Washington health experts discussed rising healthcare costs and some initiatives to help mitigate them at last week’s “Update on Efforts to Regulate Rising Costs” panel. 2022 Inland Northwest Reform State Health Policy Conference.
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One of the panelists was Sharon Eloranta, MD, Medical Director of Performance Measurement & Practice Transformation at the Washington Health Alliance. The Alliance uses data from voluntary associations to produce its reports. Full Claims Database.
“The issue that we are all here to discuss today is medical costs,” Eloranta said. “Every year we look at the state percentages. [gross domestic product] This is due to state-funded medical costs. At about $9.5 billion in 2015, he equals 2.08% of the state’s GDP. But five years later, it was almost $14 billion, approaching 3% of GDP. And it’s not sustainable. ”
Another panelist, Peter Rutherford, MD, former CEO of Confluence Health, said he’s been fascinated by the cost of healthcare for some time.
“I think we all want to keep costs down,” said Rutherford. “But one of the messages I get is that I don’t think healthcare providers can do this alone. And we need a broader approach.”
Rutherford said the current reimbursement system for medical services does not justify the cost of providing the services.
“Some services are very expensive and poorly reimbursed,” says Rutherford. “Some are relatively cheap and well reimbursed. And the disparity is a tough one.”
Rutherford said different types of patients and services and how providers are reimbursed for providing care can lead to cross-subsidies.
“…if one payer does not cover the cost of providing services to a beneficiary, other payers, employers and insurers must pay cross-subsidies,” he said. “This cross-subsidy problem is getting bigger.”
About 65% of Confluence’s budget goes to staff salaries and benefits, with 20% of that cost going to medicine and supplies, Rutherford said. About 15% of that cost is allocated to facilities, infrastructure, utilities and related services.
“The last few years have been really tough,” said Rutherford. “Our staff benefits and salary costs are growing much faster than revenue. , some of which are collective bargaining agreements.”
Staffing costs are also rising at Confluence due to staff shortages, Rutherford said.
“In the first six months of 2022, our labor costs went from 65% to 69% of our budget,” he said. “Currently, our travel expenses are about $6 million a month. Our supply costs are increasing. We are running at just over 10%.”
Another speaker on the panel, Leah Hole-Marshall, JD, Washington Health Benefits Exchangeprovides health insurance to approximately 2 million Washingtonians.
“Our biggest focus is the uninsured rate,” Hall Marshall said. “Our goal is to have the lowest uninsured rate in the country. [at] With roughly double the percentage of the best states in the nation, there’s still a lot to do here. ”
Exchange is committed to reducing healthcare costs by providing its services. Cascade Care Select Planis a public option plan.
“This is not the only strategy,” Hall Marshall said. “Our main strategy is to continue to subsidize these customers on the exchange. It came through the ARPAs enacted under the Health Emergency, which will be extended for three years.”
of the exchange public option Introduced a few years ago, it is the first of its kind in the country.
“It could be a fully state-run health plan where the state sets the fees, and if the law sets it, the provider has to accept it,” said Hole-Marshall. “The public option adopted in Washington State is a public-private partnership in which the government sets some rules.The unofficial goal is to cut insurance premiums by 10 percent.”
