5 Things Washington: Frank Chopp, Amazon, Richard Popiel

We have a few legislative tidbits for you, and some observations on what Amazon’s announcement has revealed about our health care system. We also have a video and a podcast teed up for you as part of our multi-media approach to elevating voices among health care thought leaders.  It’s some of what we think is worth watching in Washington State health care for February, 2018.

DJ 5 Things Signature


1.  Amazon shines light on the poor opinion of health care

In September, I outlined a strategy for Amazon to enter the health care space. It starts with leveraging their own employees, which appears to be the focus of their recent announcement. What has also gained focus is how the Amazon release characterized the health care sector. Warren Buffett called health care a “tapeworm.”  I thought that was a brazen term, but apparently it wasn’t.

Rod Hochmann, CEO of Providence Health and Services, agreed with the term.  The former editor of Modern Health care defended the sector (sort of) saying, to paraphrase, ‘no, it’s a cancer not a tapeworm.’ Kaiser Health News posted a letter saying health care is a “catastrophic failure.” Piers Morgan, one I am generally loathe to quote about anything, said health care was “a sick joke & the envy of no one.”

Put it all together:  there is not another sector in the US economy as openly ridiculed and derided as the one upon which we will all one day depend, and from which we will all receive services that few of us can afford on our own. That’s the stuff of a strong political backlash ahead.

2. Video: Richard Popiel at Regence

Dr. Richard Popiel is the Executive Vice President and Chief Medical Officer of Cambia Health Solutions. He works to improve members’ outcomes and the experience they have as health care consumers. He joins us in this edition of “What They’re Watching” to talk about understanding the consumer through the use of data.

“If you think about merging claims data with provider data from their EMR, their electronic health records, with consumer data that might be relevant to an individual to mobile health data, data about blood pressure or diabetes or other things that you can capture from mobile health technology, you get a deeper, richer picture, a person-wise picture of that health care consumer. And then with that information, if you apply advanced analytics and we have 20 data scientists who are using artificial intelligence, machine learning to apply to this richer data set about individuals, then you can develop insights that are much more actionable today than they have been in the past.”

3.  Podcast:  A candid assessment of ACHs

Accountable Communities of Health were first adopted in statute in 2014. Four years later, we’re beginning to see the ACHs’ plans for transformation in their regions and the steps to adopt fully integrated care and move to value based payments.

We recorded this podcast at a recent live discussion which hoped to foster some candor about ACHs and the roles we can expect them to play moving forward. We hear from Amina Suchoski, Executive Director and VP, Growth Development at United Healthcare Community & State,Alisha Fehrenbacher, Executive Director at Pierce County ACH, and Susan McLaughlin, Executive Director at King County ACH. These are three of our favorite people in Washington State health care. Take a listen here, and be sure to subscribe!


4. A few bills with momentum in session

Among the health policy bills that appear to have momentum, HB 2530 has cleared the House and has a hearing in the Senate Health and Long Term Care Committee later this week.  It provides additional support to foster kids in Medicaid and gives Coordinated Care three more months to integrate physical and behavioral health for foster kids under a contract they won a few years ago.  SB 6219, Sen. Hobbs’s Reproductive Parity Act, is scheduled for an Executive Session in the House Health and Wellness Committee after having finally passed the Senate following a 6 year hold up.

A bill to simplify administrative requirements for the Exchange passed the House with some dissension. Rep. Joe Schmick, the lead House Republican for health policy, offered an amendment that would close down the Exchange in 2023. That amendment failed. The bill’s passage may be a bit more questionable in the Senate, but is still likely.

And, an interesting bill to watch is HB 2408. It requires any carrier that offers plans for educators via the newly established School Employees’ Benefit Board must also offer plans on the individual market. WSHA and WSMA both testified in support. The health plan association and Kaiser both opposed it. The bill has been on the House floor since Friday.  It has to pass the House by a deadline tomorrow or could be dead for the session.


5.  Speaker Chopp engaging in Medicaid procurement

As speaker, Frank Chopp largely stays out of health policy. That may have been part of an unwritten agreement he made with Eileen Cody 20 years ago when she stepped aside and allowed him to become the House Democrats’ leader.  This session, he’s trying to change Medicaid procurement rules during the HCA’s extended Medicaid procurement process.

With five Medicaid plans in Washington State, and a regional procurement model from which the HCA would like to pick two or three plans per region, it’s long been known that some plans are going to lose out. CHPW argues that has already caused patient disruption. That’s led to Chopp promoting a ‘fix’ that would allow any MCO already in a region to remain, offering protection for health plans and patients. This would turn the HCA procurement approach that’s been in place since 2015 somewhat on its head.

This language may be a last minute addition to the budget that will come out in the next two weeks. Then, it’ll be a question of whether Gov. Inslee vetoes the provision (which may have more to do with whether the House passes a carbon bill than Inslee’s interest in Medicaid procurement).