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

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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