Charges made at OIC | Kreidler response lackluster | Plans called “greedy”

The charges leveled against the Chief Deputy Commissioner at the OIC are serious. At best, they bring a cloud of bias to an agency which, as a regulator, needs to be seen as a dispassionate enforcer of the law.

We, like many tracking health care in the state, are watching as the story unfolds.

1. Claims of misconduct at the OIC are a big deal…

The PSBJ story citing allegations of official misconduct by OIC Chief Deputy Commissioner Jim Odiorne are perhaps the most significant charges against a senior state government official since the 1960’s when then-Gov. Rosellini faced accusations of connections to the mafia.

We summarized the legal filings in a post this morning.

Judges are supposed to be impartial arbiters of the law.  If, at the most challenging time in health care in a generation, one of the primary regulatory offices in health care thinks it appropriate to push judges to conform to politics, what should citizens expect of the office itself when it makes its own regulatory decisions?

2. … but it’s not clear the OIC understands why.

Watching Commissioner Kreidler’s response to the claims made by Judge Patricia Petersen has been disheartening.  Commissioner Kreidler is undeniably one the most important and respected voices in Washington State politics in the last thirty years.

If this is his last term, this will be a poor legacy to leave:  silencing a woman with a esteemed 19-year as the OIC Chief Presiding Officer on grounds that seem contrary to the clear legal direction.  At the same time, dismissing any possibility of wrongdoing by his chief deputy, while asking for an investigation by an entity paid for and reporting to the OIC, is not a strategy to clear the cloud that has resulted from these claims.

In fact, Commissioner Kreidler’s response has made the cloud worse.

3. The Everett Clinic leads on price transparency

It was front page news in the Everett Herald last week:  “The Everett Clinic revealing charges for some tests.”  Sure, this is only some of the prices.  And, sure, these are only the billed charges.  But the point is that some providers, regardless of legislation, are showing leadership on posting their prices – and earning the kudos for doing it.

We got a little more information from the Clinic to help shed light on the rationale for their market leadership.

4. Docs: “good.” Hospitals: “expensive.” Plans: “greedy.”

The language of health care is tricky.  Many parts of the industry use words that mean different things to different parts of the industry:  “costs,” “access,” “quality,” to name a few.  However, things get even more divergent when the language of voters and consumers is concerned.

A new poll of 3,687 voters asked what words come to mind when parts of the health care sector were named.  The answers were provided in the form of a word cloud so one can easily see which words were provided most often.  It provides one of the starkest manifestations in some time of how poorly health plans are viewed by the public.

5. The state shifting Medicaid procurement areas

SB 6312 and HB 2572 were different bills, but which moved the state in a similar direction:  towards the integration of financing and delivery of mental and physical health in Medicaid.  One of the areas initially to be aligned are the regions in which the HCA and DSHS will be contracting for Medicaid.

Those regions are being defined in the next few weeks as the Adult Behavioral Health System Task Force convenes.  The new “regional service areas” could lead to some disruption in referral and coverage patterns downstream, in addition to the benefits of administrative simplification.

Interestingly, however, while the impacts will be to patients, referring providers, and the health plans/RSNs which pay for it, the legislation only calls for county governments to have a voice in how the regions are determined.