What if King Co thought big? | Regence staffs up in WA | FDA to regulate HIT

One of the interesting things about this time in health care is that it invites us to think big and be truly innovative.  There is a lot of that these days in what are truly exciting times for health care.

Here are some items – some big, some small – to keep an eye on this week.

DJ 5 things updated

1. UW, Seattle Times and the Oregonian

What do those three organizations have in common?  Well, we’re lucky to have some of their sharpest former talent on our team.  You’ve already heard that Amy Snow Landa, formerly of the Times, is our Managing Editor.  And, you probably know that Amanda Waldroupe, a past reporter for The Oregonian, is covering that state for us.

You may not know that Aaron Katz, one of the leading thinkers on reform in Washington State, is also writing for us while he is on sabbatical from the UW.  His latest column discusses consolidation in the marketplace.

2. Pressure builds to pull network adequacy rule at OIC

Since the latest draft OIC network adequacy rule was announced a few weeks ago, a number of stakeholders have asked Commissioner Kreidler to pull the proposed rule.  WSMA and WSHA, as well as a series of other providers, have asked the rule be set aside.  The OIC, however, has signaled it still intends to adopt the rule on April 23.

Here is the challenge for this week:  find one organization impacted by the rule that thinks this is an improvement over the status quo.  The rushed timeline, concluding 8 days before the plan filing deadline, even has folks in the administration and legislature openly, if privately, shaking their heads.


3.  What if King County thought really big

King County is exploring the idea of developing a “Community of Health,” like that envisioned in HB 2572, which was signed last Friday by the Governor.  However, what if it thought bigger than that?

King County already knows how health care works.  It self-insures its employees, with the reserves, utilization management, and claims processing in place. They already have provider clinics, an RSN for mental health dollars, and a strong population health approach.  And, they already have an outreach team built in response to Medicaid expansion and open enrollment on the exchange.

Why not just become a full health plan, and offer products on both the exchange and in Medicaid for 2016?

4. Regence staffing up in Washington market

I’ll be attending a reception this week for Regence’s new President in Washington, Don Antonucci.  Antonucci joins the Washington market after leading the Oregon plan in recent years.

Don’s known as a savvy business development talent, and has brought with him some of his senior leadership from Oregon.  Regence is making some additional hires in the market to support the biz dev efforts in what appears to be an important recommitment to Washington, where about half of the four-state plan’s members live.

5. FDA proposes regulating HIT in “risk-based” framework  

The period of the federal government broadly supporting provider investment in HIT is beginning to move to a period of greater regulation and risk for providers from misuse of that HIT.  A new report released this week begins to discuss how a “Risk-Based Regulatory Framework” will be developed.

It’s very early in this regulatory development process, and it may require additional Congressional action for this to get teeth.   However, instances like the UW’s recent announcement of data theft from 90,000 patients is likely to come under additional regulatory scrutiny.