPoint* 7 5 3 Mason General Hospital & Family of Clinics 8 5 3 Sea Mar Community Health Centers* 10 9 3 Whitman Medical Group 8 5 2 Yakima Valley Farm Workers Clinic* 9 7 1 Franciscan Medical Group 14 12 2 Physicians Immediate Care and Medical Center 11 10

30 20 10 0 10 20 30

* At least 50% of patients attributed to this medical group have Medicaid coverage. Based on claims and encounter data with dates of service between 1/1/2004 - 6/30/2015 and the measurement year of 7/1/2014 - 6/30/2015. Ranking Medical Group Performance for Commercially Insured: Medical Groups That Have Results of Between 5 and 14 Measures

Medical Group WORSE AVERAGE BETTER

FamilyCare of Kent 1 6 6 Family Health Care of Ellensburg 11 2 Overlake Internal Medicine Associates 2 8 4 South Island Medical 1 6 4 Spokane Internal Medicine 1 7 3 Women's Healthcare Alliance 5 3 Associates in Family Medicine 1 10 1 Northwest Hospital 2 10 2 Olympia Pediatrics, LLC 4 3 Summit Pacific Medical Center 2 8 3 Eastside Family Medicine Clinic 3 7 4 Ballard Pediatric Clinic 2 3 International Community Health Services* 4 2 Island Internal Medicine 1 8 1 Northwest Pediatric Center 4 2 Valley Women's Clinic 2 3 Whidbey Island Internal Medicine 6 1 Allegro Pediatrics 2 3 4 Center for Women's Health at Evergreen 3 2 Children's University Medical Group* 3 2 Harrison Medical Center 2 7 2 Northwest Orthopaedic Specialists 5 1 Overlake Obstetricians and Gynecologists 3 2 Peninsula Children’s Clinic 5 1 Children's University Medical Group (Hospital Physicians) 2 2 4 Community Health Association of Spokane* 2 6 2 Richmond Pediatrics* 1 2 3 Woodinville Pediatrics 1 2 3 Kootenai Health 1 3 2 Woodcreek Pediatrics* 2 3 3 Bellevue Family Medicine Associates 3 8 1 Country Doctor Community Health Centers* 1 4 1 Pediatrics Northwest, P.S.* 2 4 2 Providence Cardiology Associates 1 4 1 Sound Women's Care 1 2 2 Bastyr Center for Natural Health 3 7 1 Columbia Valley Community Health* 1 5 Coulee Medical Center 1 3 1 Kitsap Cardiology Consultants, P.L.L.C.* 1 5 Legacy Health 1 3 1 Moses Lake Community Health Center 3 5 2 Puyallup Endocrine & Nuclear Medicine Clinics* 1 3 1 Snoqualmie Valley Hospital 2 7 Willapa Harbor Hospital 4 9 1 Tri-State Memorial Hospital & Medical Center 2 3 1 Cascade Medical Center* 2 2 1 NorthShore Medical Group 2 4 PMH Medical Center* 2 4 Clallam County Hospital District 6 5 3 Columbia Basin Hospital 2 3 Interlake Medical Center, PLLC 3 5 Physicians Care Family Medicine* 2 3 Valley Children's Clinic* 3 3 1 Community Health Center of Snohomish County* 4 6 LG Steck Memorial Clinic 3 2 1 Newport Hospital and Health Services 4 4 1 Peninsula Community Health Services* 4 4 1 Renton Pediatric Associates 3 2 1 Mid-Valley Medical Group 3 3 The Doctors' Clinic of Spokane* 3 3 Jamestown Family Health Clinic 6 8 Lake Chelan Community Hospital & Clinics* 4 4 Lincoln Hospital 5 4 1 Planned Parenthood of the Great Northwest and the Hawaiian Islands* 6 6 1 Quality Care Medical Clinic* 6 8 Yakima Neighborhood Health Services* 3 2 South Hill General Medical Clinic* 5 4

15 10 5 0 5 10 15

* At least 50% of patients attributed to this medical group have Medicaid coverage. Based on claims and encounter data with dates of service between 1/1/2004 - 6/30/2015 and the measurement year of 7/1/2014 - 6/30/2015. Ranking Medical Group Performance for Medicaid Insured: Medical Groups That Have Results for 15 or More Measures

Medical Group WORSE AVERAGE BETTER

Group Health Cooperative 1 9 12 UW Medicine - Valley Medical Group 11 10 MultiCare Health System 2 12 10 The Everett Clinic 1 12 8 Harborview Medical Center* 1 7 10 UW Neighborhood Clinics 1 11 8 University of Washington Medical Center 1 12 7 Skagit Regional Health* 1 15 4 Swedish Medical Group 2 9 8 Sea Mar Community Health Centers* 4 14 7 Pacific Medical Centers 2 5 9 Providence Medical Group - Southwest 1 11 5 Columbia Medical Associates 2 6 8 HealthPoint* 4 14 6 Neighborcare Health* 3 12 6 Providence Physicians Group 2 8 7 Memorial Physicians, PLLC 1 9 5 Yakima Neighborhood Health Services* 1 9 5 Franciscan Medical Group 5 16 5 PeaceHealth Medical Group * 4 10 7 Rockwood Clinic* 4 12 6 Northwest Physicians Network 5 14 5 EvergreenHealth Medical Group 2 9 4 Kadlec Clinic* 4 12 4 Confluence Health 4 9 5 Yakima Valley Farm Workers Clinic* 5 11 5 Community Health Center of Snohomish County* 5 14 3 Providence Medical Group - Spokane* 4 14 1 Peninsula Community Health Services* 5 12 2 Community Health of Central Washington* 6 7 4

20 15 10 5 0 5 1015 20

* At least 50% of patients attributed to this medical group have Medicaid coverage. Based on claims and encounter data with dates of service between 1/1/2004 - 6/30/2015 and the measurement year of 7/1/2014 - 6/30/2015. Ranking Medical Group Performance for Medicaid Insured: Medical Groups That Have Results of Between 5 and 14 Measures

Medical Group WORSE AVERAGE BETTER

Virginia Mason Medical Center 9 5 Adventist Health Medical Group 8 2 Ear, Nose and Throat Clinic of the Northwest 1 2 6 Family Care Network 2 6 5 Summit Pacific Medical Center 6 3 Overlake Medical Clinics 1 5 4 Pediatrics Northwest, P.S.* 1 3 5 Sound Family Medicine 1 7 3 The Child and Adolescent Clinic 1 3 5 Allegro Pediatrics 1 2 5 Children's University Medical Group* 2 4 Columbia Basin Health Association* 2 6 4 International Community Health Services* 3 6 5 Lakewood Pediatric Associates* 2 4 North Olympic Healthcare Network 4 3 Northwest Pediatric Center 1 2 5 Samaritan Healthcare 10 Skagit Pediatrics LLP* 2 4 The Doctors Clinic 1 6 3 Jefferson Healthcare 1 7 2 Kitsap Children's Clinic, LLP* 3 3 Valley Young Peoples Clinic* 5 2 Walla Walla Clinic 1 3 4 Whitman Medical Group 3 3 Woodcreek Pediatrics* 2 3 5 Children's University Medical Group (Hospital Physicians) 4 2 Columbia Valley Community Health* 2 6 3 Island Hospital 6 1 Mason General Hospital & Family of Clinics 2 6 3 Olympia Pediatrics, LLC 2 3 Peninsula Children’s Clinic 4 2 Public Health- King County* 1 6 2 Western Washington Medical Group 1 8 1 Lake Chelan Community Hospital & Clinics* 3 2 Legacy Health 5 1 Providence Medical Group- Southeast 1 5 2 Renton Pediatric Associates 3 2 Olympic Medical Center 1 4 2 PMH Medical Center* 4 1 Southlake Clinic 1 2 3 The Polyclinic 3 6 3 Country Doctor Community Health Centers* 4 7 3 Harrison Medical Center 1 5 1 Ida Karlin Healing Center for Youth* 1 3 2 Kittitas Valley Healthcare 1 3 2 Palouse Pediatrics 5 Richmond Pediatrics* 1 1 3 Woodinville Pediatrics 1 3 2 Community Health Association of Spokane* 4 8 2 Cowlitz Family Health Center 3 6 2 NorthShore Medical Group 2 6 1 Reliance Medical Clinics* 1 4 1 The Doctors' Clinic of Spokane* 1 4 1 Tri-Cities Community Health* 4 8 2 Trios Medical Group* 3 8 1 Cascade Valley Hospital and Clinics* 2 5 1 Coulee Medical Center 1 3 1 Edmonds Family Medicine 1 3 1 Lourdes Medical Center * 2 5 1 Moses Lake Community Health Center 4 5 3 Planned Parenthood of the Great Northwest and the Hawaiian Islands* 2 5 1 Unity Care Northwest* 3 3 3 Valley Children's Clinic* 1 5 Yelm Family Medicine 1 3 1 Hall Health Primary Care Center 3 2 3 Quality Care Medical Clinic* 3 2 3 Whidbey General Hospital and Clinics 2 6 Clallam County Hospital District 2 3 1 Tri-State Memorial Hospital & Medical Center 2 3 1 Family Health Centers 2 4 Lincoln Hospital 2 2 1 Pediatric Associates of Whidbey Island 2 4 Sunnyside Community Hospital & Clinics* 4 6 1 Steck Medical Group 2 3 The Vancouver Clinic 5 5 2 Newport Hospital and Health Services 4 2 2 Mid-Valley Community Clinic PLLC* 3 1 1

10 5 0 5 10

* At least 50% of patients attributed to this medical group have Medicaid coverage. Based on claims and encounter data with dates of service between 1/1/2004 - 6/30/2015 and the measurement year of 7/1/2014 - 6/30/2015.