Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
SSB 5891
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
Brief Description: Establishing a forum for testing primary care medical home reimbursement pilot projects.
Sponsors: Senate Committee on Health & Long-Term Care (originally sponsored by Senator Keiser; by request of Governor Gregoire).
Brief Summary of Substitute Bill |
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Hearing Date: 3/24/09
Staff: Dave Knutson (786-7146)
Background:
In 2008 the Department of Social and Health Services (DSHS) and the Health Care Authority (HCA) were directed to assess opportunities for changing payment practices in ways that would better support development and maintenance of primary care medical homes. The same year, the Department of Health (DOH) was directed to develop a medical home learning collaborative to promote adoption of medical homes in a variety of primary care practice settings. The agencies submitted a progress report titled, "Payment Options and Learning Collaborative Work In support of Primary Care Medical Homes" to the Legislature on December 31, 2008.
Summary of Bill:
Public payors, private health carriers, third-party purchasers, and providers are encouraged to collaborate and identify appropriate reimbursement methods to align incentives to support primacy care medical homes. The discussions and the determination of reimbursement methods are facilitated by state agencies and as such are exempt from antitrust laws through the state action doctrine.
The HCA and the DSHS must design, oversee implementation, and evaluate one or more primary care medical home reimbursement pilot projects. The agencies must: determine the number and location of the pilots; determine criteria to select primary care clinics to serve as pilot sites; select pilot sites from those clinics that currently include activities typically associated with medical homes or from sites that have been selected by the DOH to participate in the medical home collaboratives; determine reimbursement methods to be tested; and identify performance measures for clinical quality, chronic care management, cost, and patient experience. The agencies must coordinate planning and operation of the pilots with the DOH medical home collaboratives. The act expires July 1, 2013.
Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.