February newsletter: Many milestones reached in early 2017

Washington State Health Care Authority sent this bulletin at 02/17/2017 10:22 AM PST
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Better Health. Better Care. Lower Costs.

February 17, 2017

26 health centers and clinics to try new value-based payment method

Multiple federally qualified health centers (FQHCs) and rural health clinics across Washington State have signed letters of intent to shift to value-based payment in 2017. 

The Health Care Authority’s recent request for letters of intent to adopt the alternative payment methodology (APM) yielded 26 responses. Of the existing 26 FQHCs and 55 clinics, 13 FQHCs and 13 clinics signaled their intent to adopt the new alternative payment methodology, which rewards high-quality care.

These providers offer some of the most innovative and integrated delivery models in the state, yet their reimbursement structure stifles further care delivery innovation. In these settings, payment changes are especially difficult given statutory and regulatory barriers and business models that rely on encounter-driven, cost-based reimbursement.

The milestone comes after a year of convening with FQHC and clinic representatives, as well as managed care representatives, to develop the APM under the Healthier Washington payment redesign strategy model 2. It aims to move providers to a value-based payment system that allows the flexibility to achieve better care, better health and lower costs for the populations they serve.

A note from the Director

Dorothy

As Washington State progresses in achieving its goals to pay for value, integrate care to serve the whole person, and link clinical and community supports, we wanted to share some early 2017 milestones.  For example:

  • In January we saw an increase in state employees who chose an accountable care program for their health care, with a total growth in enrollment of 52 percent.
  • Several FQHCs and rural health clinics have agreed to work toward implementation of a new alternative payment method in early 2017.
  • We’re engaged with our partners in the North Central region to begin the process to select managed care organizations that will deliver integrated physical and behavioral health care to Medicaid beneficiaries in 2018.
  • There has been active engagement at public forums on the Medicaid Transformation demonstration and many thoughtful ideas have come in from across the state in response to the project toolkit.

Achieving these milestones would not be possible without the leadership and collaboration of our communities and health care systems throughout the state.

Accountable Communities of Health

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Accountable Communities of Health (ACHs) are evolving as they assess regional health needs and identify priorities. This month the Center for Community Health and Evaluation published a report on the status of ACHs based on a statewide survey of participants. Also in February, the HCA released a new video that explains the partnership between the state and ACHs.

An Accountable Community of Health (ACH) is a group of leaders from public and private sectors in a specific region with a common interest in improving population health.

Payment Redesign

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Paying for value is one of the main Healthier Washington strategies to achieving the triple aim of better health, better care, and lower costs. Watch our new video on value-based purchasing that helps better explain the benefit of shifting away from paying for volume. Watch the video on our YouTube playlist.

Practice Transformation

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The Practice Transformation Support Hub recently launched a web-based resource portal for health care providers. The portal offers a clearinghouse of resources and tools focused on practice transformation, behavioral health integration, and new payment models. Start exploring WAPortal.org today.

The Practice Transformation Hub supports local quality improvement efforts by connecting health care providers with tools, training, and hands-on technical assistance to address the needs of the whole person. 

Analytics, Interoperability, and Measurement 

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The Healthier Washington Data Dashboard supports the need for ACHs to have actionable data on population health. Next month, the public will gain full access to the data dashboard from the AIM web page, along with resources and tools to help individuals navigate the data system.

The Analytics, Interoperability and Measurement (AIM) investment area is leveraging and strengthening existing health data systems from multiple sectors to create capacity for analytics and decision support to best serve Washington's needs.

Integrated Physical & Behavioral Health

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We’re engaged with our partners in the North Central region to begin the process of selecting managed care organizations that will deliver integrated physical and behavioral health care to Medicaid beneficiaries in 2018. Leaders from HCA will meet with North Central leaders in Wenatchee, participating in discussions and planning for Whole Person Care Collaboratives, ACH Governing Board, and clarifying the rate setting process.

The state is fully integrating the financing and delivery of physical health, mental health, and chemical dependency services in the Medicaid program through managed health care.