Highlight : 2020 Quality Composite Scores for ACHs and Counties

Overview

Using the Washington Health Alliance’s (Alliance) 2020 Community Checkup results, this highlight reports on the quality of care in Washington state’s Accountable Communities of Health (ACHs) and counties utilizing the Alliance’s Quality Composite Score methodology. The Quality Composite Score reports on performance on up to 29 measures considered to be indicators of strong primary care delivery referred to in the table below as “domains”:

• Prevention and Screening looks at the degree to which individuals are receiving recommended services on a timely basis, such as well-child visits, adolescent well-care, and screenings for chlamydia, breast, cervical, and colorectal cancer;
• Care for Chronic Diseases considers whether conditions such as diabetes, high cholesterol, depression, and hypertension are well-managed;
• Coordinated, Cost-Effective Care evaluates whether care avoids costly inpatient readmissions and potentially unnecessary emergency room visits; and
• Appropriate, Cost-Effective Care examines a variety of measures associated with the inappropriate use of specific services when other evidence-based alternatives exist, such as prescribing generic medications and avoiding the inappropriate use of antibiotics, as well as the use of x-rays, MRI and CT scans in certain cases of low-back pain.

This highlight reports on the results for all nine ACHs, 27 counties for the Medicaid population and 27 counties for those with commercial insurance. The remaining counties did not meet the minimum thresholds required for reporting. Additional background as well as a complete list of counties and the contents of each domain are included in the Quality Composite Score Overview.

What the Score Means

The composite percentile ranges between 0 and 100%. It represents the distribution of the composite scores and provides an understanding of each entity’s performance relative to others. For example, a county at the 80th percentile means we estimate its performance would exceed 80% of all other counties.

The composite score indicates how a particular entity (counties and ACHs in this report) performs relative to the Washington state average for each Community Checkup measure which is then combined within each domain. The final composite score is a weighted average of the four domains. A composite score of 0.0 indicates that the entity’s performance is the same as the state average. A positive score indicates better performance than the state average with a negative score indicating performance below the state average. The higher the score is (positive or negative), indicates the degree to which the entity’s performance is better or worse than the state average.

The domain score combines the county’s performance for the Community Checkup measures in a particular domain. As with the composite score, a domain score of 0.0 means the county’s or ACH’s performance is the same as the state average with positive or negative scores indicating better or worse performance than the state average.

The domain percentile ranges between 0 and 100% and represents the distribution of the entity’s domain performance relative to all others.

About the Visualization

Using the buttons on the top, select the ACH or county, the insurance type (commercial or Medicaid), and whether you want the domain scores to be reported.

The composite percentile will be shown first, the composite score second, and then the individual domain results will appear, if selected. Each column may be sorted by best to worst performance, from worst to best performance, and by alphabetical order. By hovering over the results, the domain percentiles are shown. By clicking on an entity’s name, you can select Organization Detail to see the entity’s complete Community Checkup results.

The colors indicate performance; dark green is better than average, grey is average, and dark red is below average.