PCMS Advocates for Members with State Rep. Jinkins

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On the evening of Tuesday, June 5, the PCMS Board of Trustees and Executive Director Bruce Ehrle met with State Rep. Laurie Jinkins, a senior majority member of the Health Care and Wellness Committee in the Washington State House of Representatives.  Rep. Jinkins represents the 27th Legislative District that includes most of Tacoma.  She kindly offered more than an hour of her time to discuss issues of importance to physicians and PAs in Pierce County.  

PCMS advocacy focused on the following topics:

--The need to improve Medicaid reimbursement rates even in a tight fiscal environment so that an expanded patient population in Washington has maximum access to providers and so that those providers who see a majority of Medicaid patients are not struggling to make their financial situations viable.  

--Combating the opioid crisis in a manner that reduces overprescribing, addiction, and overdoses that also permits for the specifics of patient care including prescribing to remain in the hands of physicians while pressing the insurance industry to cover less addictive but more expensive pain relief drugs as well as to cover treatment for those who are addicted to opioids.  It was also noted that while the use of opioids is reduced, it is important to keep in mind that just as many years ago when pain management began to be a larger care priority, there are still patients with debilitating pain who need relief.  PCMS expressed a desire to keep working with members of the legislature on the issue as state regulations are released and as new federal funding is directed to the states.  

--Continuing to add to behavioral health resources to our community.  PCMS thanked Rep. Jinkins for the bi-partisan effort in the legislature last year to add behavioral health capacity around the state including in Pierce County in recognition of the dire situation and noted that those efforts need to be continued because the need is still great.  Potential incentive programs to drive new physicians in to behavioral health were discussed.  PCMS also thanked Rep. Jinkins for her focus on outpatient behavioral health care with the goal that patients do not suffer from ailments their entire lives but are rather permitted to receive ongoing care in an outpatient setting.  

--Remaining mindful of the challenges facing the integration of physical and behavioral health at a time when primary care is being tasked with more than ever while facing an increasing shortage of primary care providers and while behavioral health resources are also limited.  PCMS added that at a time when physicians are navigating new payment systems, integrating care, adjusting to the meaningful use of Health Information Technology with their EHRs, and moving in to an era of outcomes based medicine that includes a new focus on social determinants of health that it is yet another significant layer of stress when any consideration occurs in the state government of increasing lawsuit liability applied to the vast majority of physicians who diligently seek the very best care for their patients.  PCMS noted that with the goal of achieving care integration in the next few years moving ahead as a state priority, it is at odds with the initiative to have primary care and pediatric providers get more deeply involved in mental health to help address the shortage of behavioral care to also have those same physicians face potentially increased liability.  

--Assistance with funding for social determinants of health so that as the provider community assumes mandates to screen and refer patients who are in need of such things as housing and food assistance to boost their health outcomes, there are adequate resources flowing to those sectors that can make a positive difference with those final outcomes. 

--The importance of care coordination to achieve success in efforts to improve population health, reduce disparities, cut hospital readmissions, ensure patient compliance with treatment including prescription drug usage, integrate physical and behavioral health, and permit follow-up with endeavors relating to social determinants of health.  PCMS suggested that to reduce costs, improve quality, and boost outcomes related to all those endeavors that the state and federal governments will have to assist in creating a massive field force of care coordinators to do the handholding that has been shown to make a giant difference including robust funding for physicians as care coordinators depending on the severity of the case even as home health aides, community health workers, nurse practitioners, PAs, and nurses also work as care coordinators in that new field army.  

Rep. Jinkins thanked PCMS for meeting with her outside the busy time of the legislative session.  She and PCMS agreed to keep in contact on these and related issues.