5 Things Washington: Turnover at the HCA, US House Democrats, Leanne Berge

I plan to see almost 300 of you at our 2018 Inland NW State of Reform Health Policy Conference later this week on Thursday.  We’ll have the plenary sessions recorded on video, and some of the breakout sessions available for you via podcast.



With help from Marjie High and
Emily Boerger.


1. Turnover at the Health Care Authority

Yesterday, Laura Zaichkin announced she was leaving her role as Deputy Chief Policy Officer at the HCA. She was one of the primary executive sponsors of implementing the 1115 waiver, and for the organization of the ACH initiatives. With Zaichkin’s departure, and Nathan Johnson and Dorothy Teeter’s before that, it’s not clear which executive is the lead sponsor of the waiver’s ambitions, particularly those related to the ACH initiative.

With Zaichkin’s departure, the HCA lists 26 people as executive leadership at the agency. Of those, more than half (14) are new to the agency or new to their current position since 2017. More than one quarter (7) are new to the agency or to their position in 2018.


2. Video: Leanne Berge, Community Health Plan of Washington

Leanne Berge is the CEO of Community Health Plan of Washington, one of five managed care organizations providing benefits to Washington’s Apple Health members. She joins us in this episode of “What They’re Watching” to discuss integration around social determinants of health.  Her comments were recorded earlier this year, but are still very timely.

“We’re looking at how we can fold in the integrated model around the social determinants in particular, and recognizing that whether or not we’re in an integrated managed care region – you know like what we’ve been doing in Southwest – we want to bring that same level of intensity in terms of the full integrated model across the state.”


3.  Providence Health Plan quietly re-enters the WA insurance market

Two weeks ago, Providence Health Plan (PHP) became a new entrant into the Washington State health insurance marketplace.  Providence was one of the plans allowed to sell insurance products to school employees under the new School Employees Benefit (SEBB) RFI. Under HB 2408 passed in 2018,  as a SEBB participant, Providence will be required to list a silver and gold product on the individual ACA market where it offers school employee plans.

Providence Health Plan has been the largest, or one of the largest, plans on the Oregon ACA individual market. It’s reasonable to think they will be an aggressive player in Washington, likely well beyond the individual market.  PHP has had various levels of activity in Washington for the last few decades, but has been looking to extend its footprint here for some time.


4.  Medicaid, the ACA, and the 8th Congressional

Dino Rossi is running a TV ad hitting Kim Schrier for not taking enough kids covered by Medicaid in her pediatric practice. Whether the ad is effective, I don’t know. What strikes me as interesting is that something commonly accepted inside the health care industry – that doctors have to limit their Medicaid exposure – is portrayed as uncommonly negative in the political world. It shows the gap that continues to exist between the realities experienced in health care and those in politics.

State of Reform’s Marjie High explores the context of the ad in a piece here.  She points out that Rossi’s support for rolling back the ACA will create similar – perhaps more – hardships on kids and families. Eliminating the ACA’s premium subsidies hits middle class families the hardest. Repealing the ACA also allows underwriting and issuance discrimination based on pre-existing conditions, which has sometimes included being a woman.


5.  Dems in US House planning big health reform package

US House Democrats are planning a significant set of health care reform legislation as part of their three-pronged focus of issues to kickoff the start of the session, should they re-take the House this fall.  Report:  “Health care would be divided into two buckets: cost containment, including reining in premiums, and lowering the cost of prescription drugs.”

The Democrats’ platform, called “A Better Deal,” has a series of policy proposals, including a detailed write up on pharmacy costs. Notably, however, there is no similar proposal related to health care costs in general. In the Senate, a similar platform includes policies related to prescription drugs. But, importantly, it also includes language about market consolidation (in general, not just health care) as a major structural problem of the US economy, and something they will seek to address.  That is something that could impact a sector that has and continues to witness M&A activity across a broad swath of American health care.