5 Things Washington: MTP waiver renewal, Hospital finances, End of the PHE


Emily Boerger


Our team is currently hard at work curating the list of 60 speakers who will join us at the 2022 Inland Northwest State of Reform Health Policy Conference on September 8th. We’ll release the product of that work, our Detailed Agenda, in just two weeks! In the meantime, you can take a look at our Topical Agenda to see the conversations that we have scheduled for the day. We’d love to see you there!

Thank you for your support!

Emily Boerger
State of Reform


1. State submits MTP waiver renewal application

Earlier this month, the state submitted its waiver renewal application for the Medicaid Transformation Project. MTP is Washington’s Section 1115 waiver, which is set to end on December 31st, 2022. The renewal application aims to continue current MTP programs for another 5 years (2023-2027) and seeks to add additional program expansions.

Program expansions included in the renewal application include additional Long-Term Services and Supports and an expanded age requirement and eligibility criteria for Foundational Community Supports. The state is also seeking approval of new programs including 12-month postpartum coverage and immediate coverage for individuals exiting a correctional or treatment facility upon reentering the community.


2. WSHA details ‘dire financial situation’ facing hospitals

A recent WSHA survey representing 97% of the acute care hospital beds in the state details the significant financial challenges facing Washington hospitals. Data from the survey, which evaluated the financial performance of hospitals during the first quarter of 2022 compared to the first quarter of 2021, found that total operating revenues increased by 5% while total operating expenses increased by 11%.

“These operating losses combined with significant investment losses resulted in a net loss for hospitals across Washington of a negative $929 million in the first quarter of 2022,” said WSHA CFO Eric Lewis. “This is a negative 13% net loss … It is like nothing I’ve seen in my career and hospital leaders around the state are very concerned about this.” Financial challenges facing hospitals include: inflation, labor shortages, hospital discharge delays, and temporary labor spending.

3. Health officials prepare for end of the PHE

 Health leaders are pursuing several initiatives aimed at maintaining Washingtonians’ health coverage once the public health emergency ends. The initiatives, which largely focus on communication strategies and outreach to those going through the redetermination process, were discussed during a Senate Health & Long Term Care Committee meeting last week.

“By the time the PHE ends, many people will not be familiar with having to take some kind of action to retain their Apple Health coverage, especially the roughly 370,000 that came on to the program during these last 3 years,” said HCA’s Amy Dobbins during the meeting. “This is why communication and outreach is so critical to keeping people insured.” Among several actions discussed at the meeting, HCA is working to develop an ambassador program called Apple Health Community Connectors, and MCOs are working with HCA and the Health Benefit Exchange to help avoid gaps in coverage.


4. WSMA’s Dr. Katina Rue discusses Latinx Advisory Council

The Washington State Medical Association’s Latinx Advisory Council provides Latinx physicians with a forum to develop advocacy strategies and recruit additional Latinx physicians. Only 3.1% of the state’s active 14,731 physicians self-identified as Latino in 2020.

In this Q&A, Dr. Katina Rue, Co-Chair of WSMA’s Diversity, Equity, and Inclusion Committee, discusses the benefits of the council and the importance of having a place to share experiences. “Having a community where we can share our struggles and triumphs and build bonds across the state has been a tremendous support, especially in the current health care environment, which is burning out physicians at alarming rates,” Rue says.


5. DDA looks to expand housing options for people with disabilities

The state’s Developmental Disabilities Administration is looking to expand housing options for Washingtonians with developmental disabilities. The DDA serves more than 49,000 clients, with 81% receiving in-home, personal care.

DDA Assistant Secretary Debbie Roberts discussed challenges the DDA faces in expanding housing options for DD residents during a Joint Legislative Executive Committee on Planning for Aging and Disability Issues meeting. “[The DDA’s State-Operated Living Alternatives program] has experienced some challenges in expanding due to the pandemic, the workforce shortage, and the lack of affordable housing,” Roberts said. The DDA is working with lawmakers and other health agencies to overcome housing and care challenges.