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District of Columbia

A collection of resources on health system performance in District of Columbia.

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Featured Performance Indicators

4%

Uninsured adults
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115

Mortality amenable to health care, deaths per 100,000 population
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135

Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
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District of Columbia Performance Data

Show All Performance Areas
Access to Health Care
Children
Consumer Insurance and Medical Costs
Health Care System Spending
Health Insurance Coverage
Health Status and Outcomes
Hospital Safety and Quality
Mental Health
Older Adults
Outpatient Safety and Quality
Post-Acute Care and Long Term Care
Potentially Avoidable Care
Preventive and Well Care
Working Age Adults
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Access to Health Care

Access to Health Care
Indicator
Latest
U.S. Avg.
Adults who went without care because of cost
7%
2020
10.7%
Adults with a usual source of care
76.8%
2020
76.8%
Adults with any mental illness reporting unmet need
37%
2018-19
25%
Adults with any mental illness who did not receive treatment
55%
2018-19
56%
Adults without a dental visit
32.2%
2020
35.3%
Children who received needed mental health care
74.8%
2019-20
81.3%
Children with a medical and dental preventive care visit in the past year
72.4%
2019-20
65.7%
Children with a medical home
44.7%
2019-20
46.8%

Children

Children
Indicator
Latest
U.S. Avg.
Children who are overweight or obese
29.4%
2019-20
32.1%
Children who received needed mental health care
74.8%
2019-20
81.3%
Children with a medical and dental preventive care visit in the past year
72.4%
2019-20
65.7%
Children with a medical home
44.7%
2019-20
46.8%
Children with all recommended vaccines
71%
2020
73%
Infant mortality per 1,000 live births
5
2019
5.6
Uninsured children
-
2020
5.4%
Consumer Insurance and Medical Costs
Consumer Insurance and Medical Costs
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who went without care because of cost
7%
2020
10.7%
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,760
2020
$4,813
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
5.5%
2020
6.9%
Employee deductible for employer-sponsored health insurance plans
$2,288
2020
$3,257
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
2.6%
2020
4.7%
Employee total potential out-of-pocket medical costs
$7,047
2020
$8,070
Employee total potential out-of-pocket medical costs, as a share of state median income
8.1%
2020
11.6%
Individuals with high out-of-pocket medical spending
5.6%
2019-20
7.3%
People with medical debt
7.3%
2020
14.6%
Total premium cost for employer-sponsored health insurance plans
$15,660
2020
$17,193
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
18%
2020
24.6%
Health Care System Spending
Health Care System Spending
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Doctors' office visit employer-sponsored insurance spending per enrollee
-
2019
$517
Doctors' office visit spending per Medicare beneficiary
$1,002
2020
$910
Home health spending per Medicare beneficiary
$329
2020
$507
Inpatient employer-sponsored insurance spending per enrollee
-
2019
$1,375
Inpatient spending per Medicare beneficiary
$2,957
2020
$2,488
Primary care spending as share of total, age 65 and older
4.8%
2020
5.5%
Primary care spending as share of total, ages 18–64
-
2019
7.2%
Primary care spending per beneficiary, age 65 and older
$639
2020
$702
Primary care spending per enrollee, ages 18–64
-
2019
$501
Public health funding
$366
2019
$40
Skilled nursing facility spending per Medicare beneficiary
$986
2020
$851
Total employer-sponsored insurance spending per enrollee
-
2019
$5,354
Total spending per Medicare beneficiary
$9,529
2020
$9,677
Health Insurance Coverage
Health Insurance Coverage
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Uninsured adults
4.3%
2020
12.4%
Uninsured children
-
2020
5.4%
Health Status and Outcomes
Health Status and Outcomes
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
24.2%
2020
32.8%
Adults who have lost six or more teeth
5.1%
2020
8.5%
Adults who report fair or poor health
8.7%
2020
12.3%
Adults who smoke
11.4%
2020
14.3%
Alcohol deaths per 100,000 population
12.1
2020
13.1
Breast cancer deaths per 100,000 female population
18.5
2020
19.1
Children who are overweight or obese
29.4%
2019-20
32.1%
Colorectal cancer deaths per 100,000 population
14.5
2020
12.9
Deaths of despair (suicide, alcohol, and poisoning) per 100,000 population
-
No data available
-
Drug overdose deaths per 100,000 population
58.1
2020
28.3
Hospital 30-day mortality
12.5%
07/2017 - 12/2019
13.3%
Infant mortality per 1,000 live births
5
2019
5.6
Maternal mortality per 100,000 live births
-
2019-2020
21.9
Mortality amenable to health care, deaths per 100,000 population
114.8
2019-20
86.8
Premature avoidable deaths per 100,000 population
338.8
2019-20
259.1
Premature deaths from preventable causes per 100,000 population
229.1
2019-20
173.2
Premature deaths from treatable causes per 100,000 population
109.7
2019-20
85.9
Public health funding
$366
2019
$40
Suicide deaths per 100,000 population
5.5
2020
13.5
Hospital Safety and Quality
Hospital Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Care Transition Preparedness (out of 100 points)
47
2020
51
Central line-associated blood stream infection (CLABSI), Standardized Infection Ratio
0.807
2020
0.857
Communication about medicines (out of 100 points)
58
2020
63
Communication with doctors (out of 100 points)
76
2020
80
Communication with nurses (out of 100 points)
71
2020
79
Hospital 30-day mortality
12.5%
07/2017 - 12/2019
13.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
35.9
2020
33.2
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
-
2019
3.1
Hospital discharge instructions for home recovery
84%
2020
86%
Hospital discharge planning and instructions for home recovery (out of 100 points)
84
2020
87
Hospitals with better-than-average patient experience ratings
17%
2020
48%
Patients' overall hospital experience (out of 100 points)
63
2020
71
Responsiveness of hospital staff (out of 100 points)
56
2020
66
Mental Health
Mental Health
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with any mental illness reporting unmet need
37%
2018-19
25%
Adults with any mental illness who did not receive treatment
55%
2018-19
56%
Alcohol deaths per 100,000 population
12.1
2020
13.1
Antidepressant use and adherence for depression
-
2019
45.3%
Children who received needed mental health care
74.8%
2019-20
81.3%
Deaths of despair (suicide, alcohol, and poisoning) per 100,000 population
-
No data available
-
Drug overdose deaths per 100,000 population
58.1
2020
28.3
Suicide deaths per 100,000 population
5.5
2020
13.5
Older Adults
Older Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Doctors' office visit spending per Medicare beneficiary
$1,002
2020
$910
Home health patients with a hospital admission
15%
2019
15%
Home health spending per Medicare beneficiary
$329
2020
$507
Hospital 30-day mortality
12.5%
07/2017 - 12/2019
13.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
35.9
2020
33.2
Inpatient spending per Medicare beneficiary
$2,957
2020
$2,488
Long-stay nursing home residents with a hospital admission
19%
2016
15%
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
135
2020
137.1
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
25.5
2020
29.4
Primary care spending as share of total, age 65 and older
4.8%
2020
5.5%
Primary care spending per beneficiary, age 65 and older
$639
2020
$702
Short-stay nursing home residents with a 30-day readmission to the hospital
19%
2016
19%
Skilled nursing facility spending per Medicare beneficiary
$986
2020
$851
Total spending per Medicare beneficiary
$9,529
2020
$9,677
Outpatient Safety and Quality
Outpatient Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
-
2019
67.9%
Appropriate antibiotic among adults with bacterial pneumonia
-
2019
57.2%
Post-Acute Care and Long Term Care
Post-Acute Care and Long Term Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Home health patients whose wounds healed after an operation
92%
2019
92%
Home health patients with a hospital admission
15%
2019
15%
Home health patients with improved mobility
77%
2019
80%
Home health spending per Medicare beneficiary
$329
2020
$507
Long-stay nursing home residents with a hospital admission
19%
2016
15%
Nursing home residents with an antipsychotic medication
9.5%
2020
14.4%
Nursing home residents with pressure sores
10.4%
2017
5.6%
Short-stay nursing home residents with a 30-day readmission to the hospital
19%
2016
19%
Skilled nursing facility spending per Medicare beneficiary
$986
2020
$851
Potentially Avoidable Care
Potentially Avoidable Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
-
2019
67.9%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
35.9
2020
33.2
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
-
2019
3.1
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
135
2020
137.1
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
-
2019
150.6
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
25.5
2020
29.4
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
-
2019
5.3
Preventive and Well Care
Preventive and Well Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with age- and gender-appropriate cancer screenings
76.3%
2020
68.8%
Adults with age-appropriate vaccines
53.8%
2020
43.6%
Adults without a dental visit
32.2%
2020
35.3%
Children with a medical and dental preventive care visit in the past year
72.4%
2019-20
65.7%
Children with all recommended vaccines
71%
2020
73%
Diabetic adults with an annual hemoglobin A1c test
-
2019
91.9%
Diabetic adults with an annual LDL-C test
-
2019
80%
Premature avoidable deaths per 100,000 population
338.8
2019-20
259.1
Premature deaths from preventable causes per 100,000 population
229.1
2019-20
173.2
Premature deaths from treatable causes per 100,000 population
109.7
2019-20
85.9
Primary care spending as share of total, age 65 and older
4.8%
2020
5.5%
Primary care spending as share of total, ages 18–64
-
2019
7.2%
Primary care spending per beneficiary, age 65 and older
$639
2020
$702
Primary care spending per enrollee, ages 18–64
-
2019
$501
Public health funding
$366
2019
$40
Working Age Adults
Working Age Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
24.2%
2020
32.8%
Adults who have lost six or more teeth
5.1%
2020
8.5%
Adults with low back pain with an imaging study at diagnosis
-
2019
67.9%
Antidepressant use and adherence for depression
-
2019
45.3%
Appropriate antibiotic among adults with bacterial pneumonia
-
2019
57.2%
Diabetic adults with an annual hemoglobin A1c test
-
2019
91.9%
Diabetic adults with an annual LDL-C test
-
2019
80%
Doctors' office visit employer-sponsored insurance spending per enrollee
-
2019
$517
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,760
2020
$4,813
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
5.5%
2020
6.9%
Employee deductible for employer-sponsored health insurance plans
$2,288
2020
$3,257
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
2.6%
2020
4.7%
Employee total potential out-of-pocket medical costs
$7,047
2020
$8,070
Employee total potential out-of-pocket medical costs, as a share of state median income
8.1%
2020
11.6%
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
-
2019
3.1
Inpatient employer-sponsored insurance spending per enrollee
-
2019
$1,375
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
-
2019
150.6
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
-
2019
5.3
Primary care spending as share of total, ages 18–64
-
2019
7.2%
Primary care spending per enrollee, ages 18–64
-
2019
$501
Total employer-sponsored insurance spending per enrollee
-
2019
$5,354
Total premium cost for employer-sponsored health insurance plans
$15,660
2020
$17,193
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
18%
2020
24.6%
Uninsured adults
4.3%
2020
12.4%
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District of Columbia Policy Information

Policy
Status
Medicaid Expansion Status

Traditionally expanded Medicaid (31 states + DC)

Health Insurance Marketplace Type

State-based marketplace (17 plus DC)

The state is responsible for all marketplace functions, including health plan management, consumer assistance, eligibility and enrollment, financing, and marketing and outreach. The state manages its own marketplace website where individuals can enroll in coverage.

Public Coverage Options

Has not established a public coverage option

Annual Open Enrollment Period Extensions

Extended 2022 open enrollment

Extended the 2022 open enrollment period until the end of the COVID-19 public health emergency.

Extended the 2018 open enrollment period through Jan. 31, 2018, the 2019 open enrollment period through Feb. 6, 2019, and the 2020 open enrollment period through Feb. 5, 2020 and also from Mar. 12, 2020 through Dec. 31, 2020. Extended the 2021 open enrollment period until the end of the COVID-19 public health emergency.**

Health Coverage Subsidies

Provides no premium or cost-sharing subsidies

Non-compliant Short-term Plans

Sets stricter limits on the sale of short-term coverage than the federal government

Does not prohibit underwritten short-term coverage*

Limits the initial contract duration of underwritten short-term coverage to 3 months**

Underwritten short-term coverage cannot exceed 3 months per insurer in a 12-month period***

Non-compliant Transitional Plans

Prohibits non-compliant transitional policies

Does not permit insurers to sell non-compliant transitional policies in the individual market

Other Non-compliant Plans

Does not exempt other coverage from insurance rules

Does not exempt other coverage products from federal and state rules for individual market insurance*

Promotion of ACA Marketplace Competition

One or more rules to promote marketplace competition

Established the following rules to promote a competitive ACA marketplace:

– Merged its individual and small-group markets to create a broader risk pool

– Requires all individual market coverage to be sold through the ACA marketplace

– The District requires insurers to merge the claims experience of its individual and small-group markets for purposes of developing the premium index rate. The index rate may then be modified to account for market-specific effects of risk adjustment.

Standardized Individual Market Plans

Requires standardized cost-sharing plan design

Requires participating individual market insurers to offer plans with standardized cost-sharing designs

Does not require all individual market plans to be standardized

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District of Columbia Key Demographics

700K
Total Population
$94.3K
Median Household Income
22%
Below 200% of Federal Poverty Level (FPL)
37%
% White race, non-Hispanic
42%
% Black race, non-Hispanic
11%
% Hispanic ethnicity
5%
% Asian American, Native Hawaiian, or Pacific Islander race, non-Hispanic
< 1%
% American Indian or Alaska Native race, non-Hispanic