It appears to me that the 2018 legislative session is setting up to be the “medical session” for several reasons:
1. There is an interim committee to study the State Employee Group Insurance plan. Undoubtedly, this committee made up of Senator Lakey, Johnson, Patrick, Nonini, and Nye with Representatives Wood, Anderson, Anderst, Manwaring, and Kloc will come up with good recommendations.
2. Congress seems to be making some progress on modifying the Affordable Care Act which will have impact on health insurance, Medicaid, taxes, high risk pool, Medicaid waivers etc. There will be plenty of work that will need to be done next session.
3. The legislature has wrestled with the Medicaid Gap issue for several years and is getting closer to making a decision. 2018 may be the year that a direction is chosen.
In preparation for the likelihood that the 2018 legislative session will be a busy “medical session”, I am committed to give a weekly report on what is happening, my thoughts and research, and news coming out of Washington D.C. My hope is that this “pre-discussion” will make the next session productive and relatively short. I don’t want to be making last minute decisions on these issues.
This week I would like to report on what the interim committee on the State Employee Group Insurance and Benefit Committee is doing. The first meeting was held on the 4thof May. The purpose was to begin the process of hiring a consultant. There were 6 consulting firms that submitted an RFP. The first meeting was to choose the finalists for face-to-face interviews. The three groups chosen for face-to-face interviews were Milliman, Mercer, and Westcott Partners. However, none of the 6 proposals were eliminated. There is a possibility that all six may be interviewed.
Choosing a consultant is extremely important. I applaud the committee for taking their time and trying to get this part right. I don’t have any more information about the process than this because the hiring process was done in executive session and I was not able to attend.
Some questions that I hope will be asked are:
1. What is your clientele base? Do you consult with large employers, small groups, government, fully and self-funded groups?
2. Have you had success in reducing medical costs while improving outcomes and increasing access?
3. Is your focus mostly on insurance or access to care through primary care arrangements like DPC or ACOs?
4. Do you recommend the use of bio-metrics and incentives to deal with smoking, weight management, and exercise?
5. The legislature passed a resolution requesting a medical transparency tool. What experience to you have with transparency tools?
6. What programs and recommendations have you made to your clients that have improved their health care plans?
Senator Steven Thayn