Gov. Gregoire Announces Federal Approval to Integrate Washington's Medicaid-Medicare Programs

Press Release

By:  Chris Gregoire
Date: Oct. 25, 2012
Location: Olympia, WA

Gov. Chris Gregoire today announced that federal officials have given Washington state approval to move ahead with the first phase of HealthPathWashington -- a voluntary Medicare-Medicaid initiative aimed initially at integrating patient centered care in health homes to some of the state's highest-need medical assistance clients.

"Federal approval means we can start moving ahead with implementing plans to improve care for thousands of our fellow citizens and provide savings for taxpayers at the same time," said Gregoire. "This integration gives us the ability to provide patient centered care to more than 115,000 Washingtonians who are low-income seniors and people with severe disabilities who often have difficulty accessing the care they need. HealthPathWashington is a positive change and a clear opportunity to cut avoidable costs while improving health outcomes and coordinated care."

Medicare-Medicaid clients are known as "dual eligibles." By and large, they are also among the most vulnerable and most expensive clients in both programs. The state was selected as one of 15 states to design plans that would more effectively deliver their care and coordinate the different care programs.

HealthPathWashington will integrate services and establish "health homes" to bring high-risk, high-need clients into better care and was the second state plan to win federal approval. Because the proposal will more effectively deliver care and keep its patients healthier, it also will save money for the state -- projected to save nearly $14 million over five years.

"HealthPathWashington will bring together real improvements in care as well as a support system that puts patients and their needs at the center of care," said Washington Health Care Authority Director MaryAnne Lindeblad. "Its concept of shared savings and using "health homes' for patient-centered care will be bold steps forward for both Medicare and Medicaid."

Robin Arnold-Williams, secretary of the Department of Social and Health Services, noted that HealthPathWashington was a cooperative venture in state government as well, bringing together DSHS and HCA as partners in the project.

"MaryAnne Lindeblad and Jane Beyer, the assistant DSHS Secretary for Aging and Disability Services Administration, both have backgrounds in Medicaid as well as a longtime commitment to integration of services," Arnold-Williams said. "HealthPathWashington is not all new ideas, but it is an idea whose time has come."

Some of the tools to be used in the new initiative have already been developed by Washington state, which has been a pioneer in integration of care systems.

Washington Medicaid was an early participant in disease management and chronic care management programs aimed at providing support for clients with conditions like congestive heart failure or diabetes -- conditions that needed more intensive support to prevent clients from becoming progressively sicker and requiring more expensive treatment.

The chronic care management pilots tested effective and evidence-based interventions that are the foundation of Washington's health home strategy. Washington was one of the first two states to gain access to Medicare data. The state has integrated this data into a clinical decision support tool that will help to guide and inform health home interventions.

HealthPathWashington will be a voluntary program. Although the state's 1.2 million Medicaid clients include 115,000 Medicare beneficiaries, the state is targeting 30,000 with the highest risk for poor health outcomes, whose cost of care is significantly higher, or who have a recent history of multiple hospitalizations.

For more information or background, please visit the links provided.