Apple Health (Medicaid) and managed care reports

Apple Health managed care plans

Apple Health (Medicaid) contracts with five organizations who serve both as Managed Care Organizations (MCO) and Prepaid Inpatient Health Plans (PIHP):

Managed care report cards

Apple Health Plan Report Card

This report card shows how Washington Apple Health managed care plans compare to each other in key performance areas. The report card can be used as a guide to select a health plan for Apple Health coverage. 

Performance areas Coordinated Care Community Health Plan of Washington Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Getting care ★★☆ ★☆☆ ★★☆ ★★☆ ★☆☆
Keeping kids healthy ★★☆ ★★☆ ★★☆ ★☆☆ ★☆☆
Keeping women and mothers healthy ★★☆ ★★☆ ★★★ ★☆☆ ★☆☆
Preventing and managing illness ★☆☆ ★☆☆ ★★☆ ★★☆ ★☆☆
Ensuring appropriate care ★★★ ★★★ ★★☆ ★☆☆ ★☆☆
Satisfaction of care provided to adults ★★☆ ★★☆ ★★☆ ★★☆ ★★☆
Satisfaction with plan for adults ★★☆ ★★☆ ★★☆ ★★☆ ★☆☆

View the 2023 Apple Health Plan Report Card for more information.

Past Apple Health plan report cards

Value-Based Payment (VBP) Quality Report Card

This report card shows how Apple Health plans preformed in year 2023 and identifies where plans have met the criteria for the return of withhold dollars for the quality performance measure part of the value-based purchasing strategy.

View the 2023 Value-Based Payment Quality Report Card.

Managed care

Value-based payment measure Coordinated Care Community Health Plan of Washington Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Total percent achieved 57.1% 35.7% 85.7% 42.9% 64.3%

Foster care

Apple Health Integrated Foster Care VBP measure Coordinated Care
Total percent achieved 75%
Past value-based payment report cards

National Committee for Quality Assurance (NCQA) accreditation

Washington State Apple Health managed care organizations (MCOs) are required to have and maintain NCQA accreditation. Below is each plan and their NCQA accreditation status.

Additional report information is available using the NCQA Health Plan Report Card search.

NCQA Accreditation Community Health Plan of Washington Coordinated Care Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Rating Three and a half stars Three and a half stars Three and a half stars Three and a half stars Three and a half stars
Accreditation Type Health Plan Health Plan Health Plan Health Plan Health Plan
Plan Type Medicaid HMO Medicaid HMO Medicaid HMO Medicaid HMO Medicaid HMO
Status Provisional - Under Corrective Action Accredited Accredited Accredited Accredited
Distinction Electronic Clinical Data
Health Equity Accreditation
 
N/A

Electronic Clinical Data
Health Equity Accreditation

Electronic Clinical Data
Health Equity Accreditation

 

Electronic Clinical Data
Health Equity Accreditation

Apple Health managed care quality reports

Managed Care Quality Strategy
EQR annual reports (technical report)
External Quality Review (EQR) comparative and regional reports
Consumer Assessment of Healthcare Providers and Systems (CAHPS) reports

HCA uses surveys and other data collection to help measure Apple Health clients' experience with their health plans.

Adult

Child 

Parity analysis

Managed care plan enrollment

Most Apple Health clients are enrolled in a managed care plan. The following reports are for the Apple Health managed care population:

Apple Health client eligibility dashboard

The client dashboard is an interactive tool that helps answer questions about Apple Health eligibility.

How to use the dashboard

The following instructions demonstrate several ways to use the dashboard.

How to see people by county

Option 1: From the dropdowns on the left:

  1. Select the month.

  2. Select a program. (All) is the default.

  3. Select a county or leave the selection as default.

The dashboard will automatically refresh with the choices you select. Be sure to click Apply at the bottom of each dropdown to complete the selection.

Option 2: From the tabs at the top of the screen (above the HCA logo):

  1. Select Apple Health Client Map.
  2. Select a month from the dropdown on the left.

How to see a 12-month summary

  1. On the dashboard select month dropdown, choose most recent 12 months.
  2. Select Apply.
  3. Use other available filters to refine data further.

How to see eligible children

In the Select a program dropdown:

  1. Select Apple Health for Kids.
  2. Select Apply.
  3. Use other available filters to refine data further.