DSHS and HCA to Merge
Jul 1, 2011
JUNE 30, 2011
FOR MORE INFORMATION:
Doug Porter, Director, Health Care Authority, 360-725-1040
Jim Stevenson, Communications Director, Health Care Authority/Medicaid 360-725-1915
Washington State Medicaid, Health Care Authority to merge into new Agency on
Friday, July 1
OLYMPIA — Governor Chris Gregoire's vision of consolidating the two major state health care purchasers becomes a reality on Friday, July 1, when the Washington State Medicaid program and the Health Care Authority merge together in a single state agency called the Health Care Authority.
The Medicaid program provides health care coverage to about 1.2 million low-income Washington residents, while the Health Care Authority currently provides health insurance and other benefits for up to 340,000 state employees, retirees and their dependents as well as 40,000 adults covered by the Basic Health plan.
The Governor's plan was outlined a little over one year ago — April 1, 2010 — when she issued Executive Order 10-1, saying the move to combine the two operations would help the state leverage more effective health purchasing strategies as well as prepare the state for national health care reform in 2014. All told, the consolidation is a major step toward policy changes that will make all state government health programs more effective and efficient.
Because the separate agencies have had a long background of working together on health care projects, the merger process actually got under way last year and has already paid dividends in consolidated planning and projects.
The actual switch to a new Health Care Authority should be largely invisible to Medicaid providers and clients as well as Basic Health and Public Employee Benefits subscribers, according to Doug Porter, who will be the Director of the new agency. Over the past year, he has served as both HCA Administrator and State Medicaid Director.
"The mission of the new agency will be to promote evidence-based medicine, realign incentives to improve quality care and reduce costs," Porter said. "But these are not new ideas or directions for us. Both sides of the new agency have long been engaged in the search for cost-effective answers to the problems we face."
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Washington State Medicaid, Health Care Authority to merge into new agency on
Friday, July 1
Eventually, the merger will support a broader strategy to combine behavioral health care with medical coverage. The Health Care Authority will report back to the Governor and the Legislature later with a plan that will include medical coverage, mental health services, chemical dependency treatment, and long-term care in person-centered health homes.
Medicaid, Basic Health, and Public Employee Benefits will be administered under the same policies as before. Eligibility criteria for different programs will not change.
Porter said the new agency will be working with other state departments as well as the health care industry in its attempts to develop new strategies for health care purchasing and new policies to make sure the cost goes into treatment that works.
"Studies show that up to 30 percent of what this nation spends on health care doesn't work," Porter said. "This Governor is determined to search out that waste and eliminate it. We also are pressing our state's proposals for accountability and flexibility at the federal level to make sure we have the tools we need."
In addition, the state needs to prepare for the expansion of Medicaid beginning in 2014, when the new federal health care reform law will bring an estimated 400,000 to 500,000 new uninsured Washington residents into Medicaid.
"I think it goes without saying that we cannot be the same Medicaid program we are today and be prepared for those changes," Porter said.
By expanding the Health Care Authority's responsibility for overall public purchasing of health care, the new law also fulfills the 20-year-old vision of the legislators who created HCA in the early 1990s with the understanding it would ultimately become the lead agency in setting state health care policy.
FOR ADDITIONAL BACKGROUND, CONTACT:
Jim Stevenson, Communications, Health Care Authority, 360-725-1915 (Pager: 360-971-4067).
Sharon Michael, Communications, Health Care Authority, 360-923-2746
NOTE: New rules have been adopted by the state for the hearing process used by Medicaid clients to appeal medical benefit or services decisions; however, the procedures for filing an appeal have not changed. For a free fact sheet on the new hearing rules, please e-mail stevejh2@dshs.wa.gov
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