Health Reform in Washington State: Building Bridges Over Troubled Waters
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Health Reform in Washington State: Building Bridges Over Troubled Waters
- 1. Health Reform in Washington State: Building Bridges Over Troubled Waters*NASHP Annual MeetingOctober 6, 2010 Richard K Onizuka, PhD Health Policy Director Washington State Health Care Authority * with apologies to Paul Simon
- 2. Agenda Our early (pre ACA) health reform efforts Payment reform pilot Accountable care organizations Early impact of ACA ACA and the future of our health reform 2
- 3. Early Reform: You can’t always get what you want* Governor Gregoire’s five point plan to improve health care (2005) Evidence based medicine Data transparency Health information technology Chronic care management Wellness and prevention Blue Ribbon Commission (2006) Omnibus health reform package (ESSB 5930) * with apologies to the Rolling Stones 3
- 4. Where We Started: Stairway to Heaven?* 2010 Health Reform Initiatives 2009 Health InsurancePartnership Payment Reform 2008 HITECH SHAP grant 2007 2006 Health Insurance Partnership PSHA Community Checkup 2005 Health Record Bank Pilots Patient Decision Aids Quality Forum Health Technology Assessment Prescription Drug Program Health Information Infrastructure Advisory Board 4 * with apologies to Led Zeppelin
- 5. Multi-Payer Medical Home Reimbursement Pilot: Money* Legislation authorizes State and PSHA to convene participant group August, 2009 Eight regional and national health plans committing to participate What’s the goal? Two payment models, based on outcomes, to begin early 2011 Advanced practices, baseline data * with apologies to Pink Floyd 5
- 6. Accountable Care Organizations: Come Together* Legislation (SSB 6522) Lead organization (LO) to implement two ACO pilots by January 1, 2012 One integrated and one network LO appointed August 30, 2010 Group Health Cooperative Coordinate with Multi-payer Medical Home Reimbursement Pilot * with apologies to the Beatles 6
- 7. Preparing for ACA: ChChChanges* Early opportunities – Basic Health waiver Budget realities: $3-$4B shortfall for 2011-2013 Driving delivery system transformation:Health Insurance Partnership and an exchange * with apologies to David Bowie 7
- 8. What’s Next: The long and winding road* Opportunities to expand payment reform and ACO pilots PCORI and Washington’s evidence based medicine programs Expansion of performance measurement: All payer claims database? Value based purchasing and benefit design * with apologies to the Beatles 8
- 9. Finally: We’ve got to get out of this place* * With apologies to the Animals 3
- 10. Questions? http://www.governor.wa.gov/priorities/healthcare/reform.asp http://www.hca.wa.gov/ http://www.pugetsoundhealthalliance.org/ http://www.wacommunitycheckup.org/ 10
Notas del editor
- Access -> cost -> qualityProviding high quality, affordable health care to Washingtonians based on the recommendations of the blue ribbon commission on health care costs and access
- Multiple payers = critical massPilot is early step in larger transitionTransformative payment reform: pay differently, for what?Two payment models for different practice typesFinding the “sweet spot” for payers, providersGOAL: cost savings vs system transformationASO clientsScale and scopeMedicare participation?
- Infrastructure:Governor’s health cabinetHealth insurance exchangeLow income expansionworkforceConsolidated health purchasingMedicaid and state employees (HCA)Legislative Joint Select Committee & Commissioner’s Realization committeeEarly opportunities:BH Waiver
- Patient Centered Outcomes Research Institute: Board of GovernorsFindings from CER may not be construed as mandates, guidelines, or recommendations for payment, coverage, or treatment or used to deny coverage