5 Things Washington: Networking reception, Coordinated Care, value based payments

I’m looking forward to seeing a number of you next week for our 2018 Washington State of Reform Health Policy Conference!  We’ve got an amazing lineup of providers, regulators, elected officials, plans, pharma, HIT, mental health, and agency leaders!  It’s a great group of folks, and we’d be honored to have you with us too.

Registration rates will go up on Saturday morning. So, if you know you want to be with us, save a few bucks and get registered this week. We still have tickets available but I expect that window will begin to close shortly.

DJ 5 Things Signature

1.  Two noteworthy items out of last week’s news on Coordinated Care 

Last week’s news that the OIC issued – and then resolved – a cease and desist order to Coordinated Care for the individual market led us to turn up a handful of new findings.  First, it appears Coordinated Care President Jay Fathi has been removed from his position. That makes him the third Medicaid MCO president to depart in the last year or so.

More importantly, the OIC does not appear to have both reviewed and approved a single provider contract submitted for review by Coordinated Care since 2013. That’s four years without a review and approval.  Some filings are listed as under review. Some are simply “deemed,” meaning the OIC did not review and approve the filing within the statutory time limit.  You can read our correspondence with the OIC here, which was gracious in its detailing this matter with us.

Insurance Commissioner Mike Kreidler will be joining me for a breakout session next week at our conference. We’ll discuss this recent matter, as well as his thoughts on the state of health policy in 2018, and record it all for one of our podcasts. (Subscribe!)

2. Bob Ferguson and the new enthusiasm for health care litigation

Bob Ferguson has established himself as one of the most activist attorneys general in the country. His lawsuits against President Trump’s administration have garnered him both state and national media attention.  However, closer to home, his office is also filing suits against providers for price fixing, against drug makers for illegal market activity, and against hospitals for not providing enough charity care.

In short, this is a level of legal activism we have not seen in health care in Washington State from the AG’s office in some time.

Ferguson will be our morning keynote speaker, opening with a presentation of his thoughts on the state of health care in Washington.  I’ll spend some time asking him questions on the topic to follow up.  This should be the kind of conversation that’ll quickly wake you up!

3.  Join our networking reception on January 3rd

We’re holding our first pre-conference sessions at State of Reform this year.  These are “deep dive” sessions on topics decided on by our community:  value based payments, accountable communities of health, and federal/state policy.

These sessions are followed by a networking reception we’re hosting for folks that plan to join us on January 4th. The reception is co-located with the pre-conference sessions, so one event will roll right into the other.

So, if you’d care to come out and meet some of the folks working in health care, advocating for system improvement, and working at the edge of innovation, come join us next week!  You can get signed up for the reception here.

4. John Kitzhaber on health policy in 2018

One of America’s most important thinkers on health policy continues to be John Kitzhaber. His work creating the prioritized list of benefits in Oregon Medicaid back in the early 1990s continues to be one of the smartest, most heralded innovations in Medicaid nationwide.  His more recent work on Oregon’s coordinated care organizations (CCOs) continues to be a national model to drive integration in behavioral and physical health.

Gov. Kitzhaber will join me for a breakout session at 10:30, which we’ll record for a podcast. He’s spent a fair amount of time working in Washington State since stepping down from the Oregon Governor’s mansion in 2015.  So, we’ll pick his brain on what he makes of the state’s health care system, of the 1115 waiver, and how the two states compare to one another.

5.  Value based payments: how are things really working? 

One of the topics our Convening Panel was particularly interested in was an examination of how VBP was actually working out.  Are we finding progress there?  Where we have found progress, was a VBP payment model all that it was hoped to be?  In at least one instance, a recent JAMA story cites the successful implementation of a program to reduce readmission rates (often tied to bundled payments) created a higher risk of death among patients with heart failure.

We’ve got three sharp minds lined up to share their thinking on the subject during a 9:30 breakout session: Hiroshi Nakano, Valley Medical Center; Richard Popiel, MD, Cambia Health Solutions; Kathryn Rains-McNalley, Virginia Mason.