SB 6356

S-5280.1
  SENATE BILL 6356
State of Washington       69th Legislature       2026 Regular Session
By Senator Hasegawa
1      AN ACT Relating to the use of preceptorships to train primary
2  care physicians; amending RCW 70.390.080; and creating a new section.
3  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
4     NEW SECTION. Sec. 1. The legislature finds that:
5     (1) There is a severe shortage of primary care providers in
6 Washington, particularly in rural and underserved areas of the state;
7     (2) A focus on primary care results in a health care delivery
8 system that is more productive and less expensive; and
9     (3) The efficient and affordable use of primary care clinical
10 rotations and preceptorships could expand the supply of primary care
11 providers without burdening medical students who choose to provide
12 primary care with excessive debt.
13     Sec. 2.   RCW 70.390.080 and 2022 c 155 s 1 are each amended to
14 read as follows:
15     (1) The board shall measure and report on primary care
16 expenditures in Washington and the progress towards increasing it to
17 12 percent of total health care expenditures.
18     (2) By December 1, 2022, the board shall submit a preliminary
19 report to the governor and relevant committees of the legislature
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1 addressing primary care expenditures in Washington. The report must
2 include:
3     (a) How to define "primary care" for purposes of calculating
4 primary care expenditures as a proportion of total health care
5 expenditures, and how the definition aligns with existing definitions
6 already implemented in Washington, including the previous report from
7 the office of financial management and the Bree collaborative's
8 recommendations;
9     (b) Barriers to the access and use of the data needed to
10 calculate primary care expenditures, and how to overcome them;
11     (c) The annual progress needed for primary care expenditures to
12 reach 12 percent of total health care expenditures in a reasonable
13 amount of time;
14     (d) How and by whom it should annually be determined whether
15 desired levels of primary care expenditures are being achieved;
16     (e) Methods to incentivize the achievement of desired levels of
17 primary care expenditures;
18     (f)(i) Specific practices and methods of reimbursement to achieve
19 and sustain desired levels of primary care expenditures while
20 achieving improvements in health outcomes, experience of health care,
21 and value from the health care system, including but not limited to:
22 Supporting   advanced,    integrated   primary   care    involving  a
23 multidisciplinary team of health and social service professionals;
24 addressing social determinants of health within the primary care
25 setting; leveraging innovative uses of efficient, interoperable
26 health information technology; increasing the primary care and
27 behavioral health workforce; and reinforcing to patients the value of
28 primary care, and eliminating any barriers to access.
29     (ii) As much as possible, the practices and methods specified
30 must hold primary care providers accountable for improved health
31 outcomes, not increase the administrative burden on primary care
32 providers or overall health care expenditures in the state, strive
33 for alignment across payers, and take into account differences in
34 urban and rural delivery settings; and
35     (g) The ongoing role of the board in guiding and overseeing the
36 development and application of primary care expenditure targets, and
37 the implementation and evaluation of strategies to achieve them.
38     (3) Beginning August 1, 2023, the board shall annually submit
39 reports to the governor and relevant committees of the legislature.
40 To the extent possible, the reports must:
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1     (a) Include annual primary care expenditures for the most recent
2 year for which data is available by insurance carrier, by market or
3 payer, in total and as a percentage of total health care expenditure;
4     (b) Break down annual primary care expenditures by relevant
5 characteristics such as whether expenditures were for physical or
6 behavioral health, by type of provider and by payment mechanism; and
7     (c) If necessary, identify any barriers to the reporting
8 requirements and propose recommendations for how to overcome them.
9     (4) In developing the measures and reporting, the board shall
10 consult with primary care providers and organizations representing
11 primary care providers and review existing work in this and other
12 states regarding primary care, including but not limited to the
13 December 2019 report by the office of financial management, the work
14 of the Bree collaborative, the work of the advancing integrated
15 mental health center and the center for health workforce studies at
16 the University of Washington, the work of the Milbank memorial fund,
17 the work of the national academy of sciences, engineering, and
18 medicine, and the work of the authority to strengthen primary care
19 within state purchased health care.
20     (5)   The  board   shall   review  the   cost   of primary care
21 preceptorships for hospitals and other clinical settings to train
22 primary care physicians to address the need for primary care
23 providers in rural and unserved areas in Washington. By December 1,
24 2027, the board shall submit a report to the governor and relevant
25 committees of the legislature detailing its findings.
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