PROVIDER REIMBURSEMENT AND FINANCIAL FOUNDATIONS OF UNIVERSAL HEALTHCARE

The January 15 FTAC meeting focused on advancing the financial and provider-payment foundations of a future universal health care system in Washington State. The committee oriented new members, approved prior minutes, reviewed public input, and clarified FTAC’s continuing role as a standing advisory body to the Universal Health Care Commission. Discussion emphasized aligning work plans, sequencing deliverables, and preparing for actuarial and economic modeling needed to support future policy decisions.

Key discussions centered on healthcare cost growth, which continues to exceed affordability benchmarks, reinforcing the urgency of cost containment and payment reform. Members reviewed how claims and non-claims data—particularly through the All-Payer Claims Database—are used to track cost drivers across commercial, Medicaid, and Medicare markets, and highlighted gaps that require data consolidation and possible legislative authority to address ERISA limitations.

A major focus was refining guiding principles for provider reimbursement in a universal system. The committee debated whether payment rules should be “the same” or “consistent,” ultimately favoring flexibility to ensure access, sustainability, and adequacy—especially for rural and underserved providers—while maintaining payer equity. Principles emphasized affordability, access, equity, rebalancing payments toward primary and behavioral health, and improved data standardization, while rejecting overly prescriptive concepts such as strict site neutrality.

The meeting also outlined incremental transition pathways for provider payment reform, starting with reference-based pricing in public employee plans and potentially expanding toward broader markets and long-term global hospital budgets. Parallel discussions addressed physician payment reforms, incentives for provider participation (administrative simplification and predictable funding), and safeguards against unintended consequences such as provider exit or care shifting.

Finally, FTAC discussed the scope and timing of future actuarial and economic modeling, drawing on prior Milliman work as a reference. Potential analyses include global hospital budgets, sequencing transitions from current coverage programs, employer incentives, and alternative revenue strategies. The meeting concluded with agreement on next steps: revising reimbursement principles, advancing data work, gathering additional member input, and continuing close coordination with the Commission as universal system design progresses.

Link to Video

Meeting Materials Here

Next Meetings:

• UHCC: Thurs., Feb.  12, 2026, 2-5 pm - Details available here closer to the date. 
• FTAC: Thursday, March 19, 2026, 2–4:30 p.m. - Details available here closer to the date. 

There are two ways to share input:

For FTAC

• Speak during the designated public comment time at FTAC meetings. Sign up to provide public comment by 5 p.m. the day before the meeting occurs. 
• Submit written comments at any time.  If you submit your comments less than two weeks before a meeting, we’ll include them in the following meeting’s materials.

For UHCC

• Speak during the designated public comment time at UHCC meetings. Sign up to provide public comment by 5 p.m. the day before the meeting occurs. 
• Email [email protected] at any time.  If you submit your comments less than two weeks before a meeting, they will be included in the following meeting’s materials.

We urge our members to push for a single payer plan in their public comments.

• Read our take on past UHCC and FTAC meetings

• Subscribe to Health Care Authority (HCA) for updates

Now Available, the Universal Health Care Commission 2025 Annual Report

ARE YOU INTERESTED IN SERVING ON THE UHCC? 

Currently, there  are two open seats on the Commission, subject to appointment by the Governor. Candidates should have knowledge and experience regarding health care coverage, access, and financing, or other relevant expertise. 
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