DJ Wilson, Wilson Strategic President, was invited on June 13 to speak on a distinguished panel of health care leaders at the California Association of Physician Groups (CAPG) 12th Annual HealthCare conference.
The panel “Hot State Issues-Recent Changes to Network Adequacy and Transparency Rules, Patient Protection Against Surprise Billing and Out-of-Network Provider Payment” featured California Assembly Member Rob Bonta (D-18), the California Director of the Department of Managed Health Care (DMHC) Shelley Rouillard, and Bill Barcellona, Senior VP for Government Affairs at CAPG.
Barcellona introduced Wilson as “the wisest man in the Pacific Northwest” and asked him to be the voice on what is new in Washington, Oregon, and Alaska for the California audience. While Wilson jovially declined the title, he talked at length about his take on actuarial value and narrow networks.
See a clip of Wilson in action below:
Assembly Member Bonta also updated the audience on four health care bills that he is actively working on this year. AB 533, which passed the Assembly 74-1, seeks to protect consumers from receiving bills from out-of-network providers for services performed at an in-network facility. Bonta stated that “surprise” billing is an growing problem in California health care.
“A patient who has coverage, does everything right, and believes that he or she is receiving in-network care should not be be subject to hidden costs and unfair charges,” said Bonta.
Shelley Rouillard spoke about incomplete provider directories as a stumbling block to consumers being able to understand their in-network benefits. She explained the work that her department is currently undertaking to ensure more transparency from health plan directories. She also discussed the work that they now face as a result of the passage of SB 964 which requires annual assessments of health plan networks.
“Narrow networks are nothing new, although they’ve been getting a lot of attention lately,” said Rouillard. “We consider networks adequate if they meet the legal standards of geographic access, ratios of specialists and providers to the community’s needs, timely access, and in some cases alternate access for rural areas.”
The audience of health administrators and executives shared anecdotes, both personal and professional, around the difficulty of contracting networks and navigating the regulatory environment.
Wilson Strategic staff members JJ Lee and Stephanie Wick also attended the three-day conference at the Manchester Grand Hyatt.
Wilson Strategic met some long-time friends and familiar faces from the Pacific Northwest at the event-including newly-retired PeaceHealth President and CMO Alan Yordy and Washington State Health Care Authority Director MaryAnne Lindeblad, who also spoke on a panel titled “Medicaid and Accountable Care: New Models to Improve Health of Individuals and Communities.”
Joe Gifford, Chief Executive, Accountable Care Organization of Washington, Providence Health & Services also gave a presentation “Employer Group Direct Contracting: the Providence, Boeing and Intel Experience.”
The 2015 CAPG Healthcare Conference drew approximately 1,800 members of the health care industry-including independent practice associations, hospitals, and health plans-to the San Diego area.
Special thanks to Lura Hawkins, Bill Barcellona, and CAPG CEO Donald Crane for welcoming Wilson Strategic to their event.