HOUSE BILL REPORT
HB 1512
As Reported by House Committee On:
Health Care
Title: An act relating to incentives to improve quality of care in state purchased health care programs.
Brief Description: Concerning improving the quality of care in state-purchased health care programs.
Sponsors: Representatives Morrell, Clibborn, Moeller, Cody, Green, Appleton, Roberts, Sommers, Blake, Schual-Berke, Flannigan, Sells, Kenney and Kagi.
Brief History:
Health Care: 2/15/05, 2/24/05 [DPS].
Brief Summary of Substitute Bill |
|
|
|
HOUSE COMMITTEE ON HEALTH CARE
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 9 members: Representatives Cody, Chair; Campbell, Vice Chair; Morrell, Vice Chair; Appleton, Clibborn, Green, Lantz, Moeller and Schual-Berke.
Minority Report: Do not pass. Signed by 5 members: Representatives Bailey, Ranking Minority Member; Curtis, Assistant Ranking Minority Member; Alexander, Condotta and Hinkle.
Staff: Molly Belozer (786-7104).
Background:
In 2003 legislation was adopted that requires the Health Care Authority (Authority) to
coordinate state agency efforts to adopt uniform policies based on the best available scientific
and medical evidence. Uniform policies across state purchased health care programs were
deemed necessary by the legislation to ensure prudent, cost-effective health services
purchasing, maximize efficiencies in administration of state purchased health care programs,
and reduce administrative burdens on health care providers participating in state purchased
health care programs. Adopted uniform policies are required to address:
1. formal assessment methods, including health technology assessment;
2. monitoring of health outcomes, adverse events, quality, and cost-effectiveness of
health services;
3. development of a common definition of medical necessity; and
4. exploration of common strategies for disease management and demand management
programs.
"Best available scientific and medical evidence" is defined in statute as the best available
external clinical evidence derived from systematic research.
Summary of Substitute Bill:
The Authority, the Administrator of the Authority, and the Secretary of the Department of
Social and Health Services must work in collaboration with other state agencies that
administer state purchased health care programs, private health care purchasers, health care
providers, and health insurance carriers to use evidence-based medicine principles to develop
common performance measures. The collaboration must also implement financial incentives
in contracts with insuring entities and providers. The incentives must:
1. reward improvements in health outcomes for individuals with chronic diseases,
increased utilization of appropriate preventive health services, and reductions in
medical errors; and
2. increase, through appropriate incentives to insuring entities and providers, the
adoption and use of information technology contributing to improved health
outcomes, better coordination of care, and decreased medical errors.
The Authority may require that insuring entities provide subscriber or member demographic
and claims data necessary to implement performance measures or financial incentives related
to performance.
The duty of the Authority to appoint a technical advisory committee relating to health care
policy is removed.
Substitute Bill Compared to Original Bill:
The substitute bill specifies the circumstances under which financial incentives are awarded.
The increased utilization of appropriate preventive health services are rewarded with
incentives, as are improvements in outcomes for individuals with chronic diseases.
Appropriation: None.
Fiscal Note: Available.
Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of session in which bill is passed.
Testimony For: Health Care Authority and the Agency Medical Director's Group have been pursuing evidence-based practices. This bill would allow the Authority to access claims data, that would be critical in tracking health outcomes and determining financial incentive awards.
Testimony Against: None.
Persons Testifying: (In support) Representative Morrell, prime sponsor; Richard Onizuka, Health Care Authority and Agency Medical Directors' Group; Ken Bertrand, Group Health Cooperative; and Susie Tracy, Washington State Medical Association.