The Commonwealth Fund recently released the Scorecard on State Health System Performance, 2014. Evaluating health systems across 42 quality, cost, and outcomes indicators, the report shines a light on what works and what doesn’t. The most dramatic improvements occurred when both national and state policymakers and health leaders created programs, incentives and collaborations to raise rates of children’s immunizations, improve hospital quality and lower hospital readmissions.

Overall, Washington slightly improved, moving up from 18^th to 15^th place nationwide. We remain, however, in the second quartile of performance overall. What this shows is that Washington is improving performance for avoidable hospital use and healthy lives measures, but still has work to do to improve access to care, equity and prevention.

Figure 1. The Commonwealth Fund 2009 and 2014 scorecard, Washington results highlighted (source).

Where we are improving

Washington reached top and second quartile performance for the Avoidable Hospital Use and Cost category, which measures things like avoidable emergency department visits. Another high performance area for Washington was in the Healthy Lives category, with top or second quartile results for all but two outcome measures―suicide deaths and adults with poor health-related quality―where Washington ranked in the third quartile.

What we can do better

The greatest area for improvement is in the Prevention and Treatment category where Washington ranked in the third and bottom quartiles for eight measures. In particular, Washington ranked in the bottom quartile for the following measures:

• Children with emotional, behavioral, or developmental problems who received needed mental health care in the past year
• Children ages 19–35 months with all recommended vaccines
• Medicare patients experienced good communication with provider
• Hospital 30-day mortality
• Home health patients who get better at walking or moving around

Additionally, Washington also ranked in the third and bottom quartiles for three of the Access and Affordability category, including a bottom quartile ranking for the At-risk adults without a routine doctor visit in the past two years measure.

Figure 2. Commonwealth Fund scorecard: Washington state performance ranking results, measures and data sources. 

Studies and reports like this are critical to instigating positive change in our health care system. We can’t change what we don’t measure. Our hope is that local health systems will look at these results and continue to improve how we deliver health care in Washington state.

More information

• Aiming Higher: Results from a Scorecard on State Health System Performance, 2014
• Interactive State Health System Scorecard