Group Health Northwest Backs Efforts To Craft Patient Bill Of Rights

Group Health Northwest of Spokane has become a player to be reckoned with in efforts to craft a national managed-care “Consumer Bill of Rights” as outlined in President Clinton’s State of the Union address.

A commission appointed by the president set forth a series of standards that would be legally binding on the managed care industry.

Group Health Northwest has joined Seattle-based Group Health Cooperative of Puget Sound, its parent, and Kaiser Permanente, in backing a national consumer-protection push.

Both of the Washington health care co-ops are affiliated with California-based Kaiser Permanente in a newly forged alliance called Kaiser/Group Health. It serves more than a million subscribers in Washington, Idaho and Alaska.

Kaiser Permanente is the country’s largest health maintenance organization (HMO). Group Health is the nation’s largest consumer-run HMO.

All are working for a bill of rights to protect 70 million people in HMOs.

The patient bill of rights would address such concerns as ensuring that financial incentives do not pressure doctors into withholding care, that cutting edge treatment is accessible to all, and that doctors tell patients factually up front what’s covered and what’s not. In addition, national standards would be established to measure quality of care, and consumers would receive guaranteed access to medical specialists.

“It’s hard to imagine,” says Dr. Henry Berman, president of Group Health Northwest, “that a document as far-reaching as the ‘Consumer Bill of Rights’ would not include a few things we don’t especially find to our liking.

“But,” adds the chief executive of the managed care provider for 190,000 subscribers in Washington and Idaho, “there is nothing in the standards outlined that we cannot enthusiastically support in principle. In fact, about 99 percent of the things set forth are things we are already doing. And we certainly agree that all these matters are legitimate consumer protection concerns.”

Kaiser Permanente and Group Health of Puget Sound have been committed to the advocacy effort for months. Their Spokane affiliate signed on only recently, Berman said, after he was named vice president of the Kaiser/Group Health combine. Berman said the issue of support for a patient bill of rights was put to a vote of the alliance leadership team, which agreed as a group to actively support the effort.

Berman, who chairs the Association of Washington Healthcare Plans, says, “Group Health is closer to consumers than almost any other plan because consumers constitute our board.

“A lot of health plans,” he says, “are against a patient bill of rights.”

In addition to insurance companies, opponents include many employers, business lobbyists, and Republican congressional leaders, some of whom have termed efforts to establish a patient bill of rights “a bill of goods.”

State Farm to roll back insurance rates

State Farm will roll back its insurance rates for more than half a million Washington motorists on March 1.

The company, which insures one of every six drivers in this state, backed into the rate reduction, according to the office of State Insurance Commissioner Debra Senn.

State Farm started by asking the commissioner to OK rate hike requests averaging 4 percent for State Farm’s best drivers and 8 percent for higher risk drivers, says department spokesman Jim Stevenson.

“We looked at the case they made for a hefty rate hike and we did the math,” he says, “and we said, ‘No. What you have made here is a case for a rate cut. They went back and looked at our analysis and came up with a reduction across the board of 3.6 percent.”

That translates to a rollback of 4 percent in the average rate for the company’s best (or “preferred risk” drivers) who are nine out of 10 of State Farm’s customers. The remaining one in 10, higher risk drivers, get rate increases averaging 1 percent - far better than the 8 percent originally sought.

But all of this is small change compared to the “dramatic cuts around Spokane,” reports Bob Bowles, State Farm senior marketing executive in this part of the state. “We rate by ZIP code and experience,” says the field supervisor, “and in some communities - Fairchild, Medical Lake, Liberty Lake, Otis Orchards and little places to the south - our average rate reduction is around 18 percent.”

In metropolitan Spokane, he said, the average decrease is 7.4 percent.

But some locales, like Deer Park, won’t get a rate break, Bowles says, because of the high incidence of bad accidents north of Spokane.

In line with many other companies nationally, Bowles says, State Farm is finding new ways to rejigger rates downward. In the over-50 market, for example, a flood of better drivers is bringing down rates.

How so? “Experience shows,” says the insurance expert, “that Baby Boomers turning 50 by the millions are far safer drivers than their parents were at that age.”

Distinguished alumni nominations sought

The College of Business & Public Administration at Eastern Washington University is seeking nominations for “Distinguished Alumnus of the Year.”

Deadline is Feb. 27. An awards banquet will be held in the spring. Nominations may be addressed to: Distinguished Alumnus of the Year, Office of the Dean, EWU College of Business & Public Administration, 668 N. Riverpoint, Suite A, Spokane, WA 99202-1660.

, DataTimes MEMO: Associate Editor Frank Bartel writes a notes column each Wednesday. If you have business items of regional interest for future columns, call 459-5467 or fax 459-5482.