Record high numbers of people insured in Washington

Early in my term, I established a goal of reducing Washington’s medically uninsured rate to 6 percent by the end of 2017. A recent Gallup survey, backed by census numbers, reports an unprecedented 10-point drop in the uninsured rate in Washington state. We’ve achieved our target two years early and have the second highest proportional drop in the rate of uninsured in the country.

The bipartisan effort to implement the Affordable Care Act and our community-based effort to enroll residents in new health plan options is working.

Now we are focusing our efforts on improved quality and value.

We’ve launched a Healthier Washington initiative, funded partly with a federal grant, to work with other purchasers, providers and consumers to achieve better health, better care and lower costs.

First, we must treat the “whole person” instead of separating the head from the rest of the body. A Kitsap County provider tells of a young woman being treated for a mental health condition who came in with a bad cough. While the provider encouraged her to see a doctor, she didn’t follow through and died from pneumonia.

This death could have been prevented with an integrated system of care that would have ensured the woman received treatment for her mental health condition and her medical condition. An integrated system means medical and mental health conditions are treated in the same setting with clinical care teams accountable for both the physical and behavioral health of individuals. The state Health Care Authority and Department of Social and Health Services are working on this integrated approach.

Second, the state is overhauling the way we pay for health care through contracts that focus on health improvement, not just number of visits.

We are currently rolling out one such value-based approach for state employees with a system of health providers striving for agreed-upon quality measures. If the plan achieves the quality targets and an agreed-upon cost trend, it shares in cost savings. The plans are expected to offer care management programs for chronic disease management, integrated behavioral health services, preventive screenings and immunizations, and improved customer experience.

Finally, we must bring together leaders from different sectors that contribute to health — including housing, employment and education — to make data-driven, community-based decisions on how to create healthier communities.

These Accountable Communities of Health — formal partnerships and coalitions aimed at improving access to care — are already emerging throughout the state, including in Thurston County. They’re working thanks to collaboration by medical providers, educators, first responders, social service and housing providers, and others who work daily with children, people with disabilities, seniors and others who benefit from coordinated care.

With our Healthier Washington initiative, we could see reduced chronic diseases, such as obesity and diabetes; better coordinated care for individuals with complex conditions; and lower cost trends. The state is pursuing greater federal flexibility with our Medicaid funding to reduce avoidable use of intensive services, such as acute care hospitals, nursing homes, psychiatric hospitals and long-term services and supports. This flexibility could help us improve population health, move faster toward high value purchasing and better control Medicaid costs.

Our success in health care enrollment was achieved because so many organizations and volunteers came together to make it happen. That same commitment and cooperation will help us achieve a Healthier Washington.

This story was originally published October 6, 2015 at 2:30 PM with the headline "Record high numbers of people insured in Washington."