1. July 20071 State Coverage Initiatives August 2, 2007 Washington State Health Reform Efforts Richard K. Onizuka, PhD Health Policy Director

2. July 20072 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

3. July 20073 2005: Governor’s Five-Point Health Care 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

4. July 20074 2005 Legislation SSB 5064: Health Information Technology 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 Builds on evidence based state preferred drug list Discount card introduced 2007 King County Task Force → Puget Sound Health Alliance

5. July 20075 2006 Legislation E2SHB 2575: Health Technology Assessment Program SHB 2573: Health IT Goal Washington Health Information Collaborative E2SSB 6459: Community Collaborative Grant Program Blue Ribbon Commission Executive Orders

6. July 20076 Blue Ribbon Commission 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 16 Recommendations

7. July 20077 2007 Legislation E2SHB 1569: Health Insurance Partnership –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

8. July 20078 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” Section 1: Five year reimbursement plan Section 2: Patient decision aids pilot Section 6: Chronic care management Section 9: Washington State Quality Forum

9. July 20079 5930 (cont.) Section 10: Consumer-centric health record bank pilot Section 14: Unnecessary ER utilization Section 18: PEBB dependent coverage to 25 Section 39: 5 year plan for health promotion Section 41: State employee health demonstration project

10. July 200710 Prescription Drug Program State evidence based preferred drug list 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 Prescription drug purchasing Consortium Created by 2005 legislation 56,000 enrolled in drug discount card as of July, 2007 High generic utilization, significant consumer savings

11. July 200711 PEBB Procurement 320,000+ State employees, dependants, and retirees, K-12 Health care premium trends 2007 – 4.5% 2008 – 3.0% Portfolio strategies More affordable health plan choices Managed care medical plan consolidation Self insurance and other alternatives where prudent Self funded PPO (UMP) strategies

12. 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 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 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 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

13. July 200713 The Future of Health Care Reform in Washington Governor’s vision of access, costs, and quality Key role of State and community collaboration Key involvement and participation of the consumer of health care Presence of the proper tools for systemic change/reform

14. July 200714 Washington State Health Reform Efforts Questions? Richard K. Onizuka, PhD Health Policy Director richard.onizuka@hca.wa.gov (360) 923-2820 Web site: http://www.hca.wa.gov