Seattle City Wire

Washington State Health Care Authority (HCA) is looking to transform health-care delivery and cost throughout the state and has found support from the Washington Health Alliance and Purchaser Business Group on Health (PBGH).

A letter sent to the HCA from the Alliance and PBGH, which joined with employers and union trusts representing more than 350,000 individuals in Washington, asks health care providers and plans to work together with purchasers to transform the primary care system.

"Over the years, many initiatives have attempted to accomplish this with something called value-based care," Dr. Karen Johnson, director of Performance Improvement and Innovation for the Washington Health Alliance, told the Seattle Sounder. "This means that providers, rather than being paid on a fee-for-service basis, are paid for high performance in delivering care that is focused on the needs of the patient and is readily accessible at a cost they can afford."

The letter's message is to inform the insurers and the state's Health Care Authority that buyers want to work with those agencies to transform health care delivery, Johnson said.

Johnson, who lived in Kansas City for more than 30 years, said it is exciting to move to Washington, where health care for all and the state's progressive nature in health-related policies are a priority.

"The aspects of health care here that are the most notable to me are the progressive policies, the level of collaboration, and the degree of transparency in public reporting," Johnson said. "The level of collaboration between these public sector leaders in concert with private sector leaders from large employers, union trusts, provider groups, hospital organizations, health plans and other health partners is remarkable."

Another aspect Johnson said she has not seen with other states' health-care system is enough transparency. She said that in Washington for 15 years, the alliance has made data readily available for the public to access.

"One of the aspects of our reporting that really sets Washington state apart is that we also report at the medical group and clinic level, Johnson said. "This level of transparency is actively supported by those medical groups and clinics on which we report. Their willingness to make their results public is a testament to their commitment to improvement."

The letter addresses three major transformations the organizations want in health care: "a better experience of care, healthier individuals and populations and a lower per capita cost of care."

Johnson referred to the goals as "the triple aim," that the Institute for Healthcare Improvement "espoused" in 2007 with the hope that the industry would seek to implement the platform simultaneously.

"More than 10 years later, we are still working hard to get there," Johnson said.

The pandemic has helped highlight concerns that still exist in the health-care system, Johnson said, as times and primary health care is changing.

"COVID has also forced us to be very innovative in how care is delivered. Both providers and patients recognize the benefits of receiving care this way, and telehealth as a meaningful mode of receiving basic health care services is likely here to stay," Johnson said. "This ties into our goal of primary care transformation, which is to help make the system work better so that all people are getting the right care at the right time."