Washington

- In 2007 Washington became the second state to pass DPC legislation.  For the text of the law, see Wash. Rev. Code § 48.150.010 (2007) and we also recommend reviewing the Washington Insurance Code (Title 48 RCW as well).

- The Washington legislation was a good early example of what a DPC law could achieve.  Unfortunately it left much control in the hands of the Washington state insurance commissioner, and practices were required to collect data and submit annual reports.  The law fails to distinguish DPC from concierge practices, evidenced in part by this list of registered practices.  Fortunately the insurance commissioner's annual reports not only failed to find many patient complaints, but in fact offered further evidence of the model's effectiveness as evidenced by Commissioner Mike Kreidler's repeated reports to the legislature (2015, 2014, 2013 (no link available), and 2012).  Here is the state's DPC overview page.

- Multiple DPC practices are doing well in Washington, including Qliance - one of the most influential and important DPC practices.  Qliance was born from a small direct primary care practice started by Garrison Bliss, MD.  Garrison and Erika Bliss, MD (they are cousins) now run the 40,000+ patient practice - the largest DPC organization in the United States.  Many of the group's efforts are worth noting here:

  • Medicaid Managed Care - enrolled patients via a Medicaid Managed Care pilot with Centene
  • Health Exchange - enrolled patients through the state run health exchange using provisions of the Affordable Care Act allowing for DPC to be paired with a "wrap around" health plan in the insurance exchange

- Iora Health offers DPC via a Medicare Advantage plan in Washington. 

When launching a DPC practice in Washington:

  1. Review our Starting a DPC Practice commentary
  2. Read the DPC law (Wash. Rev. Code § 48.150.010)
  3. Draft your DPC Patient Membership Agreement
  4. Draft other agreements as needed (we have lots of FREE examples linked on our Forms page)
  5. Consider purchasing our Washington specific DPC Patient Membership Agreement.  This agreement has been drafted in Microsoft Word with highlighted areas and commentary making further customization easy to complete independently.