Better Health Together is eastern Washington’s ACH (Accountable Community of Health). We believe everyone deserves a fair shot at being healthy. To make this happen, we work with more than 100 organizations across seven counties to promote practical solutions that meet the needs of the people and communities we serve. BHT was founded on the principle that when we step back and let local community lead, we find the best and most sustainable solutions to some of our most complex problems.

We advocate for policies centered on accountability, accessibility, and affordability. We disrupt the status quo by facilitating conversations and partnerships that level the playing field for community health throughout our region. 

We are governed by a multi-sector Board of Directors and employ a diverse set of tenacious problem-solvers.

It starts with community connections…

Better Health Together launched in 2013, seizing an opportunity to increase our community’s access to care by developing the Navigator Network - In-Person Assisters trained to help folks sign up for health insurance through the Washington Health Benefit Exchange. ​

We launched with an initial goal of signing up 10,000 people for qualified health plans. We enrolled 100,000 instead. This success came from relying on a robust network of diverse partners rooted and trusted within local communities. ​

While we have since grown and added new projects, this nurturing of community linkages and the collaborative spirit in this region continues to drive the work we do.

What is an Accountable Community of Health (ACH)?

Accountable Communities of Health (ACHs) bring together partners from multiple sectors to address our most challenging social and health issues. There are nine total ACHs, each serving a specific region.​

What are the goals of the ACHs?​

ACHs promote health equity and address and coordinate around social drivers of health. Their work includes:​

• Connect community and available resources by creating relationships with community partners and providers​

• Support workforce development including training and planning​

• Coordinate care between providers and organizations working with impacted communities​

• Address the opioid use public health crisis.​

Our Purpose

Mission

To radically improve the health of the region.

Vision

An integrated and anti-racist health system accountable for better health for ALL in eastern Washington.

What we mean when we say:​

• Integrated: ​Systems of care for physical, behavioral, oral, and social determinant of health efforts are connected. People are able to easily access the care they need, in a way that is comfortable and culturally appropriate.​

• ​Anti-Racist health system: ​Addresses systemic racism and health inequities with the delivery of care.​

• ​Accountable: ​Utilizes de-aggregated data to measure performance and take action with the information. We engage community in an assessment of performance​. We all share responsibility to evolve the system of care​. We embrace humility, and recognize there is knowledge from the people who are closest to the care.​

• ​ALL: ​Every person calling these places home: Ferry, Stevens, Pend Oreille, Spokane, Lincoln. Adams and Whitman Counties and the tribal reservations of the Kalispell Tribe of Indians, Spokane Tribe of Indians and the Confederated Tribes of the Colville Reservation.​

Goals

Improving access to integrated, whole-person care. 
People in the region have access to integrated physical, behavioral, and oral health in a whole person system of care.

Optimizing use of community resources. 
Strong linkages exist between the health care delivery system and community resources to address social determinants of health.

Promoting health equity for all, by all. 
Equity is integrated and elevated in the health care delivery system and the the health of every community is improved.

Achieving organizational excellence and accountability. 
BHT staff, board, and operations maximize community investment for high performance.

Commitment to Anti-racism

At BHT, we strive for health equity - where institutions support every individual in achieving their full health potential regardless of identity, environment, or lived experience. 

A fundamental part of our equity journey is coming to terms with the understanding that we live in a white-dominant culture built upon patterns of behavior that positioned white people to dominate positions of power while perpetuating avoidable and unjust health outcomes for people of color for over 400 years. We acknowledge the presence of systemic racism and white-supremacy culture at play in the policies and culture that governs our work. We must be intentional in our commitment to support the voices of Black, Indigenous, and people of color or else we risk perpetuating patterns of white-supremacy culture.

When we look at the decision-making tables, we notice most of the leaders are white. When we look at who is most impacted by these agencies’ work, the data shows people of color carrying the unjust burden of the greatest barriers. This disparity tells us we are working in a white-dominant system. If we are not intentional about applying an anti-racist lens to everything we do, we are at risk for perpetuating white supremacy culture in behaviors such as perfectionism, defensiveness, and a sense of urgency.  

In June 2020, the BHT Board approved the following position statement to guide our work (read our entire position document here):

Racism is not just when a person treats someone else differently because of their race. 

Racism is a developed false idea used to justify a culture whose behavior has positioned white people to dominate positions of power while perpetuating avoidable and unjust health outcomes for people of color for over 400 years. 

BHT is committed to building an anti-racist community and opposing oppression in all forms – not only to stand against systemic oppression but to invest in radical change and steward the process that will lead us to a better future. 

We commit to critical analysis of how white-supremacy culture influences our decision-making and acts on opportunities to disrupt cycles of discrimination and oppression. 

History

(Jump to Major Milestones)

In 2012, Empire Health Foundation (EHF) began convening a working group to maximize the Affordable Care Act in eastern Washington. When the Washington Health Benefit Exchange (HBE) launched the Request for Proposal for In-Person Navigators, EHF was approached to be the lead applicant. As the process developed, EHF’s legal counsel made the recommendation to create a sole-member 501(c)(3) organization (with EHF as the sole member) to apply for the performance-based contract. 

EHF recruited seven board members to establish Better Health Together (BHT). BHT was formally established in the summer of 2013. This founding board completed the 501(c)(3) application in time to submit the RFP to HBE. BHT was the successful bidder for the In-Person Assister Network for the region. 

At this point, the BHT Board began to recruit for an Executive Director and hired Alison Poulsen (Carl White) in June of 2014. At the same time, BHT took on the Leadership Council convening work started by EHF in 2012.

The partnership and investment from EHF helped catapult BHT into the region’s health system improvement efforts. EHF provided support and funding as BHT’s mission evolved to include initiatives related to Care Coordination and Community Health Workers. Following the successful first year of Apple Health (Medicaid) and Qualified Health Plan insurance enrollment, EHF granted BHT funds to support the development of a robust community health worker (CHW) program. Between 2014-2017, BHT employed six CHWs to provide intensive care coordination services for highly vulnerable partners. In 2015, EHF also helped fund the startup costs for BHT to become a Health Homes Care Coordinating Entity.

In 2016, the state of Washington secured the Center for Medicaid and Medicare Innovation funding for the $60M State Innovation Model (SIM) grant, which led to the securing of the $1.2B Medicaid 1115 Waiver. In 2017, BHT was designated to lead the Medicaid Waiver work as this region’s Accountable Community of Health. In this role, BHT will steward up to $70M in Pay-for-Performance contracts between 2017-2023.

In 2019, BHT expanded our access to care services when we were awarded a grant from CMS. The Healthy Kids Together (HKT) program supports families enrolling in Apple Health (Medicaid), Apple Health for Kids (CHIP), and Qualified Health Plans through Washington HealthPlanFinder. HKT focuses on serving families that face the most significant health disparities in our region by working with Native American/Indigenous /Alaska Native/First Nations, Latinx, COFA Islanders, and rural residents with our Navigators and Parent Mentors.

Also in 2019, the BHT staff and Board committed to undertaking an internal equity journey to support the work of stewarding our ACH partners on equity related collective projects and individual contract performance measures. To date, the Board has allocated over $5,000,000 toward equity-related work.