Health Care Authority, DSHS announce apparently successful bidders for HealthPathWashington

The Washington State Health Care Authority and Department of Social and Health Services announced today that Regence BlueShield and United HealthCare have been declared apparently successful bidders on a project to coordinate Medicare and Medicaid services in Snohomish and King counties beginning next year.

HealthPathWashington has two strategies to improve services and benefits. Strategy One will begin next month with a series of Health Homes in 37 of the state’s 39 counties. Strategy Two begins in April 2014 and will focus on improving chronic care coordination for the 40,000 “dual eligible” residents of Snohomish and King counties.

The two strategies employ different tools in an effort to align financing and to better integrate primary and specialty care, behavioral health and long-term services for dual eligible clients.

Planning for the program is covered by federal funding that Washington received as one of 15 states awarded planning grants to improve services for residents who are dually eligible. The HealthPathWashington project itself is being administered as a partnership between the Health Care Authority and the Department of Social and Health Services.

Payment levels under the contract will be set later this year through a joint rate-setting process by the federal Centers for Medicare and Medicare and the state. Two other bidders were not selected in the procurement. They were Molina Healthcare of Washington and Community Health Plan of Washington.

HCA Director Dorothy Teeter stressed that the project is aimed primarily at improving care, not saving money. “However, since dual eligibles make up 13 percent of our caseload and 30 percent of our costs, we anticipate there will also be savings,” she said.

Jane Beyer, assistant secretary for the Behavioral Health and Service Integration Administration in DSHS, agreed. “This is a proposal centered on the individual members of this population who need a seamless benefits structure and a nimble system that can deliver those services in a smooth, coordinated and helpful way.” Beyer said.

MaryAnne Lindeblad, state Medicaid director, noted that today’s procurement caps an almost three-year effort that began with the successful pursuit of a $1 million federal planning grant. “This has been a long and at times arduous process, but it is very rewarding to see it now coming together on behalf of a vulnerable population that needs these services and improved oversight,” she said. “I think it also has been an unprecedented experience in interagency cooperation and partnership.”

FOR MORE INFORMATION OR BACKGROUND:

NOTE: A Q&A on the joint rate-setting process for the Strategy II dual eligible project is available by request from stevejh2@hca.wa.gov

HealthPathWashington website: www.adsa.dshs.wa.gov/duals/proposal.htm
The Medicaid Expansion 2014 website: www.hca.wa.gov/hcr/me
The Health Benefits Exchange website: wahbexchange.org/