Wednesday, September 19, 2018
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HCA announces administrator for Uniform Medical Plan starting in 2020

OLYMPIA – The Health Care Authority (HCA) today announced a new contract to provide enhanced services to the nearly 200,000 public employees enrolled in Uniform Medical Plan (UMP). UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program.

After a two-year competitive process, HCA selected Regence BlueShield as the third-party administrator to serve UMP members under a new 10-year contract starting January 1, 2020. In addition to the administrative functions required of a third-party administrator, such as claims processing and maintaining the provider network, the contract includes an enhanced focus on improved care quality and customer experience.

The contract will run through Dec. 31, 2029, with an option to extend seven more years.

HCA added many enhancements to the new contract to improve members’ experience and quality of care, including:

  • Improving the website user experience for members, including provider search tools.
  • A payment structure that pays providers based on their ability to meet quality metrics rather than simply per service or treatment.
  • Participation in multi-payer initiatives and data-sharing agreements to improve health delivery and quality of care, and lower costs.
  • Introducing a commercial accountable care organization (ACO) offering among Regence’s insurance offerings to its other customers in Washington’s health insurance market. The offering will adopt the value-based payment structure that pays providers based on quality (similar to UMP Plus offered through the PEBB Program).

“This is a major step in our efforts to move toward paying for quality care, rather than simply paying for quantity of care,” said HCA Director Sue Birch. “Regence will be an excellent partner as we continue transforming our health care system to one that provides better care and better health at a lower cost.”

“We are proud to have the opportunity to continue to serve Washington state employees and partner with the HCA to support a healthier Washington and deliver innovative health care solutions to employees and their families,” said Tim Lieb, president of Regence BlueShield. “Together, Regence and the HCA are well-positioned to transform health care and deliver true Value Based Care—for Regence, 2020 starts today.”

The HCA’s current contract with Regence BlueShield as UMP’s third-party administrator expires Dec. 31, 2019.

Background

The PEBB Program covers eligible employees and retirees of state agencies and higher-education institutions, as well as K-12 school districts and political subdivisions that choose to purchase PEBB insurance coverage.

UMP currently offers three plans to eligible PEBB members: UMP Classic, UMP Consumer-Directed Health Plan (CDHP) with a health savings account, and UMP Plus.

Visit www.hca.wa.gov/pebb to learn more.

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