5 Things We’re Watching – Washington, January 2014

It’s always a little bit of a surprise when a short, 60-day legislative session becomes chaotic with different bills, policy ideas and visions for the state.  It shouldn’t be.

There are some “big bills” working their way through the session.  And, as we move towards making this newsletter a twice a month enterprise, we’ll be featuring more of those conversations.

Today, we offer these “5 Things We’re Watching,” ranging from Olympia to the primary care waiting room.

1. The Exchange Board enters legislative fray

During the last panel of our January conference, Rep. Cody made news by saying she would craft legislation to make the Exchange a state agency, giving the governor direct oversight of the operations.  That bill is now out.

At the last Exchange Board meeting, following an engaging discussion (“They will use you and abuse you!“), the Board voted to start taking formal positions on legislative proposals during this session.  How that will work in a short session, where Exchange policy positions will likely be formed by votes in special meetings via conference call and without public comment, remains to be seen.

2. OIC addressing network adequacy through new rules

Last summer, the contentiousness from OIC review of plans for the Exchange centered, in part, on the definition of adequate provider networks among Exchange plans.  That led to “special meetings” of the Exchange, appeals and lawsuits.

The Office of the Insurance Commissioner has followed up by trying to craft new rules for “adequate provider networks” among health plans.  It’s the sort of “in the weeds” work that could have tremendous implications downstream for plans, patients and providers.

3.  New reporters join State of Reform

We have a lot of great content these days at www.stateofreform.com, across multiple states.  Amy Snow Landa, formerly of the Seattle Times, has joined our staff as our new Managing Editor of State of Reform.  Her stuff at the Times was some of the best reporting around on health reform implementation, and we’re excited to have her.

She joins Amanda Waldroupe, formerly of The Oregonian, our reporter covering Oregon.  Aaron Katz, on sabbatical from the UW School of Public Health, will be starting a new column with us in February, bringing his years of experience and insight to our community.

So, because of your support, we’re growing!  Thanks for coming with us on this journey.

4. Spike in patient visits not as expected

Over the last 12 months, there was a lot of talk about primary care getting inundated in January with patient visits.  The thinking was that newly insured Medicaid and Exchange beneficiaries would come flooding into clinic waiting rooms after not having had care.

So, we asked clinics across the state – Woodcreek Healthcare, Edmonds Family Medicine, The Everett Clinic, The Vancouver Clinic, Northshore Medical Clinic – is it happening?  The answer:  yes (to spike in patient visits) and no (to newly insured).

5. “Integration” and “Innovation” 

The conversation around integration of mental and physical health in Medicaid is moving forward, and may have a clearer pathway this week than last.  House hearings yesterday on two bills – mental health procurement and implementing the State Health Care Innovation Plan – seemed to signal the House would likely move both bills out of committee relatively soon.

In the Senate, where a hearing last week on the general topic of integration, seemed to signal some support from the Republican caucus, Sen. Jim Hargrove (D-Hoquiam) still remains a key and unconvinced vote.  As much as any Senator, his influence on this will be strong and his support for a final bill important.