5 Things Washington: McMorris Rodgers and Brown, Pablo Rodriguez of SEIU 775, and Short Term Plans

We’re gearing up for our 2018 Inland NW State of Reform Health Policy Conference coming up in just over two weeks. With a host of legislators, market executives, and thought leaders, the event is a powerful one-day convening.  If you’re already registered – thank you.  It’s the support of conference attendees that supports our content the other 364 days of the year!

And, if you haven’t signed up yet, you can do so here!  How easy is that?


DJ 5 Things Signature

With help from Marjie High and
Emily Boerger.

1.  ICYMI:  Cathy McMorris Rodgers and Lisa Brown join agenda in Spokane

We are excited to be hosting both candidates in the 5th Congressional District at next month’s 2018 Inland NW State of Reform Health Policy Conference.  Our non-partisan, policy agnostic convening will be one of the few events at which both candidates have agreed to speak.  Both will have a chance to present their thoughts on health care in the next Congress, and will join me for a one on one conversation to follow.

They join almost 70 speakers from across Washington State health care to talk through the most pressing issues, topics, and considerations in health care today.  If you haven’t registered yet, you can join about 300 of your closest friends in health care at the Spokane Convention Center in about two weeks time.


2. Video: Pablo Rodriguez, SEIU 775

Pablo Rodriguez is the Senior Executive of Insights and Innovation at SEIU 775 Benefits Group. He joins us in this edition of “What They’re Watching” to talk about some of those innovations in behavioral health, healthy weight, and safety.

“So, around behavioral health we’re really focused on how do we actually get home care workers access to behavioral health in a more timely manner. So a lot of times they’re dealing with highly anxiety provoking situations in and of a moment, so we’ve partnered with Ginger.iO, a tech-based solution, to actually be able to get them access to a coach right then and there.”

3.  Short term medical plans coming to WA?

The ACA essentially got rid of “short term limited duration” (STLD) health plans. Under the ACA, plans had to be one year long with a minimum set of benefits that fell into a set actuarial range – all things STLD plans don’t do. However, as a result of a Trump Administration rule, the OIC is now preparing a rule to re-allow such plans into the state with a set of relatively narrow provisions. The idea of STLD plans is they have reduced benefits and reduced costs. They tend to attract healthier people and thus undermine the risk pool consumers leave behind (usually the individual market).

Expect this to be taken up by the legislature. In California, a bill passed last week that would simply ban such plans.  I’d bet that approach gets some discussion in Olympia, too.

4.  School employees plans announced

The HCA released its apparently successful bidders for the new School Employees Benefit RFP.  Aetna, Kaiser, Premera and Providence were announced as the winners of the bid.  The HCA says that “each entity that bid was selected.”

It’s notable that Regence and United chose not to submit proposals for what will be a sizable pool of commercial beneficiaries. From the SEBB website: “Starting January 1, 2020, all K-12 school districts, educational service districts, and charter schools will be required to participate in the SEBB Program.”

5.  Medicare RFI on physician payments

CMS has been soliciting information to inform potential rule making related to value based provider contracting. One RFI related to changing Stark Law requirements drew 375 comments as of the close of its public comment period on August 24th, of which 200 are yet to have been made public.

Interestingly, the American Hospital Association is pushing for a full exception for any referrals that exist within a value based payment model. While that may have merit, it would also put a significant hole in Stark.  The definition of “value based payment” is still loose, and could vary widely. Meanwhile, Rebound, a SW Washington based orthopedic group, focuses its 5-page comment letter discrediting comments made by physical therapists.