5 Things Washington: Special session series, Q&As with Lt. Gov. candidates, Robyn Rothman

This might be one of the more packed 5 Things newsletters we’ve produced, with links to some really strong coverage and commentary. I hope you’ll find something of interest – and agree that the content you get from our team at State of Reform is unique in the market.

As you may know, since State of Reform launched a decade ago, we’ve never asked for payment for our content. It’s free to anyone who would like to get into the policy weeds with us and wrestle with the important questions in Washington State health care.

All of this work has been funded by folks that register and sponsor our annual conferences. That has allowed us to provide a different kind of content, one less concerned with “clicks” and less beholden to just a handful of underwriters.

Next week, I will send you a note about how our model has to change. No one is ready to go back to a large conference at the Westin or Spokane Convention Center any time soon, likely not until well into 2021. I think we have a plan to move forward, and I hope you’ll come along with us. More on that next week.





With help from Emily Boerger

1. Series: Health policy in the Special Session

Legislators will be meeting in June to respond to the fiscal impacts of COVID-19. They should start thinking about the policy implications of a post-COVID paradigm, too. Pre-COVID talking points won’t do the trick. So, in this new series titled “The Special Session,” we explore ideas for a post-COVID health system and how policy makers might support a new model for care. These are “think pieces” to support your creative brainstorming, not our advocacy positions.

Current posts discuss reinsurance, funding and executing a serological study, and reconsidering hospital and community funding models. While we frame this series around the special session, the reality is that any change will take an electoral mandate, strong stakeholdering, and a willingness of advocates to move from “playing defense” to working to shape a “new normal.”

If you want to share your thoughts on what a post-COVID world could look like, scribble them down and send them my way.


2. What the new MCO RFP means

Last week, the HCA surprised some in the market, including me, with a new RFP for MCOs. No incumbent plans are at risk, but in the 7 of 9 regions where fewer than five of the state’s MCOs operate, plans can apply to expand their service areas.

At first, this didn’t make sense to me. But, after talking it through with additional stakeholders, I think this reflects a continuing challenge of getting some behavioral health and SUD providers fully integrated into managed care. More importantly, I think this is a signal to expect a broader, full and open MCO reprocurement soon, perhaps in 2021.

3. More on reimagining hospital and community financing

During COVID, we’ve asked our health systems to turn operating suites into negative pressure ICUs, to cover all costs related to COVID testing, and to endure the financial peril of collapsing consumer demand. “Some may not survive,” says Swedish’s CEO. If we want a health system that is agile and resilient, we need a financing model that is prospective, predictable and doesn’t penalize providers financially for doing the right thing for the community, something I write about here.

I asked two of Washington State’s most well-regarded policy thought leaders to critique my piece, and to further a conversation about financial stabilization. Former HCA Director Dorothy Teeter builds on it, detailing a five-step approach towards population-based innovation. Bob Crittenden, Gov. Inslee’s former Sr. Policy Advisor, says the moment calls for holistic reforms but is doubtful that stakeholders are ready to meet the moment.


4. Rundown on the Lt. Gov. candidates

Washington’s lieutenant governor’s race already has interesting dynamics at play, with some candidates working to navigate campaign finance law and others hoping to avoid tricky electoral arithmetic. Moreover, if Gov. Inslee is selected to be part of a Democratic cabinet after 2020, the sitting lieutenant governor will become the new governor. While Gov. Inslee is running for re-election, he is in the mix to lead the EPA should Vice President Biden capture the Oval Office in the fall.

Reporter Michael Goldberg spoke with the four leading candidates for lieutenant governor in recent weeks to discuss their campaigns and visions for Washington State. Those posts are at our sister site, the Washington State Wire. Take a deep dive into their priorities in these Q&A’s with US Rep. Denny HeckSen. Steve HobbsAnn Davison Sattler, and Sen. Marko Liias.

5.  Video: Robyn Rothman, Health Care Without Harm

Robyn Rothman is the Associate Director of State Policy Programs at Health Care Without Harm, an organization that aims to transform health care to reduce its environmental impact and become “a community anchor for sustainability and a leader in the global movement for environmental health and justice.” She joins us in this edition of “What They’re Watching” to discuss the effects of climate change on health care.

“I think increasingly in the US, not just in health care, everyone is realizing that climate risks make things more expensive…We focus on the cost because sustainability work literally pays off with cost savings and that’s usually a big factor for hospitals…It pays off in the long run. We’ve done analysis about all the costs if you’re not prepared versus the much more minor investments to get prepared.”