SENATE BILL REPORT
SB 5147
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. |
As Reported by Senate Committee On:
Health Care, February 10, 2015
Title: An act relating to establishing a medicaid baseline health assessment and monitoring the medicaid population's health.
Brief Description: Concerning monitoring health and health outcomes for medicaid patients. [Revised for 1st Substitute: Establishing a medicaid baseline health assessment and monitoring the medicaid population's health.]
Sponsors: Senators Becker, Bailey, Brown and Rivers.
Brief History:
Committee Activity: Health Care: 1/27/15, 2/10/15 [DPS].
SENATE COMMITTEE ON HEALTH CARE |
Majority Report: That Substitute Senate Bill No. 5147 be substituted therefor, and the substitute bill do pass.
Signed by Senators Dammeier, Vice Chair; Frockt, Ranking Minority Member; Angel, Bailey, Baumgartner, Brown, Cleveland, Conway, Jayapal, Keiser, Parlette and Rivers.
Staff: Mich'l Needham (786-7442)
Background: The Legislature has passed a number of bills related to performance measures for Medicaid coverage:
The 2013 Legislative budget included a requirement that the Health Care Authority (HCA) contracts with managed care organizations must incorporate accountability measures that monitor patient health and improved health outcomes, with an expectation that each patient receive a wellness examination that documents the baseline health status and allows for monitoring of health improvements and outcome measures;
The 2013 Legislature also passed ESHB 1519 requiring outcomes and performance measures for the array of Medicaid programs contracted by HCA and the Department of Social and Health Services, which include medical, behavioral health services, chemical dependency services, and long-term care services and supports. The agencies are required to include common measures in contracts by July 1, 2015; and
The 2014 Legislature passed E2SHB 2572 to improve health care purchasing and transform the health care delivery system. The bill created a Performance Measure Coordinating Committee to recommend standard statewide measures of health performance by January 1, 2015, that can be used to inform public and private health care purchasers.
The Performance Measure Coordinating Committee provided recommendations to the HCA in December that include measures for prevention, chronic illness, and acute care. There are 52 different measures categorized by population measures; clinical measures for children, adolescents, and adults by health plans, primary care medical groups, and hospitals; and measures related to health care costs.
Summary of Bill (Recommended Substitute): The Medicaid-managed care organizations must conduct a baseline health status assessment of enrollees. The health assessment is linked to the performance measure set recommended by the Performance Measure Coordinating Committee.
By December 1, 2016, and annually thereafter, HCA and the Department of Social and Health Services must report to the Legislature on the performance measures. The report must also include the following:
the number of Medicaid clients enrolled over the previous year;
the number of enrollees who received a baseline health status measurement over the previous year;
an analysis of trends in health improvement for Medicaid enrollees; and
recommendations for improving the health of Medicaid enrollees
EFFECT OF CHANGES MADE BY HEALTH CARE COMMITTEE (Recommended Substitute):
Links the Medicaid enrollee baseline assessment to the measure set recommended by the Performance Measure Coordinating Committee.
Requires an annual report of the performance measures, and adds the number of Medicaid clients enrolled over the previous year, the number of enrollees who received a baseline health assessment, an analysis of trends in health improvement for Medicaid enrollees consistent with the measure set, and recommendations for improving the health of Medicaid enrollees.
Appropriation: None.
Fiscal Note: Available.
Committee/Commission/Task Force Created: No.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Staff Summary of Public Testimony on Original Bill: PRO: It is important to capture a baseline health assessment for Medicaid enrollees. The intent is to ensure people get care and measure at the end of the year that their health condition, like diabetes, was treated. It is important that we measure the outcomes or we won't know if there is a health improvement.
OTHER: We want to make sure the bill relates to the common performance measure set that was just recommended by the Performance Measure Coordinating Committee. It is the intent that the standard measures will be used statewide, with a public process to periodically update the measure set. It is the intent to report on the common measure set and maybe we just need to clarify how the measure set relates to the reporting in the bill. It is envisioned that there will be voluntary reporting of the measures. Collecting the common measure set will help providers with alignment since we will all be collecting and reporting on the same outcomes.
Persons Testifying: PRO: Senator Becker, prime sponsor.
OTHER: Lisa Thatcher, WA State Hospital Assn.; Dan Lessler, Chief Medical Officer, HCA.