Released in February 2022, “Total Cost of Care” analyzes 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. Results are reported on a per member per month (PMPM) basis across counties and Accountable Communities of Health (ACHs) for the commercially and Medicaid insured for calendar years 2018, 2019, and 2020. Using risk-adjustment, disease burden is reported comparing results to the state average, allowing for more equitable comparison across geographic areas.