Accountable Communities of Health 101 Presented by the Accountable Community of Health Team December 10, 2014
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Accountable
Communities
of Health 101
Presented by the Accountable Community of Health Team
December 10, 2014
Q&A Instructions
2
• Please use the question feature to submit
questions.
• We will have a designated Q&A after each
section and will answer as many questions as
possible.
• We will provide additional resources and
opportunities for you to direct questions to the
appropriate source.
Agenda
3
2:30 p.m. Welcome
Chase Napier, Health Care Authority
2:35 p.m. Healthier Washington Overview
Kat Latet, Health Care Authority
3:00 p.m. Health is More than Health Care: regionally based health
improvement
Sue Grinnell, Department of Health
3:20 p.m. The ACH Initiative and Next Steps
Chase Napier, Health Care Authority
Winfried Danke, CHOICE Regional Health Network
Larry Thompson, Whatcom Alliance for Health Advancement
Carol Moser, Benton-Franklin Community Health Alliance
Kat Latet, Health Care Authority
4:00 p.m. Adjourn
• Improve understanding of the Accountable
Community of Health Initiative and why it matters
for a Healthier Washington
• Provide a review of where we have been, where
we are and what’s next
• Acknowledge the number of initiatives moving
forward, clarify some acronyms and terminology,
and provide resources to seek out additional
information
Objectives
4
Healthier Washington Overview:
how we got here!
5
6
Growth has been among expansion adults
721 721 723 721 716 720 724 740 744 747 747 749 750 749 748 753 753
145
130
55
231 276 356 382 400 415 430 443 454 465
1,267 1,270 1,274 1,273 1,271 1,275 1,281
1,460 1,505
1,587 1,609 1,624 1,635 1,645 1,653 1,669 1,678
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
Jun-13 Aug-13 Oct-13 Dec-13 Feb-14 Apr-14 Jun-14 Aug-14 Oct-14
Tho
usa
nd
s
Expansion Adults
Basic Health Plan
Other Federal Programs
Partial Duals
Family Planning
Former Foster CareAdultsPregnant Women
Elderly Persons
Disabled Children
Disabled Adults
Caretaker Relatives(Family Medical)Apple Health for Kids
Total
Medicaid Expansion
Vision 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
Systems Working Together for a
Healthier Washington
8
The Healthier WA Proposal
CMMI SIM Round 2 invests in the strategies and
infrastructure to implement the Innovation Plan.
State Legislation
E2SHB 2572: SHCIP Policy
Framework and ACH testing.
E2SSB 6312: Integrated
whole-person care
State Health Care Innovation Plan (SHCIP)
CMMI State Innovation Model (SIM) Planning Grant
Systems Working Together for a
Healthier Washington
A Healthier Washington
Accountable Communities of
Health
Payment Redesign
Practice Transformation
Supports
Integrated Purchasing and Delivery System Reform: RSAs, EAs, & BHOs
Prevention Framework and
Plan For Improving Population
Health
Analytics, Interoperability,
and Measurement
Goals:
1. Improve
population
health
2. Transform
delivery
systems
3. Reduce per
capita
spending
Strategies:
1. Healthy
Communities
2. Integrated
care & social
support
3. Pay for
value – State
as first
mover
ACH
Accountable Community of Health
• Hold tight…. This is why you are here.
COH Communities of Health
• Covered in this webinar…
RSA Regional Services Areas
• Recently designated geographic areas for Medicaid purchasing. • Will serve as a foundation for moving toward state agency and local alignment of
regional services
EA Early Adopter
• Reflects the early adoption of integrated Medicaid purchasing through a contract between the Health Care Authority and Managed Care Organizations (MCOs) at risk for the full continuum of physical and behavioral health services.
• Decided collectively by counties within an Regional service area
BHO Behavioral Health Organization
• Manage mental health and substance use disorder (behavioral health) in non-Early Adopter regions
• Physical/Medical services will still be covered by Apple Health Contracts
Review of Healthier Washington
Acronyms and Definitions
Q&A
Still to come…
• Health is More than Health Care
• The ACH Initiative
• Next Steps
• Resources
Health is More than Health Care:
regionally based health improvement
12
• Need to align actions around the
Triple Aim
• No single sector or organization
can independently create
transformative, lasting change
• Clinical, community, and
government entities must
coordinate
• Shift from traditional State-
community outreach approaches
Recognizing the Need
A regionally governed, public-private
collaborative or structure tailored by the region
to align actions and initiatives of a diverse
coalition of participants in order to achieve
healthy communities and populations.
What are ACHs?
Existing Regional/Local Health
Improvement Organizations
15
Regional Approaches to Health
Improvement Across the U.S.
• Minnesota - Accountable Community of Health
• Oregon - Coordinated Care Organization
• Colorado - Regional Care Collaboratives
• Maryland - Local Health Improvement
Coalitions/Community Health Hubs
• New York - Population Health Improvement Programs
• Illinois – Regional Public Health Hubs
16
• Convening multiple sectors and systems
• Recognition of community’s role in
population health improvement
• Obtaining, sharing and utilizing data
• Physical/behavioral health integration
• Lowering health costs through efficiency
and innovative methods
Similarities of Regional Approaches to
Health Improvement
17
How will ACHs be Unique?
18
Clinical Community ACHs
Still to come…
• The ACH Initiative
• Next Steps
• Resources
Q&A
The ACH Initiative
20
21
Core Functions of the ACH
Accountable Communities of Health (ACHs) will:
• Serve as a regional forum for collaborative decision-making across
multiple sectors and systems to align actions to achieve healthy
communities and populations, improve quality and lower costs.
• Act as an accelerator, disseminator and collector of regional best
practices, lessons learned and shared challenges to drive health
systems transformation focusing on population health, social
determinants of health, clinical-community linkages and whole person
care.
• Collectively impact health through regional purchasing strategies,
starting with Medicaid.
The ACH Initiative Timeline
The Phases of the ACH Initiative
23
1. Strategic Planning (2013-2014): SHCIP/Healthier
Washington
2. Community Engagement (2014): COHs
3. Community Empowerment (2015): Pilot/Design Awardees
4. Community Empowerment and Accountability (2016-
ongoing): Formally Designated ACHs
Washington’s Communities of Health
(COHs)
• 10 grantees received up to $50,000 each
• Geographic populations proposed by the 10 awardees
• Initiation of the formal State and community partnership in the ACH initiative
• ACHs have not yet been officially designated in Washington
24
Washington’s Communities of Health
(COHs)
25
Examples of COH work going on in Washington…
26
CHOICE Regional Health Network
Winfried Danke, Executive Director
Cowlitz Grays Harbor Lewis Mason Pacific Thurston Wahkiakum
• Why collaborate
across 7 counties
and multiple
sectors?
• The origins of our
region’s COH
Collective Impact Model
CPAA Governance Structure
Local Forums
Cowlitz Grays
Harbor Lewis Mason Pacific Thurston Wahkiakum
Broad Cross-Sector Participation
Regional Council
Support Team
Work Groups
Whatcom Alliance for Health
Advancement
Larry A. Thompson, Executive Director
30
Snohomish Health Policy Group
• Weight management in the school system
• Palliative Care
Snohomish Health Leadership Coalition
• Community Paramedic case management of EMS users in
Fire District 1 funded by Verdant
• Molina Case management of high utilizers of EMS, Jail & ED
Whatcom Alliance for Health Advancement
• Connecting people to care and insurance (IPA program)
• CMS care transitions program
• Intensive Case Management
• End of Life Choices
Origins of the North Sound Accountable Community of Health: County level organizations coming together
31
What is the North Sound
Accountable Community of Health?
• BFCHA: Applicant for six County
COH (Benton, Franklin, Walla
Walla, Columbia, Garfield, Asotin)
• Organized health collaborative
since 1993
• Three Counties added Nov 5
Greater Columbia
Accountable Community of Health
• 53 Participants from 38 organizations
• Laying the Foundation: Community Health Needs
Assessments, SWOT Analysis, Social Determinants,
Medicaid Data, Population Statistics, BRFSS, Health Plan
Data, Stakeholder Input
Collective Impact Model driving
Representation & Understanding
• Multi-County RSA: Centralized governance with
“aim” focused subcommittees
• Nine County Retreat Scheduled for December 19th
• Sharing Successful Interventions and Finding
Common Ground
Governance Structure Under Discussion
Innovation through ACH Development
37
ACH Initiative
Learning Adjusting
Q&A
Still to come…
• Next Steps
• Resources
Next Steps: Design and Pilot
Grants
39
The ACH Initiative Timeline
Pilot ACHs
41
Pilot ACHs will provide proof
of concept by:
• Completing a “startup
initiative”
• Testing and informing ACH
designation criteria
• Providing learning
opportunities
• Contributing to the statewide
the design of ACH evaluation
Design Regions
42
Design Regions will build on
the ACH design efforts that
occurred during COH planning
by:
• Responding to lessons
learned
• Focusing on capacity,
engagement, governance and
community support
• Adjusting based on RSA
boundaries
For more information:
• Healthier Washington
Email: [email protected]
Web: www.hca.wa.gov/hw
• ACHs
Email: [email protected]
Web: http://www.hca.wa.gov/hw/Pages/communities_of_health.aspx
• Integrating Behavioral and Physical Health Purchasing
Email: [email protected]
Web: http://www.hca.wa.gov/hw/Pages/integrated_purchasing.aspx
Q&A and Resources
Thank you from
the ACH Team!
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