WSMA LEGISLATIVE CONFERENCE AIRS CONCERNS ON MEDICAID

DJ Wilson | Jan 24, 2012 |

Yesterday, I attended the WSMA Legislative Conference, held every year to coordinate a unified physician message on issues before the Legislature.  About 140 physicians and administrators were in attendance yesterday.

The list of speakers before the group was impressive, as usual:  Rob McKenna, Jay Inslee, Mike Kriedler, and staff from the Governor’s office.  I will post a review of McKenna’s comments later today, with a review of Inslee’s comments coming tomorrow.

Physicians are visibly upset – particularly those from Clark County, but also Pierce, King and other areas – about the termination by the HCA of the Columbia United Providers health plan.  After 18 years of providing coverage and working closely with physicians to coordinate care, the HCA is no longer offering a contract to CUP for Medicaid managed care.  CUP currently covers 47,000 lives in Clark County, 60,000 lives statewide, making it the third largest Medicaid plan in the state – or was.

Dr. Doug Myers, President of WSMA, is a physician from Clark County, and carried the message of concern to Speaker Frank Chopp and a number of other legislators.

The topic also headlined the Monday Memo sent out to the WSMA statewide email list yesterday.

A glaring problem: HCA not awarding a contract to Columbia United Providers, an organization that has successfully served Medicaid managed care patients while supporting a viable physician network.

A related concern: Will the new-to-the-program plans be able to actually deliver on their commitment of having adequate and viable physician networks? The possible/likely downshift in payment rates in Clark County will be a significant issue, affecting the sustainability of practices and patients’ access to care.

More broadly, the absence of traditional participants – CUP, Premera, Regence – and the introduction of new players in the Medicaid market – Amerigroup, Coordinated Care Corporation, and UnitedHealthcare Community Plan – introduces added uncertainty about the manner in which these organizations will deal with physicians’ practices.  We’re in contact with those organizations to gain a better understanding in advance of the July 1 start.