Weekly Report for May 28, 2015 – Seeking the Right Care at the Right Time

May 28, 2015

Atul Gawande, MD, is relentless in his efforts to shine a bright light on the future of health care. His “Checklist Manifesto” and “Being Mortal” sit on many bookshelves in the Puget Sound area, including bookshelves at WSHA.

His latest New Yorker article is a good, but uncomfortable read (see it here). It’s a stimulating read, and it stings a little. No one wants patients to be having those kinds of experiences, and no one thinks it’s a sustainable approach.

But as I read it, I was struck by the degree to which Washington State health care leaders already understand problem and are moving forward on the issues. We have made tremendous progress on some of these issues, and we’ve done it with honest and engaged partnerships among stakeholders and elected officials. There’s been a real willingness to come together and solve problems.

We are also lucky to live in a state where as much as we have accomplished together, we recognize how much more must be done. Improving the cost and quality of health care is central to WSHA’s mission, and those of our member hospitals. It’s how we approach our legislative, policy and patient safety work. For example:

Transparency: Our quality and pricing websites provide needed data—and context—to patients and their families.

All-Payer Claims Database: The initial legislation passed last year, and needed fixes were made by the legislature this year and recently signed into law. This creates an important repository of data that will fuel improvements long into the future.

Partnerships: No one organization has all the solutions to the cost-and-quality tangle of health care, which is why we partner with other organizations such as WSMA, the Washington Health Alliance and the insurers to take on the key questions of health care value.

Washington is a state that is ready to build on success and continue to challenge itself—a commitment that is driving Healthier Washington as well. While the challenges can be daunting, there is also a wealth of possibilities.

We look forward to exploring the possibilities with you.

Scott Bond
President and CEO of the Washingtion State Hospital Association
ScottB@wsha.org

Pullman Regional Hospital’s community workshops to focus on health literacy

Pullman Regional Hospital has received a $15,000 Express Outreach grant award that will help fund a new community outreach health literacy program for seniors.

Awarded by the National Network of Libraries of Medicine Pacific NW Region, the one-year grant will fund “Technology as a Pathway for Better Senior Health Access,” an outreach program that will offer free workshops throughout the year to help participants learn steps for “medical inquiry” using the Internet, technical computing skills, and National Network of Libraries of Medicine health research skills.

“Through guided workshops and training, older adults will be exposed to resources and skills to improve computer literacy,” said Noel Nicolai, Education Coordinator at Pullman Regional Hospital. Read more.

Health Summit Provides Insight into Healthier Communities


“At the Edge of Amazing” is a day-long community summit sponsored by the Providence Institute for a Healthier Community and the Snohomish County Health Leadership Coalition, and cosponsored by WSHA. The summit, from 8 a.m. to 4:30 p.m. on Thursday, July 23, offers an exciting opportunity to learn more about communities coming together to improve the health of the local population, and offers hospital leaders across the state a chance to see one community in action. More than 50 local organizations representing 50,000 people in Snohomish County will make a public pledge to improve nutrition and activity levels countywide.

This summit might be a good model for other communities, and hospitals and health systems who are learning to work in this area should consider attending. Governor Jay Inslee and BlueZones creator Tony Buettner will speak at the summit. Click here for registration and ticket information. (Claudia Sanders)

Help shape pharmaceutical waste regulation

The Department of Ecology (DOE) is seeking input from hospitals regarding pharmaceutical waste management. We encourage hospitals, specifically environmental services personnel, pharmacists and nurses to provide input to DOE on waste management practices and challenges via a confidential online survey. Results from the survey will help inform DOE’s work to streamline and enhance Washington State’s pharmaceutical waste rules. Comments will be accepted until Friday, June 12, 2015.

This work is in response to SB 5577 – Concerning pharmaceutical waste and growing challenges regarding the management and disposal of pharmaceutical waste. WSHA supported SB 5577 and will continue to work with DOE, hospitals and other partners to improve waste management and regulation. (Ian Corbridge)

Senators Cantwell, Murray Introduce Bill to Improve Payment Models for Rural Health Care Organizations

Last week, with input from WSHA, U.S. Senators Maria Cantwell and Patty Murray introduced a bill to improve Medicare Accountable Care Organizations for patients and health care providers. The bill, the Rural ACO Improvement Act of 2015, promotes access to coordinated, patient-focused health care in rural and underserved areas by making ACO assignment more accurate and inclusive in communities lacking primary care physicians.

The bill allows Medicare ACOs to include primary care visits by nurse practitioners, physician assistants and clinical nurse specialists. It also allows for primary care services to be offered in federally qualified health centers and rural health clinics.

Read the full press release here. We strongly support this legislation, and thank our Senators for their leadership. WSHA members can contact Cassie Sauer at (206) 216-2538 or John Flink at (406) 439-1698 with questions about our federal advocacy agenda and programs.

Fiscal Watch Updates

Changes to Washington’s medical lien law

House Bill 1503, signed into law by Governor Jay Inslee and effective July 24, 2015, makes several changes to existing state law on medical liens, RCW 60.44.

These changes require that:

  1. Third parties collecting on behalf of lien-holders be licensed debt collectors.
  2. Notice is provided to patients regarding the use of medical liens.
  3. Liens are released within 30 days of payment and acceptance of the amount due under the lien.

WSHA supported the additional transparency and notice requirements and worked closely with the bill’s sponsor to remove other burdensome and unsuitable sections. WSHA will provide a more detailed bulletin on HB 1503 in the coming weeks. (Zosia Stanley)

Medicare Access and CHIP Reauthorization Act Includes help for rural hospitals

The recently passed Medicare Access and CHIP Reauthorization Act (MACRA) includes several provisions aiding rural hospitals. The act repeals the Sustainable Growth Rate (SGR) formula, which eliminates what would have been a significant reduction to Medicare physician payment and reauthorizes the Children’s Health Insurance Program, critical to maintaining health coverage for millions of children.

Lesser-known provisions are the extension of payments to Medicare low-volume hospitals and Medicare-dependent hospitals through calendar year 2017. The act also extends the therapy caps exceptions process for Medicare physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) services through 2017. This process enables extension of medically necessary therapy beyond the original therapy cap level.

This extension of the exception is particularly important to patients who receive therapy services from critical access hospitals (CAHs). Since patient coinsurance for outpatient services at CAHs is calculated based on charges rather than payment amount, the therapy cap would be exhausted earlier than in other settings in the absence of the exception process. Additional information is available on the Therapy Services web page of the CMS web site. (Andrew Busz)

Addressing the Unique Benefit Needs and Expectations of Health Care Professionals

One of Washington Hospital Services new industry partners, InsMED Insurance Agency, Inc., helps members identify and introduce voluntary insurance offerings to residents, fellows and employed physicians. These voluntary programs are designed to complement current group long term disability coverage and allow your physicians to protect greater amounts of income, student loans and retirement plan contributions.

The policies include permanent rate discounts and may be offered without medical underwriting, and participating professionals will be able to maintain their coverage throughout their careers.

If you would like to learn more about your opportunities to more fully insure your health care professionals without incurring any additional cost please feel free to contact us at Washington Hospital Services or Mary Guirn, InsMed’s Vice President of Customer Service, at(800) 214-7039 FREE. (Beth Zborowski)

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