Apple Health (Medicaid) and managed care reports
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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):
- Community Health Plan of Washington (CHPW)
- Coordinated Care (CC)
- Molina Healthcare of Washington, Inc. (MHW)
- UnitedHealthcare Community Plan (UHC)
- Wellpoint Washington (previously Amerigroup) (WLP)
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) |
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Getting care | ★☆☆ | ★★☆ | ★★☆ | ★★☆ | ★☆☆ |
Keeping kids healthy | ★★☆ | ★★☆ | ★★☆ | ★☆☆ | ★☆☆ |
Keeping women and mothers healthy | ★★☆ | ★★☆ | ★★★ | ★☆☆ | ★☆☆ |
Preventing and managing illness | ★☆☆ | ★☆☆ | ★★☆ | ★★☆ | ★☆☆ |
Ensuring appropriate care | ★★★ | ★★☆ | ★☆☆ | ★☆☆ | ★☆☆ |
Satisfaction of care provided | ★★☆ | ★★☆ | ★★☆ | ★★☆ | ★★☆ |
Satisfaction with plan | ★★☆ | ★★☆ | ★★☆ | ★★☆ | ★★☆ |
View the 2024 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 2024 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 2024 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 | 83.3% | 100% | 83.3% | 66.7% | 66.7% |
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 | Accredited - Under Corrective Action | Accredited | Accredited | Accredited | Accredited |
Distinction | Electronic Clinical Data Health Equity Accreditation |
Health Equity Accreditation | Electronic Clinical Data Health Equity Accreditation |
Electronic Clinical Data Health Equity Accreditation |
Electronic Clinical Data Health Equity Accreditation Health Equity Accreditation Plus |
Apple Health managed care quality reports
- Managed Care Quality Strategy
- Annual EQR Technical Report
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- January 2024 report (Measurement year 2022)
- January 2023 report (Measurement year 2021)
- January 2022 report (Measurement year 2020)
- Annual Comparative Analysis Report
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- 2023 with Appendix A, B, C, and F
- Appendix D: Regional comparison results
- 2022 with Appendix A: Methodology
- Appendix C: Measure tables (includes NCQA benchmarking)
- Appendix D: Regional comparison results
- Appendix E: Measure comparison by race/ethnicity, three-year trend
- 2021 with Appendix A and E
- 2023 with Appendix A, B, C, and F
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) reports
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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 managed care enrollment by plan and county
- Summary of Apple Health managed care enrollment for the past 12 months by plan and county
- Summary of behavioral health managed care enrollment for the past 12 months by plan and county
Managed care program annual reports
- Integrated foster care (IFC) (2023)
- Integrated managed care (IMC) (2023)
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
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The following instructions demonstrate several ways to use the dashboard.
How to see people by county
Option 1: From the dropdowns on the left:
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Select the month.
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Select a program. (All) is the default.
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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):
- Select Apple Health Client Map.
- Select a month from the dropdown on the left.
How to see a 12-month summary
- On the dashboard select month dropdown, choose most recent 12 months.
- Select Apply.
- Use other available filters to refine data further.
How to see eligible children
In the Select a program dropdown:
- Select Apple Health for Kids.
- Select Apply.
- Use other available filters to refine data further.
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