Recently, Violet joined health industry leaders at the 2025 Washington State of Reform Health Policy Conference in Seattle. Experts from across the US gathered to discuss strategies for improving and sustaining Medicaid access in Washington State. 

Moderated by Amina Suchoski from the Health Management Associates (HMA), the session titled Advancing Medicaid Access in Washington State brought together prominent experts from the Washington State Medical Association (WSMA), Molina Healthcare of Washington, and Better Health Together. The panel explored the intricacies of Medicaid administration, the role of managed care, and how community-based initiatives can help bridge gaps in health care access for marginalized populations.

The Medicaid landscape in Washington

Dr. Jay Fathi, President and CEO of Molina Healthcare of Washington, kicked off the session with an overview of Medicaid, explaining its vital role in providing health care to low-income individuals. Medicaid covers approximately one in four residents in the state of Washington, and its administration varies between fee-for-service models and managed care. Managed care, which involves contracting with health plans to coordinate care, has become the dominant model.

Jennifer Hanscom, CEO of WSMA, emphasized the significant role of managed care plans, which include health care professionals like social workers, nurses, and behavioral health specialists, ensuring that patients receive timely and appropriate care. Managed care plans improve outcomes and access, and are crucial to reducing emergency room visits by effectively managing chronic conditions. Hanscom also noted that Medicaid in Washington has shifted towards value-based-payments, where contracts are increasingly tied to patient outcomes rather than fee-for-service.

The inequities of Medicaid payment structures

A major theme throughout the discussion was the inequities in health care payment systems, which disproportionately affect marginalized communities. Hanscom highlighted how payment disparities impact providers, especially in underserved areas, where reimbursement rates are lower than the actual cost of care. This has led to a bottleneck in access to specialty care, with many providers limiting the number of Medicaid patients they accept.

Amina Suchoski proposed a Medicaid Access Program that would seek to address these inequities by creating a funding match between the state and federal government. This initiative aims to alleviate the financial strain on Medicaid providers and increase access to care, particularly in rural communities.

The critical role of community-based care and care hubs

Alison Poulsen of Better Health Together also underscored the importance of community care hubs—state-supported initiatives designed to connect people with social services like housing, food, and mental health support. With 80% of a person's health influenced by factors outside of traditional health care, these hubs are pivotal in addressing social determinants of health (SDOH).

The community care hub model is designed to streamline access to these services, working in tandem with health care providers, social workers, and community-based organizations. This integrated approach aims to improve health outcomes by ensuring that individuals receive the right care at the right time, particularly in areas where health care services are scarce or fragmented.

Technology’s role in expanding access

The panel also touched on the role of telehealth in increasing health care access, especially in rural and underserved areas. Hanscom highlighted the surge in telehealth usage during the pandemic and its potential to continue expanding. Virtual care eliminates barriers like transportation, long wait times, and time off work, making health care more accessible for patients who might otherwise struggle to seek in-person care.

However, challenges remain in ensuring that telehealth services are adequately reimbursed, especially in community health settings. Hanscom expressed a desire to see telehealth remain a viable option post-pandemic, as it allows  for greater flexibility and access to care for Medicaid enrollees.

The session concluded with a call for innovative solutions to support the sustainability of Medicaid so  that all residents, particularly the most vulnerable, have access to the care they need. Whether through increased funding, better integration of social services, or the continued expansion of telehealth, the goal remains the same: to create a Medicaid system that is both sustainable and equitable for all.

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