Washington

The Health Care Cost Transparency Board analyzed healthcare spending from 2017 to 2023, using data from both public and commercial insurers in the All-Payer Claims Database. The analysis revealed that spending on retail pharmacies increased by 71 percent during this period, which is a significantly faster rate of growth compared to any other category of services. Rising prices were the primary driver of growth in spending on prescription drugs, with the number of prescriptions increasing by only three percent, compared to a 66 percent price increase. This study aligns with other studies that show that list prices set by manufacturers are the primary reason why costs are escalating. 

Also in Washington, the Health Care Authority's (HCA) 2025-27 Operating Budget was reduced for Apple Health (Medicaid) managed care organization (MCO) rates by one percent, or approximately $90 million, for calendar year 2026. HCA provided guidance and FAQ on the managed care rate reductions effective January 1, 2026.  

Also in Washington, the Health Care Authority (HCA) updated the substance use disorder (SUD) provider guide, clarifying state and federal laws that limit the use and disclosure of SUD information. 

Finally in Washington, starting August 1, submitting eligibility policy questions and data requests for Eligibility Policy Innovation and Community Support (EPICS) is transitioning from the email inboxes to the ServiceNow platform, renamed to Apple Health Policy.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.