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Session agenda

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

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Session agenda

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  1. Building Accountable Communities of Health Washington State of Reform Health Policy ConferenceJanuary 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, PhD, Deputy Director, Whatcom Alliance for Health Advancement, Supporting the North Sound Accountable Community of Health

  2. Session agenda • Brief overview of Accountable Communities of Health (ACH) (5 minutes) • Presentations from panelists on plans to implement the ACH model (25 minutes) • Questions from the audience (15 minutes)

  3. Washington State Health Care Innovation Plan (SHCIP) • Improve how we pay for services • e.g., value-based purchasing • Ensure health care focuses on the whole person • e.g., integration of physical health, mental health, and chemical dependency care • 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

  4. 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.

  5. Pilot ACHs • Complete a “startup initiative” todemonstrate 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

  6. Two Selected Pilot ACHs • 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. • 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.

  7. 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

  8. Where the Health Care Authority (HCA) sees ACH’s going

  9. Representative Laurie Jinkins Member, Healthcare and Wellness Committee, Washington State House of Representatives

  10. HEALTHY, VIBRANT PEOPLE AND COMMUNITIES ACHIEVING THEIR FULL POTENTIAL ACHIEVE TRIPLE AIM Flexible Model for Reducing Chronic Disease Improve Diabetes and Depression Comm Health Workers and Care Coordinators Integration Health Info Tech Health Info Exchange Quality Measures Learning Culture Collective Impact Respect | Innovation | Collaboration | Leadership

  11. 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 Community Health Workers and Care Coordinators Standard SOW Communication with providers (tech) Provider referral Education Home visits Service delivery Care Coordination Health Info Technology and Exchange Data sharing agreements Shared EMR’s , care plans & progress notes Shared “health” port Provider prompts Auto-alerts Work flow processes Integration Early identification IMPACT model Screening Health action plans Mobile BH and PC Tele-counseling Service co-location Quality Measures CTP Measures Diabetes and depression measures Consistent across organizations Implemented thru Health Info Tech Learning Culture Data & info sharing Training Shared learning Evidence based practices

  12. PIERCE COUNTY ACCOUNTABLE COMMUNITIES OF HEALTH Vision: TBD (e.g. Healthy People in Healthy Communities) Priorities: Mental Health | Chronic Disease Prevention| Access to Care Health Equity & Other Advisory Groups Community Forums Ad Hoc Committees Citizen’s Review Panel Coalitions Providers Community Clinical Board of Directors Comm. Orgs. Payers Health Innovation Partnership Community Coalition (TBD) Improve Care Quality & Reduce Costs Workgroups Prevention & Root Causes of Health Workgroups Governing Body: 501(c)3 HEALTH EQUITY

  13. Carol Moser Executive Director, Benton-Franklin Community Health Alliance

  14. GREATER COLUMBIA COMMUNITY OF HEALTH Presented by Carol Moser, Executive Director Benton-Franklin Community Health Alliance January 8, 2015

  15. The Greater Columbia Basin

  16. Tri-City Hospitals (Kennewick General, Lourdes Health Network, Kadlec Regional Medical Center) build Tri-Cities Cancer in 1992

  17. 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

  18. SE WashingtonCommunity of Health #6

  19. Data Driving Decisions

  20. RSA Designations made us Greater!

  21. Collective Impact Model Driving Governance, Committee Structure

  22. Finding Alignment looks promising

  23. Elya Moore, PhD Deputy Director, Whatcom Alliance for Health Advancement Alliance Supporting the North Sound Accountable Community of Health

  24. North Sound ACH, 1 of the 2 Pilot ACHs 4

  25. Our Common Agenda • A coalition with the triple aim of transforming the health system: • to improve the health of our communities and our people • to improve the experience of careand access to care • and to lower per capita health care costs • in Snohomish, Skagit, San Juan, Island and Whatcom counties

  26. Our Guiding Principles • We can accomplish more together than we can individually • Trust, respect, transparency, continuous learning, and data-driven decision-making • Collaboration between sectors is key • Communities must be engaged to shape strategies • The way care is currently organized and delivered will not be effective in achieving our shared aim • To improve overall community health we need to go upstream

  27. Our Process • Build on the strengths, experiences and successes • Align efforts with existing state, county or local priorities, outcomes, strategies and metrics. • Create measurable goals, and ensure accountability towards outcomes • Ensure that our plan is clear, robust, well-researched, inclusive and actionable, yetpractical

  28. CASE Initiative: Coordinate, Align, Standardize, Enhance, and Expand care coordination programs in our region • Highest utilizers of jails, EMS, and EDs • Coordinate existing efforts to achieve better results and more savings among those currently served • Scale up to achieve maximum effect • Produce a North Sound ACH regional care coordination operations manual and a mini-business plan using findings from the CASE Initiative.

  29. The North Sound ACH Commitment • To succeed 1st with a short-term initiative that can demonstrate significant progress and cost savings in the 1st 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.

  30. North Sound ACH governance model Adding first responders in 2015 (EMS, fire, or police)

  31. Follow the North Sound ACH Online: http://whatcomalliance.org Receive our the NSACH newsletter or come to a meeting or event: lpleong@hinet.org

  32. Questions

  33. Questions to run on • How will ACHs inform, support, and advise Medicaid purchasing? • How should the ACHs be organizing to guarantee ability to capture and reinvest shared savings to address upstream determinants of health? • 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? • What is the nature of the relationship between ACHs and health plans? How is it defined? Managed? • What keeps you up at night when you think of the proverbial rubber hitting the road?

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