The Pierce County Medical Society hosted a WSMA meeting with State Representative Joe Schmick, the Ranking Member of the Washington House Health Care and Wellness Committee as well as staff from the State House Republican Caucus to discuss cost drivers in health care. Attendees included WSMA Board Members and Staff as well as PCMS Executive Director Bruce Ehrle. The meeting took place on Monday, August 14 at the PCMS office building in Tacoma.
The group discussed a wide variety of factors that contribute to the ongoing high costs of health care in the United States including a lack of health literacy on the part of patients that leads to acute conditions being treated in the most expensive care settings such as the ED due to failure to establish relationships with primary care providers, lack of adherence to preventive health behaviors, shortages in primary care providers, administrative costs including those associated with utilization of HIT as well as business regulations that impact physician practices, failure to address health globally with poor metrics on social determinants of health leading to poor outcomes and high costs, lack of care coordination in the home at the community level, and pharmaceutical prices.
An additional focus of the meeting centered on how allowing physicians and health systems with good records of treatment utilization to more broadly participate in “gold card” programs with payers that eliminate burdensome pre-approval processes can achieve cost savings both from an administrative standpoint for the provider and payer as well as from an incentive standpoint to have additional providers following best practices in treatment utilizations so as to be allowed to participate in such programs.
Rep. Schmick was appreciative to the group for the feedback regarding cost drivers as he performs fact finding on the topic during the recess period between legislative sessions in Olympia.