Washington Health Alliance

 

Important: The Washington Health Alliance is not a provider organization or health plan. Please do not attempt to use the Washington Health Alliance site to submit claims. 

 

About the Washington Health Alliance

As a purchaser-led, multi-stakeholder collaborative with 185 member organizations, the Washington Health Alliance is committed to leading health system change in Washington state. The Alliance has a bold vision: the physicians, other providers, and hospitals in the region will achieve the top 10 percent in performance nationally in the delivery of quality, evidence-based care and in the reduction of unwarranted variation, resulting in a significant reduction in medical cost trends. To achieve this goal, it will require the aligned efforts of those who give, get and pay for health care. 

What is the Community Checkup? 

The Community Checkup is a report that presents performance results for medical groups, clinics, hospitals and health plans, as well as counties and Accountable Communities of Health in Washington state. The report is intended to help everyone make more informed decisions and to motivate improvement in health care quality and value. The report relies on claims and encounter data supplied by health plans, self-insured purchasers, union trusts and the Washington State Health Care Authority (Medicaid). Data submitted for the report is de-identified and aggregated for reporting purposes. The following data suppliers shared their data to help create the report:

Health Issuers and Network Administrators

• Aetna Health and Life Insurance Company
• Asuris Northwest Health
• Bloodworks Northwest
• Cigna Health and Life Insurance Company
• Kaiser Foundation Health Plan of Washington
• Kaiser Foundation Health Plan of Washington Options, Inc.
• Lifewise Health Plan of Washington
• Premera Blue Cross
• Regence BlueShield
• UnitedHealthcare Insurance Company
• Washington State Health Insurance Pool

Managed Medicaid Plans

• Amerigroup
• Community Health Plan of Washington
• Coordinated Care
• Molina Healthcare of Washington
• UnitedHealthcare Community Plan

Medicaid

• Washington State Health Care Authority

Purchasers and Labor Trusts

• Association of Washington Cities
• The Boeing Company
• Carpenters’ Trust of Western Washington
• City of Seattle
• King County
• Puget Sound Energy
• Service Employees International Union 775
• Sound Health and Wellness Trust
• Washington State Health Care Authority Uniform Medical Plan
• Washington Teamsters Welfare Trust

Independent Practice Association - Provider Network

• First Choice Health 

 

How is the Community Checkup Created?

Assembling the measure results is a multi-step process that includes the following:

• Data Submission and Validation - Data suppliers submit claims and encounter data directly to Milliman, the data vendor for the project. Milliman works directly with data suppliers to validate the data submitted and the initial performance measure results.
• Medical Group Roster Updates - Medical groups are asked to update their clinician rosters and practice locations every year.
• Measure Calculation - Milliman removes patient identifying information to ensure privacy, aggregates the data and calculates measure results.
• Attribution of Results to Clinic Location - Milliman attributes patients to providers using agreed-upon attribution methods, approved by physicians. Then, provider results are attributed to clinics and medical groups based on clinic rosters maintained by the Alliance.
• Medical Group Review of Draft Results - The Alliance runs results and posts them to a secure online portal. Medical groups access and review their draft results via the secure portal and notify the Alliance of any potential data issues.
• Measure Results Finalized - The Alliance, Milliman, and the medical groups resolve data issues in order to finalize the dataset and run final results.
• Measure Results Made Public - Medical groups receive a detailed final report and a more general report is released to the public. Additionally, the results are incorporated into a searchable online tool on the Alliance web site at www.wacommunitycheckup.org.

For more information about the Community Checkup please visit www.WaCommunityCheckup.org.

For more information about the Alliance, please visit www.WAHealthAlliance.org.

Please direct questions about the Community Checkup report development process to:

Phone: 206.448.2570

Email: communitycheckup@wahealthalliance.org