5 Things Washington: Changing MCO leadership, Sen. Patty Murray, Health in the budget

Today is day 93 of the 105-day legislative session. For such an abnormal period of time, with most of the session activities conducted virtually, this has been a somewhat ambitious session for Democratic majorities. Recent long sessions have seen some significant progressive legislating, like the public option bill and the long term care trust from 2019. This is a shift from a previously divided legislature and even the recession-hardened legislatures of most of the Gregoire years. Prior to that, the Locke years were largely centrist, too.

I don’t think we have seen this much progressive legislating since the ’93-’94 session. We’ll see whether the 2022 midterms are as tough on Democrats as that 1994 session was. On the one hand, this is a much different state than it was in 1994. On the other hand, many of the traditional winds align against Democrats, particularly the first mid-term of a Democratic presidency. Moreover, the re-districting now underway will draw a map with “no partisan advantage” in a state with 57% Democratic performance. That might fundamentally change the next legislature.





With help from Emily Boerger

1. Budget negotiations are underway

Both the House and Senate have passed their versions of the 2021-2023 operating budgets and lawmakers are now in negotiations for the final budget. State of Reform reporter Sydney Kurle took a look into the budget notes and keyed in on some interesting health-related spending within the proposals.

Both proposals include funding for behavioral health initiatives such as the Senate’s proposal to allocate $3 million in funds to provide grants to tribes to prevent opioid use and expand treatment, and $10.47 million to fund six additional youth mobile crisis teams. The Senate version also includes $300 million for the Washington Immigrant Relief Fund. The House’s version of the budget includes $2 million to the DOH to conduct a COVID education campaign on Spanish Public Radio and $4.8 million for quality assurance and care navigation at the Department of Corrections.

2. 5 slides: Payment transformation

In an effort to meet patient demands, reduce costs, and deliver better quality of care, payment reform has become a primary focal point in our health care system. On Wednesday, April 21, from 12:00 – 1:00pm PST, we’ll host Tami Hutchison, Senior Director, Episodes of Care at Signify Health, Max Holfert, Program Director, Provider Partnership Innovations at Regence Blue Shield, and Dr. Judy Zerzan, Chief Medical Officer at the Health Care Authority, for a conversation on payment transformation that supports health outcomes.

This free event is part of our “Virtual Conversations” series, and will feature “5 Slides” or graphics brought by our guests and our team at State of Reform. This event is free to attend, but you have to register to join us. You’ll be able to pose questions and participate in the conversation as well, just as you do in our conferences. So, we’d love to have you with us.


3. Washington leaders highlight road ahead for federal health reform

Last week I had the chance to speak with US Sen. Patty Murray, Chair of the important Health, Education, Labor & Pensions (HELP) Committee, about her vision for health policy in the 117th Congress. Murray offered keynote remarks at the 2021 State of Reform Federal Health Policy Conference where she reflected on the federal COVID response, her health reform priorities, and building cohesion among a diverse group of Senate Democrats.

During the conference we also saw a glimpse of the subtle tension that exists within the House Democratic Caucus during our Congressional Democrats panel with US Reps. Earl Blumenauer and Kim Schrier. Blumenauer says now is the time for Democrats to think bigger and make substantial changes to health care without getting “paralyzed” by complexity. Schrier, who represents Washington’s divided 8th CD, offered a more moderate take and stressed her constituents’ weariness to large scale changes to their health care. The full conversation is available here.

4. Shifting MCO leadership

The recent retirement of Doug Bowes from United Healthcare’s Medicaid plan is the third position to turn over among Washington State’s five MCO plans. Last month, Amerigroup Washington announced the appointment of Anthony Woods as the new president of its Medicaid health plan. Peter Adler departed Molina health care in January.

That leaves Beth Johnson, President & CEO of Coordinated Care, and Leanne Berge, CEO of Community Health Plan of Washington, as the longest standing MCO leaders. Johnson has served in her role for about 3 years, and Berge has led CHPW for nearly four and a half years.


5. Health care in correctional facilities

A recent audit of King County jails found that Black individuals in the custody of the Department of Adult and Juvenile Detention are more likely to face negative consequences in jail such as higher security housing, more rule infractions, and more severe punishments. The audit also details mental health shortfalls at the King County Correctional Facility, where the demand for psychiatric care exceeds its capacity.

The audit was one of several reports related to health care in Washington correctional facilities released in recent weeks. An Office of the Corrections Ombuds report found that delays in cancer diagnosis and treatment in Washington State Department of Corrections facilities led to death for at least one incarcerated patient and terminal diagnoses for several others. And earlier this month, a joint CDC and UW study found that fewer than half of the inmates in jails and prisons said they would accept a COVID-19 vaccine, with the most common reason for refusal being distrust of health care, correctional, or government personnel/institutions.