Cross-System Outcome Measures for Adults Enrolled in Medicaid

As directed by Engrossed House Bill 1519 (Chapter 320, Laws of 2013)

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With the passage of Engrossed House Bill 1519 (Chapter 320, Laws of 2013) and Second Substitute Senate Bill 5732 (Chapter 338, Laws of 2013), the Washington State Legislature directed that contracts executed by the Department of Social and Health Services (DSHS) and the Health Care Authority (HCA) with service contracting entities (Managed Care Organizations, Behavioral Health Organizations, and Area Agencies on Aging) include measures related to shared client outcomes in the following areas:

  • Health and wellness
  • Participation in meaningful activities
  • Involvement with criminal justice systems
  • Reductions in avoidable costs in hospitals, emergency rooms, crisis services and criminal justice systems
  • Stable housing in the community
  • Client satisfaction with quality of life
  • Population‐level health disparities

Candidate measures were identified by workgroups created by the 5732/1519 Cross‐System Steering Committee convened by DSHS and the HCA. Workgroups included representation from approximately 60 community organizations, state agencies, and Tribes.

Note that data tables available from this site include both (1) measures selected for use in contracting and (2) measures that are provided for informational purposes that are not part of agency contracts with Behavioral Health Organizations, Area Agencies on Aging, or Managed Care Organizations.

Guide to Interpretation 

Geographical Information

Measure Specifications

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File Medicaid clients served by Area Agencies on Aging

File Medicaid enrollees with mental health service needs (BH)

File Medicaid enrollees with substance use disorders (BH)