The right model to improve health outcomes for Washington
A Look At The Numbers provides information on how Medicaid managed care organizations (MCOs) partner with Washington to provide care for a growing Medicaid population.
Medicaid managed care enables Washington to deliver higher quality care and improved health outcomes for Medicaid recipients, while managing healthcare costs.
The care people need when they need it. That is the model of managed care.
Medicaid in Washington
Washington’s Medicaid program, Apple Health, provides healthcare to many individuals facing economic and social barriers, as well as expanded benefits and services to improve their health and well-being.
Apple Health currently serves 2 million Washingtonians. This number has grown by over 100,000 people since February 2020.1 In Washington, Medicaid covers 1 in 6 adults, 3 in 8 children, 3 in 5 nursing home residents, and 1 in 3 individuals with disabilities.2 88% of Washingtonians on Apple Health are managed by MCOs.3
Washingtonians served by Apple Health1
Serving Washington since 1987
Washington has long been a leader in using MCOs to deliver healthcare to its citizens. The Health Care Authority (HCA) first implemented a Medicaid managed care program for physical health in 1987.4 Between 2016 and 2020, HCA worked to integrate physical health, mental health, and substance use disorder treatment services into one system for the millions who receive care through Apple Health.5
Apple Health launches in Washington.
Five MCOs serve the Medicaid population of Washington.6
Higher quality care
Improving population health
The managed care model is structured to hold MCOs to high standards set by federal and state governments. Washington requires all Apple Health plans to be accredited by the National Committee on Quality Assurance (NCQA). On NCQA’s overall rating scale of 0 to 5, the Apple Health MCOs have averaged between a 3.4 and 3.5 rating over the past three years, which is slightly above the national median in recent years.9
87% of the parents and caretakers of children under the age of 18 enrolled in Washington Apple Health rated their Medicaid plan 8 out of 10 or higher in a customer experience survey done in August 2019.10
Washington releases an annual Apple Health Plan quality report card which documents MCO performance and helps Medicaid-eligible enrollees choose a high-quality plan that is right for them. This report card is developed in collaboration with the state’s Health Care Authority and Washington Healthplanfinder.