5 Things Washington: Early bird registration, Cascade Care, Behavioral health update

This edition captures so much of what we’re trying to build for you at State of Reform. It’s a platform for some of our state’s most thoughtful voices (#4). It features the independent reporting from our team covering health care like no other outlet in the state (#1, #3, #5). And, it offers an opportunity to network, build community and foster relationships (#1, #2) in support of meaningful reform.

Much of what we do is free to read or watch. But, it’s not free to write or produce. Typically, we fund our work through the success of our conferences. So, as we open registration for our fall virtual event, we’re hopeful you’ll join us for this virtual conference and continue to put wind in our sails here at State of Reform.

Thanks for the honor of informing your work.





With help from Emily Boerger

1. An update on behavioral health & COVID-19

We recently hosted our “5 Slides: Impact of COVID-19 on Mental Health” virtual convening with Tom Sebastian, CEO of Compass Health, Megan Gary, MD, Assistant Medical Director, Psychiatry, at Kaiser Permanente, and Jeff Hite, PsyD, a Provider Program Director for Beacon Health Options. Through a series of 5 slides, the three leaders discussed the impact of COVID-19 on mental health and the outlook for mental health challenges in Washington’s future.

The issues the panel brought up, including this report from the DOH, were also discussed during a recent Senate Behavioral Health Subcommittee meeting. Trevor Covington of the DOH warns that September through December will be a difficult time in Washington: “This is where we’ll likely see increased rates of depression, suicidal ideation, particularly increased substance use related to despair, and those sorts of topics. So, this is really a hard period for us as a state and one I want us to really be aware of.”


2. Early bird registration open!

We’ve opened early bird registration for our 2020 Inland Northwest Virtual State of Reform Health Policy Conference! The cost of hosting the event is likely to be more expensive in the virtual space, if you can believe that, but we’ve lowered the registration price significantly, particularly for the Early Bird rate. That rates is only open for two weeks, however, so you’ll want to sign up asap.

We’ll host the event over two days this year, rather than one long event, based on the guidance of our Convening Panel. We’ll release the Topical Agenda in the coming days, but if you already know that you want to attend this year’s event, be sure to take advantage of the discounted price and register today!

3. Public option plan pricing variation

Earlier this month HCA announced the apparently successful bidders for the Cascade Care public option RFA — Bridgespan, Community Health Network of Washington, Coordinated Care, LifeWise, and UnitedHealthcare. Recent slide decks presented during the Washington Health Benefit Exchange Board Meeting this week highlight public option plan pricing variation by carrier. “Average public option premiums for each carrier ranged from -3% to +21% compared to 2020 average premium,” one presentation states.

Interestingly, public option plans are not always the lowest priced option in the market. For Coordinated Care, public option plans are their most expensive offering. For BridgeSpan, public option premiums average over $100 more expensive their their lowest premium option for in the same county. This deck breaks down the pricing in further detail.


4.  ‘Healthcare, we need to talk.’ Signed, Public Health

I previously took a crack at outlining four areas I think policymakers can consider to promote modernization of our public health system. This week, we asked some of Washington’s most thoughtful public health leaders, publishing three commentaries on reforming the system.

Jaime Bodden, Managing Director of the Washington State Association of Local Public Health Officials, wrote this piece describing public health system modernization through a Foundational Public Health Services framework. Betty Bekemeier, Director of the Northwest Center for Public Health Practice, discusses collaboration and alignment of health care and public health in this commentary, and Jefferson Ketchel, Executive Director of the Washington State Public Health Association, explores sustained investments in public health here.

5. Delays in COVID test results

Despite expanded testing recommendations and the CDC’s guidance on testing asymptomatic individuals, evidence suggests rising consumer demand for COVID-19 tests and a shortage of supplies are making it difficult to offer timely, widespread testing. To test the ease of getting tested in Washington, Reporter Emily Boerger made a few calls to testing centers across the state inquiring about testing protocols for asymptomatic individuals exposed to the virus.

The responses ranged from one Snohomish County location saying results would be available in 48-72 hours, to a Spokane County center saying it’s “basically pointless” to get tested because results will take about 14 days. Reporter Michael Goldberg followed up by asking Gov. Inslee about the impact of delayed test results on contact tracing during a recent press conference.


Bonus: VM and CHI join forces

News broke yesterday that VM and CHI Franciscan were merging after years of working in a strategic partnership. They’ll form a joint operating company, giving both organizations 50% of the ownership of the new entity. I’m told that CHI will make a significant capital investment in some of the VM facilities, while working to scale the VM Lean Production model of care across the CHI system to lower the costs of care delivery.

This strikes me as a very good move for both organizations. The details still need to get finalized, and there are always ways these things can fall apart in time. CHI’s proposed merger with PeaceHealth fell apart in 2013 over concern about managing shared services, for example. But, if this deal comes together, it would appear to merge the unique excellence in quality at VM with a broader financial base at CHI, likely improving both organizations’ position as a result.