Forum Principles

Principles Guided by Values

The Forum's work advances our guiding values and principles. Too often, health care "fixes" address only one key aspect of the system, rather than recognizing the impact each segment has on the whole. The Forum believes we need to create an affordable and sustainable health care system that can address the critical health care needs of all our citizens. To that end, our inter-dependent guiding values and principles include:

• Value: Access
  Principle: Individuals should have access to providers and to health insurance that provides basic benefits.

"Who will be there to care for me?" is a question that Washington residents voice with increasing concern. We face a shortage of doctors, nurses and pharmacists. We observe providers who are closing their practices to Medicare and Medicaid patients because of inadequate reimbursement or leaving critical specialties because of unaffordable malpractice insurance. Taken together, the worry is mounting about access to providers.

And that's only one half of our critical access picture. With the highest unemployment in the nation, the ranks of the uninsured in our state continue to rise at an alarming rate. As the uninsured increasingly seek care at hospital emergency rooms, further pressure is placed on our system. Even our progressive programs to care for the working poor are threatened by state budget shortfalls.

The issues are complex and the Forum pledges to support public policies that promote greater access, including adequate reimbursement for Medicaid and Medicare, tort reform, and support for educational programs for health care professionals in short supply.

• Value: Affordability
  Principle: Affordability must become a central component of our health care system, for the sake of individuals, government, and purchasers.

Having the latest whiz bang technology or the newest procedure won't improve our citizens' health if we can't figure out a way to make the most important elements of health care affordable to the greatest number of individuals. That means we can't waste resources or mandate every possible benefit. Our state and our nation need to have a serious conversation about what constitutes sound health care policy. And one key litmus test for these discussions must be affordability.

Our citizens need access to health coverage and we need health plans that provide the most valuable health care benefits, not plans that are priced out of affordability by mounting government mandates or cost shifting from public programs. We must focus on value in health care, stretching each dollar by providing the right care at the right time.

• Value: Quality
  Principle: Providers should follow best practices and evidence-based guidelines, with a strong emphasis on patient safety.

Chronic disease is on the rise and the population is aging. Add to this, advancing technologies, new medications, and new procedures and providers have a wide array of tools to manage in order to deliver high quality health care. The Forum supports initiatives that encourage providers to follow nationally recognized disease management guidelines and that promote patient safety. And we believe that patients should know about the performance of providers so that they can make informed choices.

• Value: Accountability
  Principle: In order to balance access, quality and affordability, both consumers and government must be accountable for the choices they make.

We learned from experience that consumers expect the right to choose-between providers, between health plans and between types of coverage. Now consumers need to recognize that accountability comes along with that choice. In our society, we budget for food, clothing and shelter, yet we expect someone else to cover all of our health care costs. The Forum believes our health system will improve if consumers are given a direct voice in selecting the kind of services and coverage they need, want and are willing to help pay for. With more "skin in the game" consumers should have greater flexibility to choose the providers they want to deliver their care.

Because our system is a combination of private employer-based and public government-funded, government accountability also is essential. An adequately funded safety net is an essential component of a sound health care system. Cost shifting to private insurance and inadequate reimbursement to providers caring for patients through government programs has exacerbated the health care crisis we face.

We support adequate government funding of public programs, consumer choice of a variety of health plans, providers and coverage, and the use of cost-sharing in premiums and benefits to restrain health care inflation.

• Value: Efficiency
  Principle: The "hassle factor" for patients, providers and health plans should be reduced wherever possible through simplified administration and a secure flow of information.

The Forum understands that the administrative burden of health care has complicated the lives of providers, health plans and by extension patients. That's why so much of our early efforts has focused on finding areas where we can standardize, simplify, and streamline interactions between providers and health plans. Our first 10 initiatives, unveiled in the Spring of 2002, focused on claims processing, referrals and authorizations and credentialing. Work in these three areas continues, with input from hundreds of providers around the state.

Healthcare organizations want to be able to securely exchange information electronically. After significant early efforts, the Forum incubated OneHealthPort, a company that will provide information security services to the health care community. By working together on the security portal, OneHealthPort members hope to realize cost savings, achieve system efficiencies and mitigate the risks of online transactions.