Spotlight on Washington: 2014 scorecard on Washington’s health system performance

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Spotlight on Washington: 2014 scorecard on Washington’s health system performance

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 18th to 15th 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).

scorecard_chart_annotated

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. 

2014 Commonwealth Fund Scorecard Measures

Washington state performance ranking

Data source and year

Access and affordability
Adults ages 19-64 uninsured Third quartile 2011/12 CPS ASEC survey
Children ages 0-18 uninsured Second quartile 2011/12 CPS ASEC survey
Adults who went without care because of the cost in the past year Second quartile 2012 BRFSS survey
Individuals under age 65 with high out-of-pocket medical costs relative to their annual household income Third quartile 2011/12 CPS ASEC survey
At-risk adults without a routine doctor visit in the past two years Bottom quartile 2012 BRFSS survey
Adults without a dental visit in the past year Second quartile 2012 BRFSS survey
Prevention and treatment
Adults with a usual source of care Third quartile 2012 BRFSS survey
Adults ages 50 and older who received recommended screening and preventive care Second quartile 2012 BRFSS survey
Children with a medical home Second quartile 2011/12 NSCH survey
Children with a medical and dental preventive care visit in the past year Second quartile 2011/12 NSCH survey
Children with emotional, behavioral, or developmental problems who received needed mental health care in the past year Bottom quartile 2011/12 NSCH survey
Children ages 19–35 months with all recommended vaccines Bottom quartile 2012 NIS survey
Elderly patients who received a high-risk prescription drug Second quartile 2011 5% Medicare enrolled in part D
Elderly patients who received a contraindicated prescription drug Second quartile 2011 5% Medicare enrolled in part D
Medicare patients experienced good communication with provider Bottom quartile 2013 CAHPS patient survey
Hospital 30-day mortality Bottom quartile 2008/11 CMS hospital compare
Hospital discharge instructions for home recovery Second quartile 2011 HCAHPS survey
Patient-centered hospital care Third quartile 2011 HCAHPS survey
Home health patients who get better at walking or moving around Bottom quartile 2012/13 OASIS CMS home health compare
Home health patients whose wounds healed after an operation Third quartile 2012/13 OASIS CMS home health compare
High-risk nursing home residents with pressure sores Second quartile 2012/13 MDS CMS nursing home compare
Nursing home residents with an antipsychotic medication Second quartile 2012/13 MDS CMS nursing home compare
Avoidable hospital use and cost
Hospital admissions for pediatric asthma, per 100,000 children Second quartile 2010 HCUP, AHRQ
Medicare admissions for ambulatory care–sensitive conditions, ages 65–74, per 1,000 beneficiaries Top quartile 2012 Chronic Condition Warehouse- Medicare
Medicare admissions for ambulatory care–sensitive conditions, age 75 and older, per 1,000 beneficiaries Top quartile 2012 Chronic Condition Warehouse- Medicare
Medicare 30-day hospital readmissions, per 1,000 beneficiaries Top quartile 2012 Chronic Condition Warehouse- Medicare
Short-stay nursing home residents with a 30-day readmission to the hospital Second quartile 2010 MedPAR, MDS-Medicare
Long-stay nursing home residents with a hospital admission Top quartile 2010 MedPAR, MDS-Medicare
Home health patients also enrolled in Medicare with a hospital admission Top quartile 2012 CMS Home Health Compare- Medicare claims
Potentially avoidable ED visits among Medicare beneficiaries, per 1,000beneficiaries Top quartile 2011 5% Medicare SAF
Health Insurance premium for employer sponsored single-person plans Top quartile 2012 MEPS survey, AHRQ
Total Medicare (Parts A & B) reimbursements per enrollee Top quartile 2012 Chronic Condition Warehouse- Medicare
Healthy lives
Mortality amenable to health care Top quartile 2009/10 CDC NVSS
Years of potential life lost before age 75 Top quartile 2010 CDC WISQARS
Breast cancer deaths per 100,000 female population Second quartile 2010 CDC Wonder
Colorectal cancer deaths per 100,000 population Top quartile 2010 CDC Wonder
Suicide deaths per 100,000 population Third quartile 2010 CDC Wonder
Infant mortality, deaths per 1,000 live births Top quartile 2009 CDC Wonder
Adults with poor health-related quality Third quartile 2012 BRFSS survey
Adults who smoke Top quartile 2012 BRFSS survey
Adults who are obese Second quartile 2012 BRFSS survey
Children who are overweight or obese Top quartile 2011/12 NSCH survey
Adults who have lost six or more teeth Top quartile 2012 BRFSS survey

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.

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