The Washington Health Alliance’s Total Cost of Care Highlights analyze Washington state’s health care spending using payments by multiple health plans, and includes patient costs, deductibles, coinsurance, and co-payments. Spending is broken down by different categories including inpatient, outpatient, and prescription drugs, and more than 60 individual services. Using risk-adjustment, disease burden is reported comparing results to the state average, allowing for more equitable comparisons.
Results are reported for 2018, 2019, and 2020 for the commercially and Medicaid-insured populations. Due to differences between the methodologies used to obtain results for each report, comparisons between the two is inappropriate.
Released in July 2022, the Total Cost of Care for Medical Groups and Clinics Highlight reports cost on a per patient per month (PPPM) basis, using the Alliance’s Primary Care Physician Attribution Method to allocate all health care costs to a particular PCP regardless of where the associated services were received.
Released in March 2022, the Total Cost of Care Highlight reports on a per member per month (PMPM) basis across all counties and Accountable Communities of Health (ACHs).