National Health Policy Conference February 4, 2008

1. Washington State Health Reform Efforts National Health Policy ConferenceFebruary 4, 2008 Richard K. Onizuka, PhD Health Policy Director

2. Today’s Presentation Health Reform Efforts Blue Ribbon Commission on Health Care Costs and Access Health Information Technology Pilot Project What Washington Can Do for Washington…and Other States

3. State Facts • Population ~ 6.4 million • Only state named after US President • State spending on health care ~ $4.5B, up from $2.7B in 2000 • Percent of state budget ~ 28%, up from 22% in 2000 • Approximately 593,000 insured, includes 73,000 children (2006 estimates) • Produces more apples than any other state

4. Governor Chris Gregoire’s Five-Point Health Care Strategy • Emphasize evidence-based health care • Promote prevention, healthy lifestyles, and healthy choices • Better manage chronic care • Create more transparency in the health care system • Make better use of information technology

5. Blue Ribbon Commission Strategies • High-quality, high-performing health care system • Affordable health insurance options • Next generation health • Health promotion and prevention Recommendation #4 (of 16) • Health information technology

6. Senate Bill 5930 “An act relating to providing high-quality, affordable health care to Washingtonians based on the recommendations of the Blue Ribbon Commission on Health Care Costs and Access” • Section 10: • Health information infrastructure • Consumer-centric health record banking • Goal: • Deliver health information - when and where needed

7. HIT Efforts SSB 5064 (2005): Health Information Technology • Health Information Infrastructure Advisory Board (HIIAB) • EMR and Health IT Strategy • Final Report - December 2006 • Health Record Banking • Roadmap for State Action

8. Consumer-Centric Health Record Banks • Consumer controlled • High-value data set • Repository for “copies” • Deposit • Withdraw • Query • Secure, private, & confidential • Engagement innovation

9. Clinical Encounter Health Record Banking Model High-Value Data Set Health Record Bank A Patient Input/AccessPHR Patient Permission? Health Record Bank B 9

10. HIT Initiatives Arizona State Alliance for e-Health HISPC Dossia CCHIT Oregon RWJF ONCHIT Florida SCI HealthVault AHIC Markle Foundation HITSP Kentucky Google Revolution Health CMS: MTG HL 7

11. What Washington Can Do (one State’s opinion) • Develop national standards • Funding – describe, not prescribe • Fund pilot and evaluation of difficult solutions (e.g., financial sustainability) • Find out what states need • Please, not more policy committees

12. Federal Action “…the most promising avenue for extending health insurance coverage, limiting growth of spending, and improving the quality of care lies in action by the states, abetted by federal legislation and regulation that will encourage this state action” Henry J. Aaron, The Brookings Institution Testimony Before the Committee on the Budget September 11, 2007

13. Washington State Health Reform Efforts Questions? richard.onizuka@hca.wa.gov (360) 923-2820 http://www.hca.wa.gov