AN OVERVIEW OF THE HEALTHIER WASHINGTON INITIATIVE GREATER

AN OVERVIEW OF THE HEALTHIER WASHINGTON INITIATIVE, GREATER COLUMBIA ACH AND THE PATIENT CENTERED MEDICAL HOME MODEL OF CARE

Healthier Washington Healthcare Transformation Strategies 2

US health care system most expensive in the world

Average Spending on health per capita, $8, 508

Baby Boomers Need Coordinated Care BABY BOOMER CARE

Acute Care Model of Care = Old Framework Fee for Service Causes of Death

Washington State is on a mission to transform its healthcare delivery system! Current System Transformed System Fragmented clinical and financial approaches to care delivery Integrated systems that deliver whole person care Disjointed care and transitions Coordinated care and transitions Disengaged clients Activated clients Capacity limits in critical service areas Optimal access to appropriate services Individuals impoverish themselves to access long -term services and supports (LTSS) Timely supports delay or divert need for Medicaid LTSS Inconsistent measurement of delivery system performance Standardized performance measurement with accountability for improved health outcomes Volume-based payment Value-based payment

Medicaid Transformation Goals • Reduce avoidable use of intensive services and settings— such as acute care hospitals, nursing facilities, psychiatric hospitals, traditional long-term services and supports, and jails • Accelerate the transition to value-based payment—using payment methods that take the quality of services and other measures of value into account • Ensure that Medicaid cost growth is 2% below national trends—through services that improve health outcomes and reduce the rate of growth in the overall cost of care • Improve population health—prevention and management of diabetes, cardiovascular disease, mental illness, substance use disorders, oral health and more

Health is more than health care Because we know that health is more than health care. Adapted from: Magnun et al. (2010). Achieving Accountability for Health and Health Care: A White Paper , State Quality Improvement Institute. . Minnesota. Factors contributing to the variability in mortality

CDC Health Impact Pyramid

Building healthier communities through regional collaboration

Population & Medicaid # by County** County Population* Medicaid Population** % Medicaid % of GCACH Medicaid Asotin 22, 610 7, 113 31. 5% 2. 9% Benton 201, 877 57, 622 28. 5% 23. 2% 4, 059 1, 166 28. 7% 0. 1% Franklin 94, 347 35, 200 37. 3% 14. 2% Garfield 2, 247 600 26. 7% 0. 2% Kittitas 47, 364 9, 537 20. 1% 3. 8% Walla 60, 922 16, 861 27. 7% 6. 8% Whitman 49, 791 8, 055 16. 2% 3. 2% 251, 446 111, 924 44. 5% 45. 1% 712, 053 248, 078 34. 8% 100% 7, 427, 570 1, 837, 342 24. 7% Columbia Yakima Population GCACH Population WA * ofm. wa. gov/Washington-data-research/county-and-city-data **www. hca. wa. gov/about-hca/apple-health-medicaid-reports 3 -19

Greater Columbia ACH is creating a Culture of Health

Patient Centered Medical Homes

8 Change Concepts

How to create “Value” in healthcare

The Movement to Value-Based Payment By 2021, 90% of Medicaid payments will be linked to VBP models. Commercial carriers have already begun to follow suit. Increasing provider financial risk

Learning Collaboratives • Monthly Learning Collaboratives for PCMH providers • Focusing on topical areas of interest, especially those tied to PCMH Milestones o EMS Community Paramedicine o Behavioral health integration o Prescription Drug Monitoring Program (PDMP) o Care Coordination o Trauma and the Opioid Crisis o Etc.

GCACH - PCMH Cohort #1 $12, 673, 219 Astria Sunnyside, Yakima, and Toppenish Hospitals Catholic Charities Serving Central WA CHAS Health Columbia Basin Health Association Community Health of Central WA Kadlec Regional Medical Center Kittitas County Public Hospital District Lourdes Health Network Memorial Physicians Palouse Medical Prosser Memorial Providence St. Mary’s Medical Center Pullman Regional Hospital Student Health Options Tri-Cities Community Health Yakima Valley Farm Workers Clinic Yakima Neighborhood Health Services

Behavioral Health Providers – Cohort #2 $ 4, 211, 631 Barth Clinic, LLC Blue Mountain Counseling Catholic Charities of Yakima Comprehensive Healthcare First Steps Community Counseling Ideal Balance Lourdes Hospital LLC Lutheran Community Services NW Palouse River Counseling Quality Behavioral Health Serenity Point Counseling Services, LLC Somerset Counseling Sundown M Ranch The Valley Alcohol Council, Inc (Merit) Tri-Cities Community Health Yakima Valley Council on Alcoholism (Triumph Treatment Services) Yakima Valley Farm Workers Clinic

Opioid Resource Networks (ORNs) Benton-Franklin-Walla Opioid Resource Network $300, 000

Community Health Fund $1. 4 Million to Address SDOH Local Health Improvement Network (LHIN) Access to Care/Transportation Benton-Franklin Community Health Alliance X Blue Mountain Regional Health Partnership X Healthcare System Navigation Housing X X X Whitman County Health Network Yakima County Health Care Coalition Behavioral Health Employment X Kittitas County Health Network Southeast WA Rural Health Network Nutrition/Food Insecurity X X Education X X X X X

Community Resilience Campaign $600, 000 GCACH is launching a regional resilience campaign to help mitigate the effects of Adverse Childhood Experiences (ACEs) Task force of SME to ensure the campaign is focused, targeted, demographically sensitive, and complementary to the efforts already being carried out locally.

GCACH Health Information Technology (HIT) Initiatives • The GCACH is advancing data and digital strategies to advance interoperability and population health management within and across our partnering organizations o Health Commons for community complex care coordination o CSI Healthcare Community for partnering provider collaboration o Population health management technology integration o The Collective Platform (Pre. Manage/EDIE) for care transitions o Image. Trend (Community Paramedicine Pilot Project) o Data. Motion (Direct Secure Messaging) for interoperability o Community Resource Directory to help address patients’ and providers’ social needs

The Health Commons

Sponsorship/Scholarship Program • 2019 Sponsorship Fund: o $30, 000 • 2019 Behavioral Health Scholarship Fund: o $490, 000

Supportive Housing

Current Funds Flow

GCACH Board of Directors Board Member Sector Organization Brian Gibbons Healthcare Provider Astria Sunnyside Hospital Carrie Green Philanthropy Three Rivers Community Foundation Dan Ferguson Workforce Development Yakima Valley College Darlene Darnell Community Based Organization/Faith Based Organization Catholic Charities Dana Oatis Behavioral Health Lourdes Health Network Eric Nilson Public Safety Kennewick Fire Department Jorge Arturo Rivera Managed Care Organization Molina Healthcare Julie Petersen Hospital Kittitas Valley Healthcare Les Stahlnecker Education ESD 123 Lottie Sam Tribe Yakama Nation Madelyn Carlson Transportation People for People Martha Lanman Public Health Columbia County Public Health Dept. /Garfield County Health District Rhonda Batchelor Consumer Lourdes Health Network Rhonda Hauff Housing Yakima Neighborhood Health Services Ruben Alvarado Local Government City of Pasco Sandra Suarez Federally Qualified Health Center Yakima Valley Farm Workers Clinic Susan Grindle Social Service Hope. Source

GCACH Backbone Staff Member’s Name Job Title Email Carol Moser Executive Director cmoser@gcach. org Wes Luckey Deputy Director wluckey@gcach. org Becky Kolln Director of Finance and Contracts bkolln@gcach. org Sam Werdel Director of Practice Transformation swerdel@gcach. org Diane Halo Opioid Resource Network Project Manager dhalo@gcach. org Rubén Peralta Community and Tribal Engagement Specialist rperalta@gcach. org Rachael Guess Finance and Contracts Coordinator rguess@gcach. org Jenna Shelton Practice Transformation Navigator jshelton@gcach. org Martin Sanchez Practice Transformation Navigator msanchez@gcach. org Lauren Johnson Communication and Administrative Coordinator ljohnson@gcach. org

Thank you!