AWHP Healthcare Goals
Carriers help our members pay for healthcare. The affordability of insurance matters to us, and we carefully monitor legislative and regulatory proposals for their impact on insurance premiums and healthcare costs.
We also negotiate with providers and facilities for the lowest reasonable payments for healthcare services. This helps our members pay less out of pocket for their share of costs and helps minimize premium rate increases.
Preventive and contraceptive services are available to our members without any cost-share obligation.
Access to Care
Carriers form high-performing networks of quality providers and facilities. These networks of providers and facilities are selected for their ability, the health outcomes of their patients, and their ability to deliver the services covered by a member’s health plan.
Quality of Care
All providers and facilities in a carrier’s network are credentialed, this means that the health plan confirms that a provider’s Washington state license to practice is active, and that their history qualifies them to deliver services to our members.
Carriers employ medical directors and case managers to help our network of providers identify the best course of treatment for our members, especially members with complex or chronic health conditions. Carriers also ensure that their health plans’ drug formulary includes drugs in every therapeutic category identified by the Food & Drug Administration.
Carriers also provide information to providers and facilities about the health of members that they treat. Providers and facilities then use this information to understand what approaches to care are working, and to identify trends and gaps in patient care. This improves the quality of care not only for our members but for all Washingtonians.
Keeping Coverage Affordable
- Federal Changes to the Affordable Care Act
- Individual & Small Group Market Stability
- Administrative Cost Management & Minimum Loss Ratios
- State Health Benefit Exchange
- Behavioral Health Integration
- Medicaid Rate Reasonableness
Solving Healthcare Problems
- Opioid Crisis
- High-Cost Drugs
- Balance Billing
- Access to Care
- All Payer Claims Database
New Laws & Regulations
- 2018 Legislature
- Recently Adopted Regulations