Health Plans Commit to Primary Care Model

The Washington State Health Care Authority announced that eight Washington health plans have signed a Memorandum of Understanding (MOU) committing to support and make good faith efforts to implement the state’s multi-payer primary care model. The eight included all five of Washington’s Medicaid MCOs, as well as Kaiser Foundation Health Plan of Washington, Regence BlueShield, and Premera Blue Cross. The commitment by the health plans is an important step in ensuring the necessary alignment of quality measures and payment methodology among plans. While the conceptual framework has general support from health plans and primary care providers, important details such as payment rates and assignment risk still must be worked out to ensure the model is viable across all types and sizes of primary care practices. This is particularly important for small practices and primary care providers in rural areas where administrative and supportive services are scarcer. WSHA’s comments on the model recommended HCA work with a broad set of providers with financial and clinical expertise to work out the details and encouraged voluntary provider participation. WSHA will be providing further input to HCA. We welcome additional comments and questions.  We will provide additional information on HCA’s implementation of the model as it becomes available. (Andrew Busz, AndrewB@wsha.org)