5 Things Washington: Sen. Annette Cleveland, budget “asks,” What you missed

This month’s event in Spokane was a strong one.  Thank you to everyone that joined us at the Convention Center!  Next month, we hold our Convening Panel meeting for our January event, the 2019 Washington State of Reform Health Policy Conference.  If you have ideas for speakers, now is a great time to send us your ideas for sessions and topics!

DJ 5 Things Signature

With help from Marjie High and
Emily Boerger

1. Podcast: A conversation with Sen. Annette Cleveland

Senator Annette Cleveland represents Washington’s 49th legislative district, covering central and west Vancouver. In her day job, Cleveland works in the healthcare sector as the Federal Government Affairs Officer at Legacy Health, and in the Washington State Senate she serves as Chair of the Senate and Long Term Care Committee.

In this podcast, I sat down with Senator Cleveland at the 2018 INW State of Reform Health Policy Conference to discuss her district, her views on the upcoming elections, and some of her key healthcare priorities heading into the 2019 legislative session. If you don’t know her well, this is a great conversation with her that gets to the heart of how she approaches the job of legislating. Take a listen here, and be sure to subscribe!

2. Reviewing agency budget “asks”

The Office of Financial Management has made available most of the “Decision Packages” submitted to Governor Inslee for review.  These packages are the set of “asks” made by state agencies to the governor’s office.  Some fall within the budget scope allotted by OFM.  Some, when taken together, exceed the total amount of funding that the agency was otherwise authorized to budget.  They come listed in priority order for the governor’s review.  His budget, which includes the final decisions on these “asks” will come out in December.

We review the asks of three state agencies here:  HCA, DOH, DCYF.  Notably, the HCA is asking for $57m in new funds to cover savings previously promised and “booked” under the Healthier Washington initiative, but which are not expected to materialize.

3.  What you missed in Spokane

If you weren’t able to make it to the conference, don’t worry, we’ve got you covered. You can check out this highlight video from the conference to get a feel for the sights and sounds of the event, and you can view the speaker presentations that were shared as well.

We’ve also captured our keynote discussions and presentations for you to review. US Dept. of HHS Region X Director John R. Graham kicked off the day with our morning keynote. During the lunch hour, Rep. Cathy McMorris Rodgers offered remarks via teleconference, followed by a dynamic executive keynote panel. And, Lisa Brown rounded out the day with the afternoon keynote.

4.  King Co and Seattle executive budget proposals sent to councils

Dow Constantine and Jenny Durkan unveiled their executive budget proposals for 2019-2020 on Monday. Constantine’s King Co budget highlights the county’s transition to Integrated Managed Care for behavioral health services with the addition $2.6 mil for eight new program manager positions. It adds almost $19.7 mil to the BH budget overall and $21.9 mil to public health. Investments in homelessness prevention are sprinkled throughout with an emphasis on increasing shelter options and strengthening linkages to BH services through case management and community treatment.

Mayor Durkan’s budget proposal adds $2.9 mil to address homelessness, though mainly through a number of upstream prevention programs. Though a total of $89.5 mil would be spent on homelessness services, the budget only provides $460,000 for case management and behavioral health assistance.


5.  The future of commercial health plans

Since 2014, lots of energy has been spent to innovate in the commercial/PPO market. Plan stakeholders tell me market consolidation among providers has limited the ability to address cost pressures. Meanwhile, I’m also told employers are largely unwilling to trade constrained networks for a price break.

So, within that context, this commentary from Vimly’s CEO Shannon Jurdana is worth a review. It highlight three things that commercial health plans should be keeping an eye on.  One takeaway:  higher margin business is getting harder to manage effectively and administratively more complex.