Our state’s annual health care quality report, the Community Check-up, was released last week and identified gaps in care. Unfortunately, an insurance card doesn’t necessarily mean access to care or access to quality care. The latest report from the Washington Health Alliance compares clinics, medical groups, hospitals, counties and Accountable Communities of Health on common types of quality care, such as preventive screenings and care for chronic conditions. The Alliance community has agreed upon a goal that Washington State providers will be in the top ten percent of performance nationally. But we are falling well short of the national 90th percentile for many children’s health measures. Unfortunately, children insured through Medicaid fare even worse. For example, 69% of commercially insured Washington children receive the recommended six or more well-child visits in the first 15 months of life, while only 43% of Medicaid insured children meet that recommendation.