Post on 12-Mar-2020
Working
Together for
a Healthier
Washington
Presented by DOH Secretary John Wiesman
& HCA Director Dorothy Teeter
October 12, 2014
• No off label, experimental or
investigational use of medications are
discussed during this presentation.
• I (we) have no interests of commercial
services, products or support that requires
disclosure
2014 WSPHA Annual Conference
Presentation Disclosure
• Healthier Washington
Phase 1: State Health Care Innovation Plan
Phase 2: Healthier Washington – Five Core
Investments
• Opportunities to Participate
• Q&A and Next Steps
Today’s Topics
State Health Care Innovation Plan
4
http://www.hca.wa.gov/shcip/Documents/SHCIP_InnovationPlan.pdf
Goal - a Healthier Washington
Pay for value and outcomes starting with
the State as “first mover”
Empower communities to improve health
and better link with health delivery
Integrate physical and behavioral health
to address the needs of the whole person
Seven Building Blocks
Critical - Legislation Enacted
E2SHB 2572 – Purchasing reform, greater
transparency, empowered communities
E2SSB 6312 – Integrated whole-person care
State Health Care Innovation Plan
Phase 1: Planning
5
Existing Momentum
Performance Measure
Coordinating
Committee
Prevention
Framework
Community
of Health
Grants
Fully
integrated
purchasing
6
Performance Measures:
Evolution of Common Measure Sets in WA
Statewide Performance Measures
SB 2572 in Support of the State Health Care
Innovation Plan
Performance Measures Coordinating Committee
(PMCC) and Workgroups Formed
Final PMCC Recommendations
Evolution of the Common Measure Set
Development: PMCC
Medicaid Performance Measures
Medicaid Adult Quality Measures
SB 5732/HB 1519 Requirements for Performance
Measures
7
Improve the health of
Washingtonians through intentional
linkages between public health,
health service delivery, and systems
influencing the social determinants
of health
Priority: Prevention and
management of chronic disease and
behavioral health issues, while
addressing root causes.
Initial Focus Areas:
• Cardiovascular Disease and
Diabetes
• Healthy eating, active living,
tobacco free living and obesity
prevention
• Mental illness, substance
abuse/use (opioids)
• Trauma informed practices
OBJECTIVES By December 31st, 2018, Washington State will increase the proportion of the population who receive
evidence based clinical and community preventive services that lead to a reduction in preventable health conditions.
By December 31st 2018, Washington State will increase the proportion of the population with better physical and behavioral health outcomes by engaging individuals, families, and communities in a responsive system that supports social and health needs.
By December 31st 2018, Washington State will increase the number of communities with improved social and physical environments that encourage healthy behaviors, promote health and health equity.
By December 31st 2018, Washington State will increase the number of integrated efforts between public health, the health care delivery system and systems that influence social determinants of health to lower costs, improve health, improve the experience of care and contribute to the evidence base.
GOAL
The people of Washington will be healthier at every stage of life
VISION
The people of Washington embrace and sustain a culture of health
Engage communities and systems in health promotion activities
Align funding and resources to incentivize prevention
Engage and influence health and other systems to improve health and reduce cost
MEASURES
PRINCIPLES
Alignment | Balance | Collective Action | Health | Health Equity | Participation | Quality
ACTIONS
STRATEGIES
Washington Prevention
Framework
8
Washington’s Communities of Health
(COHs) Grantees
9
Community of Health Principles
10
• This is just the first step. Accountable Communities
of Health with evolve over time as they progress
through a continuum of development.
• Focus on the Triple Aim, recognizing the overall goal
of the Innovation Plan is improved care, improved
health, and lower costs
• Redefining "partnership,” by leveraging the
strengths and resources of local communities and
the state to meet the needs of both.
ACH Levels of Development
11
1. Designated entity exists but no formal staffing or structure is
in place.
2. Staffing and organizational structures are in development and
regional coordination is underway, including the identification
of needs and priorities.
3. Staffing and organizational structure are in place and
functioning to implement strategies/initiatives.
4. Demonstrated success of the staffing and structure, resulting
in integrated services, resource sharing, etc.
12
2020: Fully Integrated Purchasing
Across the State
Behavioral Health
Organizations
Apple Health Managed Care
Plans
2016
Transition Period
Pathway to Integrated Purchasing:
Mental Health, Chemical Dependency and Medical Services
Regional Service Areas (RSAs)
Integrated Purchasing in “Early Adopter” RSAs, with shared savings incentives
2014 Legislative Action: 2SSB 6312 By January 1, 2020, the community behavioral health program must be fully integrated in a managed care health system that provides mental health services, chemical dependency services, and medical care services to Medicaid clients
Healthier Washington:
Five Core Investments
13
Washington State’s Round 2 SIM Grant Application:
“The Healthier Washington project builds the capacity to move health
care purchasing from volume to value, improve the health of state
residents, and deliver coordinated whole-person care.”
Healthier Washington:
Better health, better care, lower costs
Phase 2: Implementation
http://www.hca.wa.gov/shcip/Documents/SIM_Grant_Application.pdf 14
Grant Application Timeline
Application Submitted
July 21, 2014 $92.4 million request
Announcement of Award
October 31, 2014 Late October announcement anticipated
Period of Performance
January 1, 2014 – December 31, 2018
4 year project with 1 year of pre-implementation planning
THE GOAL:
Partners working together for a Healthier Washington
Measurement
Financing & Administration
Information Technology
Public
Health
Nutritious
Food
Transportation
Employment Education
Crisis Intervention Family
Support
Criminal Justice
Consumer Engagement
Practice Transformation
Workforce Development
Substance Abuse
Physical Health
Long-Term Care
Mental Health
Oral Health
Health &
Recovery
System Supports
Housing
Built Environment
Whole
Person
Community
15
Strategies, Investments & Goals
16
1. Community Empowerment & Accountability
• Serve as a regional forum and coordinator
• Act as an accelerator, disseminator and collector
• Collectively impact health at the community and
regional level
Accountable Communities of Health (ACHs) will:
17
2. Practice Transformation Support
• Washington will develop a
“Practice Transformation Support Hub”
to help providers:
oAccelerate physical and behavioral
health integration
oAdapt to value-based payment
oDevelop clinical-community
linkages
o Facilitate shared learning and capture
best practices
• Patient and Family Engagement and
Workforce Development
18
3. Payment Redesign
• MODEL TEST 1: Early Adopter of Medicaid Integration
Test how integrated Medicaid financing for physical and behavioral
health accelerates delivery of whole-person care
• MODEL TEST 2: Encounter-based to Value-based
Test a value-based alternative payment methodology in Medicaid for
participating federally-qualified health centers and rural health
clinics and pursue new flexibility in delivery and financial incentives
for participating Critical Access Hospitals
• MODEL TEST 3: Puget Sound PEB and Multi-Purchaser
Through existing PEB partners & volunteering purchasers, test new
accountable network, benefit design and payment approaches
• MODEL TEST 4: Greater Washington Multi-Payer
Test integrated finance and delivery through a multi-payer network
with a capacity to coordinate, share risk and engage a sizeable
population
19
4. Analytics, Interoperability & Measurement
• Develop a consistent set of
measures for health
performance
• Enhance information exchange
capacity
• Bolster analytic capacity
20
5. Project Management
Lead
agency
21
Opportunities to Participate
22
Opportunities to Participate
• Join the Healthier Washington Feedback Network:
― Sign up at: healthierwa@hca.wa.gov
NOTE: If you signed up for the State Health Care Innovation Plan
Feedback Network, you are already signed up
• Watch for information on ACHs & join regional discussions:
― Information will be posted at:
www.hca.wa.gov/shcip/Pages/communities_of_health.aspx
• Performance Measures meetings are open to the public:
― To attend the Governor’s PMCC Committee Meetings in
person or by webinar, locate information at:
www.hca.wa.gov/shcip/Pages/performance_measures.aspx
• Monitor the Prevention discussion via the Public Health
Improvement Partnership:
― http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/
PublicHealthSystemResourcesandServices/
PublicHealthImprovementPartnership
23
Q&A
24
Community Empowerment and
Accountability: Next Steps (Phase 3)
25
Where We’re Going
Q3 2014
Q4 2014
2015 2016 2017
Two Pilot ACHs
2018
You are here!
Progression through the “ACH Continuum”
Fully developed ACHs by the end of 2018!
COH Planning Grants
Design Communities
26
For more information,
contact:
The Healthier Washington
Project Team
Call: (360) 725-1643
Email: healthierwa@hca.wa.com
Website:
www.hca.wa.gov/shcip
Thank you