Kaiser Permanente at Last Week’s Exchange Board Meeting
The following is a transcript of the testimony provided by representatives of Kaiser Permanente, Sue Hennessey and Tom Henke, at the Washington Health Benefit Exchange Board Meeting last week on August 21.
The Board allowed for public comment after a discussion on the number of approved plans for the Exchange and the desire to extend the deadline so those plans in the appeal process, such as Kaiser Permanente, could be approved to be on the Exchange in 2014.
Sue Hennessey, VP of Strategic Planning and Health Plan Services:
“Good morning, my name is Sue Hennessey and I have the privilege of serving as the VP of Strategic Planning and Health Plan Services at Kaiser Permanente Northwest. Accompanying me today is my colleague, Dr. Tom Henke, who is a practicing physician and the COO of our esteemed Permanente Medical Group of the Pacific Northwest. Thank you for the opportunity to provide comment today, we’re talking a lot today about plans, rates, approvals, rules, deadlines, and statutes.
Also in the room is a huge, huge intent full of hope and full of disappointments today. We’re a room full of people that need to talk about what our intention is. Our intention is to take better care of the citizens of Washington and deliver on the promises of the ACA, which are: improved coverage, increased access to care and improved affordability for health care services. Our current situation, State of Washington, leaves us far short of our intentions and our goodwill. Particularly for the citizens of Clark County, the largest population center in the state with only one choice. Our work is not complete. Though time is short, we must use that time to qualify additional plans, create a more robust exchange, and consider options that create a path to a more open and full set of choices for the citizens of Washington.
Kaiser Permanente is both a major insurer and an award winning care delivery system. We serve 123,000 people in southwest Washington. We remain steadfast in our efforts to work with you to build a robust exchange and to serve those citizens. We are convinced that we have in this room, the very players who can correct the course to create an exchange that fills the promises of choice, access, and affordability. Together we can do better.
We did submit a formal letter to the board yesterday and our intention is that that would be submitted into the mix of this meeting. We do want to end our time with you today reviewing what we think are choices you have in front of you, but before we do that I’ll summarize that and Tom will talk with you about what this looks like from the chair he sits in as a practicing physician.”
Tom Henke, COO of Permanente Medical Group PNW:
“Well thank you, I’m a family practice physician. I’m not an insurance guy so I have some trouble following all of these discussions. I understand that you’re all volunteers and I appreciate that, volunteering to try and improve the health of people in the state of Washington.
I graduated from medical school in 1984, and after finishing my residency, spent three years in Kentucky and taking care of people in the Appalachian to satisfy a national service corps requirement. Then I came to the northwest, Longview, to join Kaiser Permanente in 1990. Then, what I wanted to focus on is that we take care of a lot of members in Cowlitz and Clark county.
We’re interested in taking care of a lot more. we have roughly 70 adult primary care physicians, 20 pediatricians and a slew of physicians affiliated and who support those teams. We have urgent care hours every night in each county and on the weekends. We keep, I get a tally of every day, of how many open panels we have. We strive to have to have 50% open panels, its 60% today. We’re ready to take on the patients.
I don’t understand all the insurance technicalities, I do know that the SHOP stuff was approved but the individual wasn’t. To a provider of care, it doesn’t make any difference if the patient is under the SHOP or the individual or under the Medicaid, they’re still patients. We still want to take care of them. The delivery system is basically the same. So it’s a mystery to me how you get into this problem where you’re approved for group but not for individual: because a patients a patient a patient and the same delivery system. I really appreciated the comments about let’s not lose sight of the forest through the trees, competition is good, I’m totally for that. I’m totally for cost transparency. I’m totally for what you guys are trying to do to help improve healthcare.
I know there’s an article in the journal of the AMA in which recently they pretended to have a person who was 62 who needed a joint replacement, they called America’s 100 Best Hospitals to get a price, and half of them refused to ever give a price. Of the ones who gave a price it varied from $50-$70 thousand: everything you’re doing can help us to try and help us get those 70 million people some insurance options. The more options they have the better.
We’re willing to compete. We have put a lot of stake into providing good care. We’re the highest rated health plan by the NCQA in the Northwest. That’s assuring people that get immunized when they need to, they get their prevention screening, and they get their chronic illnesses treated. From the delivery system standpoint we’d like you to just think about those patients given the choices they have. Like I said, we’ve got the patients in the system already. Thank you.”
“We believe the board could take a series of steps to create more options in the exchange. First and foremost, we believe that you’re already on this pathway to potentially to hold additional meetings should additional plans be approved. And we would submit that you could do that daily if needed. Secondly, we do not believe that the August 31st deadline is hard and fast. And we appreciate the staff reaching out to CCIO, we’ve done the same and we believe there is flexibility.
We have the specific ask that Richard ask for the flexibility in the meetings today and tomorrow that he has with HHS. We believe the board can also indicate to the OIC that plans that are in appealed should be considered and we should sincerely offer the time to consider those appeals to get those plans approved. And that the deadlines, we believe that there is more flexibility, the board should ask for seek and direct to the degree that you have the degree of authority to extend those deadlines.
We also have a specific ask for Kaiser Permanente, our on-exchange plans have received no objections today from the OIC. They’re filed and ready for consideration. We’re more than willing to work closely with the OIC to get those plans reviewed. We ask that the board certify our on-exchange plans today, pending that review by the OIC. We are committed to working with the OIC under such conditions as the board directs to get those plans certified promptly.”