5 Things Washington: 5 Slides, Federal reinsurance program, Patty Hayes

One of the ways we are responding to this COVID crisis is to create interactive virtual conversations that tee up some of the most important issues and challenges in health care today. Next week, we host our first multi-state panel discussion called “5 Slides We’re Discussing.” You can read about it in item #1.

This event is free, though as we get our feet underneath us, we may add a small fee to these events over time. 100,000 small businesses have already disappeared. 1m small businesses are expected to evaporate. We’re working hard to change our business model to stay off that list!

Thanks for your support and encouragement for the work we’re doing.





With help from Emily Boerger

1. Introducing “5 Slides We’re Discussing”

State of Reform tries to serve as a platform to build community, inform conversations, and elevate some of the most interesting voices and challenges in health reform today. We do this through our daily health care reporting across nine states, our newsletters like this one, and through our annual State of Reform health policy conferences.

So, during this time of COVID and “Stay Home” orders, we are launching a new series called “5 Slides We’re Discussing.” The 5 Slides conversation will gather a panel of some of health care and health policy’s most thoughtful minds around a discussion of five slides. Panelists will bring slides with graphics, data points, or illustrations of what they see as the most important challenges facing the sector today.

Our first conversation, “5 Slides: How Medicaid MCOs are dealing with COVID,” will take place on Wednesday, May 20, from 12pm – 1pm. The conversation will feature Peter Adler, President & CEO of Molina Healthcare of Washington, and Barsam Kasravi, MD, President & CEO of Anthem Medicaid of California. We may add one more perspective before it’s done. We would love to have you with us as we kick off this digital series. You can learn more and register for the digital event here.


2. WHA: Care in Washington scores poorly

The Washington Health Alliance released its 2019 Community Checkup Report, highlighting the latest statewide data on over 110 performance measures related to health care quality, pricing, spending, and overuse. In its 13th iteration, the checkup report brings together information from 1,978 clinics, 376 medical groups, 123 hospitals, 16 health plans, 39 counties, and all 9 Accountable Communities of Health.

Notably, for the commercially-insured, 77% of Washington’s performance measures are below the national 50th percentile, with 50% below the national 25th percentile. The comparison is similar for the Medicaid-insured, where 76% of the state’s measurements are below the national 50th percentile, including 53% below the 25th percentile. The report also evaluates variation in preventive care across the state, ranks the performance of medical groups, and details the state’s annual health care spending growth. Full details are available here.

3. Financial impacts to physician practices

The COVID-19 pandemic has financially shocked the health care system in jarring ways. A recent survey from the Washington State Medical Association (WSMA) finds that since March 1st, 47% of physician practices report having lost revenue up to $150k, 32% have lost between $150k and $500k, and 13% have lost more than $1 million. Seventy-three percent of practices report having only 1-6 weeks “days cash on hand.”

Reporter Emily Boerger spoke with WSMA CEO Jennifer Hanscom about the survey results, changes to care delivery, long-term impacts of COVID-19, and the next actions she hopes to see from state government. “How many of these practices are going to be able to bridge to a point where they can continue to keep their practice open long-term?” asks Hanscom. “Especially in smaller communities where they are reliant on these community physicians, are we going to see a shut down because they just basically had to go out of business…It’s the complex nature of the unknown.”

4.  Video: Patty Hayes, Seattle-King Co Public Health

Patty Hayes, RN, MN, is the Director of Public Health – Seattle & King County, the 9th largest local health department by population in the country. Hayes has over 30 years of experience in public health, policy development, and advocacy. She joins us in this edition of “What They’re Watching” to discuss three actions that are critically important to improving maternity care in Washington State. These remarks were recorded before the COVID outbreak during our January conference in Seattle.

“We have a major problem with maternity care, prenatal care, and post-birth care in this country and in Washington State in that we must address it from the perspective of where the woman and the family is coming from. We can change all of the policies we want, but if we’re not grounded in equity and social justice and really looking at what the needs of the woman are, we’re going to continue to have the number of maternal deaths we have.”


5. State leaders call for reinstatement of federal reinsurance program

Insurance Commissioner Mike Kreidler, along with health committee chairs Rep. Eileen Cody and Sen. Annette Cleveland, sent letters to the state’s federal delegation last month calling on Congress to reinstate the federal reinsurance program. Through the ACA, between 2014 and 2016 the federal reinsurance program reduced individual market premiums in Washington by between 10-15%, writes Kreidler.

In their letters, the three leaders reason that the impact of the COVID-19 pandemic has made supporting the individual health insurance market even more critical. “I continue to believe that reviving the federal reinsurance program is the most important step that Congress could take to maintain and increase the stability of our individual market,” says Kreidler. “In addition, at a time when insurers are facing uncertainty regarding the financial impacts of COVID-19 treatment, it would provide certainty for them that the costs to care for their highest cost enrollees would be limited.”