Transcript 2007_SCI_Summer_Meeting_onizuka

Washington State
Health Reform Efforts
State Coverage Initiatives
August 2, 2007
Richard K. Onizuka, PhD
Health Policy Director
July 2007
1
Today’s Presentation
A chronology of Washington State’s
Health Reform efforts
Governor Chris Gregoire’s vision for
Health Reform
2005-2007 legislative activities
Blue Ribbon Commission on Health Care
Costs and Access
July 2007
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2005: Governor’s Five-Point Health
Care Strategy
July 2007
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Emphasize evidence-based health care
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Promote prevention, healthy lifestyles,
and healthy choices
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Better manage chronic care
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Create more transparency in the health
care system
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Make better use of information
technology
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2005 Legislation
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SSB 5064: Health Information
Technology
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Collaborate with Health Information
Infrastructure Advisory Board (HIIAB)
Develop strategy for adoption and use of
EMRs and Health IT
Final report December, 2006 for health
record banking model
SSB 5471: Drug Consortium
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Builds on evidence based state preferred
drug list
Discount card introduced 2007
King County Task Force → Puget Sound
Health Alliance
July 2007
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2006 Legislation
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E2SHB 2575: Health Technology
Assessment Program
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SHB 2573: Health IT Goal
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Washington Health Information Collaborative
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E2SSB 6459: Community Collaborative
Grant Program
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Blue Ribbon Commission
Executive Orders
July 2007
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Blue Ribbon Commission
Strategies
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Build a high-quality, high-performing
health care system
Provide affordable health insurance
options for individuals and small
businesses
Ensure the health of the next generation
Promote prevention and healthy
lifestyles
16 Recommendations
July 2007
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2007 Legislation
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E2SHB 1569: Health Insurance Partnership
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July 2007
Voluntary small group market “connector”
Premium subsidies
Enrollment September, 2008
Program begins January, 2009
SSB 5093: Children’s health coverage
expansion
E2SSB 5930: Implement BRC
Recommendations
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Senate Bill 5930
“An act relating to providing high-quality,
affordable health care to Washingtonians
based on the recommendations of the
Blue Ribbon Commission on Health Care
Costs and Access”
July 2007
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Section 1: Five year reimbursement plan
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Section 2: Patient decision aids pilot
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Section 6: Chronic care management
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Section 9: Washington State Quality Forum
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5930 (cont.)
July 2007
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Section 10: Consumer-centric health record
bank pilot
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Section 14: Unnecessary ER utilization
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Section 18: PEBB dependent coverage to 25
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Section 39: 5 year plan for health promotion
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Section 41: State employee health
demonstration project
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Prescription Drug Program
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State evidence based preferred drug list
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Prescription drug purchasing Consortium
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July 2007
Created by 2003 legislation
Based on state P&T Committee review and
recommendations
Used by HCA (UMP), Medicaid, and L&I
25 drug classes as of July, 2007, eight additional
by 2009
Cost avoidance of $44M 2005-2007
Continued annual drug class review updates
Created by 2005 legislation
56,000 enrolled in drug discount card as of July,
2007
High generic utilization, significant consumer
savings
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PEBB Procurement
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320,000+ State employees, dependants, and
retirees, K-12
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Health care premium trends
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Portfolio strategies
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July 2007
2007 – 4.5%
2008 – 3.0%
More affordable health plan choices
Managed care medical plan consolidation
Self insurance and other alternatives where
prudent
Self funded PPO (UMP) strategies
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Governor’s 5-Point Strategy
Emphasize evidence-based health care.
Promote prevention, healthy lifestyles and healthy
choices.
Better manage chronic care
Create more transparency in the health care system
Make better use of information technology
Cover All Kids
BRC Strategies
Build a high quality, high performing health care system
Provide affordable health insurance options for individuals
and small businesses
Ensure the health of the next generation
Promote prevention and healthy lifestyles
BRC Recommendations
Use State Purchasing to Improve Health Care Quality
Lead in prevention and management of chronic illness
Provide cost and quality information
Deliver on the promise of HealthIT
Reduce unnecessary ER visits
Reduce health administrative costs
Promote cost-effective community care initiatives
Increase choices for private insurance
Partner with federal government to improve coverage
Organize the insurance market to improve access
Address affordability of coverage for high cost individuals
Link health insurance to Children’s Health policies
Improve childhood nutrition and physical activity
Pilot a health literacy program for parents and children
Strengthen the public health system
Integrate prevention & wellness into state health programs
State Actions
PDP program (PDL and Drug Consortium)
HTA program (first technology assessment 2007)
P4P pilots (DSHS managed care, UMP generic utilization)
Health Insurance Partnership
5 year strategic plan to change reimbursement
Patient decision aides pilot
Chronic care management
Washington State Quality Forum
Children’s coverage expansion
Pilot health record banks and extend provider grants
Health promotion
Health literacy pilot
The Future of Health Care
Reform in Washington
July 2007
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Governor’s vision of access, costs, and quality
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Key role of State and community collaboration
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Key involvement and participation of the
consumer of health care
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Presence of the proper tools for systemic
change/reform
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Washington State Health
Reform Efforts
Questions?
Richard K. Onizuka, PhD
Health Policy Director
[email protected]
(360) 923-2820
Web site: http://www.hca.wa.gov
July 2007
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