Building Accountable Communities of Health Washington State of
Building Accountable Communities of Health Washington State of Reform Health Policy Conference January 8, 2015, 2: 15 – 3: 00 pm Representative Laurie Jinkins, Member, Healthcare and Wellness Committee, Washington State House of Representatives Carol Moser, Executive Director, Benton-Franklin Community Health Alliance Dr. Elya Moore, Ph. D, Deputy Director, Whatcom Alliance for Health Advancement, Supporting the North Sound Accountable Community of Health
Session agenda ü Brief overview of Accountable Communities of Health (ACH) (5 minutes) ü Presentations from panelists on plans to implement the ACH model (25 minutes) ü Questions from the audience (15 minutes)
Washington State Health Care Innovation Plan (SHCIP) 1. Improve how we pay for services – e. g. , value-based purchasing 2. Ensure health care focuses on the whole person – e. g. , integration of physical health, mental health, and chemical dependency care 3. Build healthier communities through a broad collaborative regional approach – e. g. , Accountable Communities of Health http: //www. hca. wa. gov/hw/Pages/about_the_plan. aspx
Washington’s Goals for ACHs § ACHs are formal entities – regionally governed, public private partnership organizations § Provide a multi-sector voice for delivery system reform, shared health improvement goals, and regional purchasing strategies § Serve as a forum for regional collaborative decision-making to accelerate health system transformation, focusing on social determinants of health, clinical-community linkages, and whole person care § Accelerate physical and behavioral health care integration through financing and delivery system adjustments, starting with Medicaid. 4
Pilot ACHs • Complete a “startup initiative” to demonstrate the valuable role of ACHs • Test and inform ACH designation criteria, to be finalized by the end of 2015 • Provide learning opportunities as a peer leader to Design communities • Inform the statewide ACH evaluation design, including rapid-cycle learning and improvement 5
Two Selected Pilot ACHs 1. North Sound Accountable Community of Health, supported by Whatcom Alliance for Health Advancement. The North Sound Accountable Community of Health serves the North Sound Regional Service Area: Whatcom, Skagit, Island, San Juan and Snohomish Counties. 2. Cascade Pacific Action Alliance, supported by CHOICE Regional Health Network. The Cascade Pacific Action Alliance serves the Timberlands and Thurston-Mason Regional Service Areas: Cowlitz, Grays Harbor, Lewis, Mason, Pacific, Thurston and Wahkiakum Counties.
Design Communities • Leverage the planning process, including the newly developed Community Health Plans • Respond to lessons learned during the planning process • Focus on capacity building, building on lessons learned from the Pilots 7
Where the Health Care Authority (HCA) sees ACH’s going
Representative Laurie Jinkins Member, Healthcare and Wellness Committee, Washington State House of Representatives
HEALTHY, VIBRANT PEOPLE AND COMMUNITIES ACHIEVING THEIR FULL POTENTIAL ACHIEVE TRIPLE AIM Flexible Model for Reducing Chronic Disease Collective Impact Respect | Innovation | Collaboration | Leadership Learning Culture Quality Measures Integration Comm Health Workers and Care Coordinators Health Info Exchange Health Info Tech Improve Diabetes and Depression
VISION Healthy, vibrant people and communities achieving their full potential. MISSION To improve the health of our community by collaboratively delivering integrated and cost-effective healthcare and human service solutions across Pierce County. VALUES Respect | Innovation | Collaboration | Leadership Primary Interventions and Potential Strategies Health Info Technology and Exchange Data sharing agreements Community Health Workers and Care Coordinators Standard SOW Shared EMR’s , care plans & progress notes Communication with providers (tech) Shared “health” port Provider referral Provider prompts Education Auto-alerts Home visits Work flow processes Service delivery Care Coordination Integration Quality Measures Learning Culture Early identification CTP Measures Data & info sharing IMPACT model Diabetes and depression measures Training Consistent across organizations Evidence based practices Screening Health action plans Mobile BH and PC Tele-counseling Service co-location Implemented thru Health Info Tech Shared learning
PIERCE COUNTY ACCOUNTABLE COMMUNITIES OF HEALTH Vision: TBD (e. g. Healthy People in Healthy Communities) Priorities: Mental Health | Chronic Disease Prevention| Access to Care Citizen’s Review Panel Coalitions Community Forums Community Clinical Board of Directors Comm. Orgs. Workgroups Health Equity & Other Advisory Groups Community Coalition (TBD) Health Innovation Partnership Prevention & Root Causes of Health Improve Care Quality & Reduce Costs Governing Body: 501(c)3 HEALTH EQUITY 12/4/2014 Ad Hoc Committees Providers Payers Workgroups
Carol Moser Executive Director, Benton-Franklin Community Health Alliance
GREATER COLUMBIA COMMUNITY OF HEALTH Presented by Carol Moser, Executive Director Benton-Franklin Community Health Alliance January 8, 2015
The Greater Columbia Basin
Tri-City Hospitals (Kennewick General, Lourdes Health Network, Kadlec Regional Medical Center) build Tri-Cities Cancer in 1992
Foresight of Community Leaders The mission of BFCHA: To bring the community and healthcare providers together to: • Work cooperatively • Foster community-wide stewardship • Assess community health needs and facilitate long-term, comprehensive, community wide solution that achieve affordable, high quality wellness and accessible health care for all residents of the Mid-Columbia
SE Washington Community of Health #6
Data Driving Decisions Top Area County Asotin Benton Columbia Franklin Garfield Walla WA State
RSA Designations made us Greater!
Collective Impact Model Driving Governance, Committee Structure
Finding Alignment looks promising
Elya Moore, Ph. D Deputy Director, Whatcom Alliance for Health Advancement Alliance Supporting the North Sound Accountable Community of Health
North Sound ACH, 1 of the 2 Pilot ACHs 4
Our Common Agenda A coalition with the triple aim of transforming the health system: Ø to improve the health of our communities and our people Ø to improve the experience of care and access to care Øand to lower per capita health care costs in Snohomish, Skagit, San Juan, Island Whatcom counties
Our Guiding Principles Ø We can accomplish more together than we can individually Ø Trust, respect, transparency, continuous learning, and datadriven decision-making Ø Collaboration between sectors is key Ø Communities must be engaged to shape strategies Ø The way care is currently organized and delivered will not be effective in achieving our shared aim Ø To improve overall community health we need to go upstream
Our Process Ø Build on the strengths, experiences and successes Ø Align efforts with existing state, county or local priorities, outcomes, strategies and metrics. Ø Create measurable goals, and ensure accountability towards outcomes Ø Ensure that our plan is clear, robust, well-researched, inclusive and actionable, yet practical
CASE Initiative: Coordinate, Align, Standardize, Enhance, and Expand care coordination programs in our region Ø Highest utilizers of jails, EMS, and EDs Ø Coordinate existing efforts to achieve better results and more savings among those currently served Ø Scale up to achieve maximum effect Ø Produce a North Sound ACH regional care coordination operations manual and a mini-business plan using findings from the CASE Initiative.
The North Sound ACH Commitment • To succeed 1 st with a short-term initiative that can demonstrate significant progress and cost savings in the 1 st 6 months. • We are motivated by, and committed to, long term, sustainable, health improvement, and capturing and reinvesting shared savings to address upstream, root causes of health, with a focus on prevention. • The CASE Initiative is an essential stepping stone to reaching this goal. By coming together around the CASE Initiative, we will continue to build trust, while also demonstrating the collective impact of working together.
Adding first responders in 2015 (EMS, fire, or police) North Sound ACH governance model
Follow the North Sound ACH Online: http: //whatcomalliance. org Receive our the NSACH newsletter or come to a meeting or event: lpleong@hinet. org
Questions
Questions to run on 1. How will ACHs inform, support, and advise Medicaid purchasing? 2. How should the ACHs be organizing to guarantee ability to capture and reinvest shared savings to address upstream determinants of health? 3. How will the ACHs advise and collaborate with the Behavioral Health Organization on behavioral health integration (chemical, mental, and physical), both in terms of service delivery and financing? 4. What is the nature of the relationship between ACHs and health plans? How is it defined? Managed? 5. What keeps you up at night when you think of the proverbial rubber hitting the road?
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