5 Things Washington: OIC rules, Bree Collaborative, Rep. Kim Schrier

One of the new elements of our upcoming conference is our Pre-Conference Sessions on January 8th, the day before the main event. By “new,” I mean this will be the third year we’ve hosted these in response to folks asking for an opportunity for a “deep dive” into specific subject areas.

Next week, we’ll post 6 or 7 Pre-Conference Session titles. Folks can “vote” for their preference by registering. We’ll take three sessions with up to 30 folks per session, and refund any registrations for sessions that are canceled.

So, if you have an interest in a “deep dive,” two-hour session into a topic, let me know what the topic might be. We can see what the rest of the community thinks about it based on their votes in the weeks to come.



With help from Emily Boerger

1. Bree Collaborative’s maternity bundle

The Dr. Robert Bree Collaborative — a group of stakeholders that work to identify evidence-based strategies to improve quality, costs, and outcomes of care — has focused on improving maternal care in Washington State for several years. But, last summer the Bree Collaborative began a big project in obstetrics and worked to create a proposed bundled payment model for maternity care.

The draft payment model specifies that the fixed payment would include prenatal care (270 days prior to delivery), labor and delivery, and postpartum care (84 days post-delivery). Services covered would include prenatal screenings, education, postpartum visits, and patient supports, among others. The Bree Collaborative will hold a November meeting on the draft before opening up a 4-week comment period.

2. US Rep. Kim Schrier on prescription drug costs

After several pieces of health legislation were marked up by the House Ways and Means Committee on Tuesday, reporter Michael Goldberg caught up with Rep. Kim Schrier for an update on health legislation from Congress. As both a doctor and a person with a pre-existing condition, Rep. Schrier brings a unique perspective to crafting policy.

Topics discussed include her bill to expand Medicare to include routine vision benefits, Nancy Pelosi’s bill to lower the cost of prescription drugs, and her approach toward health legislation more broadly.


3. The OIC has a lot on its plate right now…

The Office of the Insurance Commissioner is busy. They have 16 rules they are currently working on and they expect to have nearly all finalized by the end of the year. They are also conducting stakeholder work ahead of more rule making and implementation of the recent balance billing legislation.

Emily Boerger reviewed the OIC’s proposed rules in this story. Eight of the rules are estimated to be “complex” and touch on issues related to network adequacy, incorporating ACA provisions into state law, and improving access to reproductive health. A list of the 2019 proposed draft rules along with scheduled meetings and public comment dates are available here.

4. Video: Victoria Evans, Molina Healthcare

Victoria Evans is the Director of Behavioral & Physical Health Integration at Molina Healthcare. It’s an area where Medicaid organizations have spent tremendous time learning about how best to implement integrated care, something Washington is really a national leader on. Evans joins us in this edition of “What They’re Watching” to discuss differentiating populations and finding innovative ways to serve them.

“I really think about how we start to move the pendulum to focusing on earlier identification, intervention, and providing the right resources at the right time in the right ways — in ways that people actually want to get care. That we stop sort of saying, “this is how you access our system,” and start saying, “where are you naturally going to be and how do we bring services to you in a way that you’re ready to receive so we can continue to build?”


5. Advisory vote on Long Term Care Trust Act

Washington’s November 5 ballot will feature 12 advisory votes — allowing the public the chance to weigh in on the tax increases that took place during the recent legislative session. One of those advisory votes is on the 0.58% wage premium put in place through the passage of the Long-Term Care Trust Act.

The advisory votes are non-binding and won’t change any laws. But it does offer the chance to look at the gap between policy and public opinion. Advisory votes are somewhat controversial, especially among Democrats. A bill to get rid of them (SB 5224) passed out of committee last session, but failed to make it all the way through the legislature.