More than 12,000 PEBB members choose new high-quality medical plans for 2016
OLYMPIA – As part of the Health Care Authority’s (HCA) effort to move from volume to value in purchasing health care, we offered three new medical plan options for 2016. More than 12,000 enrollees in HCA’s Public Employees Benefits Board (PEBB) Program chose one of those offerings.
The new plan offerings and final numbers are:
- Uniform Medical Plan (UMP) Plus: About 10,400 PEBB members enrolled in one of two UMP Plus offerings available in King, Kitsap, Pierce, Snohomish and Thurston counties. One plan is offered through the Puget Sound High-Value Network, and the other through UW Medicine Accountable Care Network.
- SoundChoice: About 1,600 PEBB members enrolled in SoundChoice, GroupHealth’s new plan offering in King, Pierce, Snohomish and Thurston counties.
Moving from volume to value means shifting our purchasing of health care away from the traditional fee-for-service approach in which providers are paid for the number of services provided. Paying for value means HCA will pay providers based on the quality of care delivered, including patients’ satisfaction with their health care experience, and improved health outcomes on a host of measures.
“The number of PEBB enrollees who chose one of our new offerings tells us that people are hungry for—and providers are ready to offer—high-quality care that improves health and saves money,” said HCA Director Dorothy Frost Teeter. “Even as we celebrate the success of this first year, we are looking ahead to 2017 and beyond to see how we can extend these or similar plan offerings statewide so that all PEBB members have access to coordinated, high-quality, whole-person care where they live.”
The UMP Plus plans and Group Health offerings, including SoundChoice:
- Offer best-in-class patient service and experience, including high-quality and timely services at lower costs.
- Deliver coordinated physical, mental health and substance abuse services.
- Assume financial and clinical accountability for a defined population of PEBB members.
As the purchaser of health care for more than 2 million Washington residents through Apple Health (Medicaid) and the PEBB Program (1 of every 3 non-Medicare residents), HCA is poised to drive the marketplace toward paying for value. Paying for value is one of the main strategies in Healthier Washington, our state’s effort to achieve the triple aim of better health, better care and lower costs. The strategy was supported in House Bill 2572, a Gov. Jay Inslee bill passed by the Legislature in 2014.
Open enrollment—during which time the more than 350,000 public employees, retirees, and their family members enrolled in PEBB coverage can change medical and dental plans and make other changes—ran throughout November 2015 for coverage beginning Jan. 1, 2016.
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