Health Reform in Washington State:

Building Bridges Over Troubled Waters*

NASHP Annual Meeting

October 6, 2010Richard K Onizuka, PhD

Health Policy Director

Washington State Health Care Authority * with apologies to Paul Simon

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

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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 Stones3

Where We Started: Stairway to Heaven?*

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* with apologies to Led Zeppelin

2007

Health Technology Assessment

Health Record Bank PilotsPatient Decision AidsQuality Forum

Health InsurancePartnershipPayment ReformHITECH

SHAP grant

Prescription Drug ProgramHealth Information Infrastructure Advisory Board

2006

2008

2009

2010

2005

Health Reform Initiatives

Health Insurance PartnershipPSHA Community Checkup

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

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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 Beatles6

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

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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

Finally: We’ve got to get out of this place*

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* With apologies to the Animals

Questions?

• http://www.governor.wa.gov/priorities/healthcare/reform.asp

• http://www.hca.wa.gov/• http://www.pugetsoundhealthalliance.org/• http://www.wacommunitycheckup.org/

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