The Washington State Health Care Innovation Plan

Imagine a state where everyone had a personal connection and easy access to the medical care they need, and where the care was coherent, coordinated and focused. That is the stated goal of the Washington State Health Care Innovation Plan, according to Karen Merrikin, the new administrator of the plan, who came to Bellingham to meet with interested leaders in our health care community on October 17.  She told the group, “Our current health care system too often provides high-cost, low-value health care and our goal is to collaborate with payers and providers toward health system transformation that delivers reliable, higher-value, lower-cost care in Washington State.”

How to make that happen? The Washington State Health Care Innovation is a five year plan to use the purchasing power of the state to align incentives across all areas of health care delivery for care purchased or administered by the State of Washington. These are the tools she identified:

• Basic infrastructure to manage care
• Aligned quality incentives
• Aligned payment incentives tied to outcomes
• Support for primary care practice transformation, to achieve the patient centered medical home
• Strengthened health IT
• A modernized work force to meet current needs, with emphasis on primary care and behavioral health
• New tools for people to understand and access care
• Local accountability for organizing and delivering care, based in the community. An example would be our local Whatcom Alliance for Health Care Advancement (WAHA).

In order to achieve the above goals, Merrikin described a new organizational structure, with the state divided into 7 to 9 regional zones. The NW Washington region would contain Whatcom, Skagit, Island, San Juan and Snohomish counties. Medicaid administration would move to these areas. Other features would include a community health organization (ACHO), and an embedded regional extension center to support needed practice transformation activities. Key state supports would also be aligned to the region, and a transformation trust fund is envisioned to support training and innovation.

Remaining key questions include “how will the savings be re-invested”?

The draft plan will be presented at the beginning of November, feedback will be solicited through mid-November and the final plan will be finished December 31.