Pathway to our Regional Health Improvement Project

We’ve been eagerly awaiting news on the Medicaid Transformation Waiver but, since we aren’t ones to just sit around, we’re moving full speed ahead.

We’ve spent months synthesizing the wealth of information generated in our Idealized Design and Community Linkage mapping sessions to develop and inform our Regional Health Improvement Plan and the selection of a Regional Health Improvement Project. During our focus group conversations, our community worked together to inventory existing linkages between community resources, and identify where linkages were broken or non-existent. Across those conversations, one need presented itself over and over again: the need to “coordinate the coordinators.”

The diversity of partners in our ACH Leadership Council members demonstrates the leadership and dedication needed to radically improving the health of our region. We agree the most emergent need is not to scale any one community resource or service but to build stronger and more navigable connections between the coordinators and resources already available.

This was realized in our design sessions as a need for “air traffic control” or a patient-centered workforce that helps coordinate services across all sectors. Independent organizations need the flexibility to explore their own models and develop their strengths, but to nurture healthy community, patients need services that communicate, collaborate, and speak the same language of care.

From this idea, we’ve pulled together a workgroup to explore the Pathways HUB model and serve as the steering committee for our Regional Health Improvement Project. Alisha Fehrenbacher from Empire Health Foundation, presented on to the ACH Leadership Council in March on her experiences implementing the Pathways HUB model (view her slides here) in Oregon. It is an evidence-based model currently deployed in over 20 regions of the US, that positions care organizations around a centralized HUB, and has been shown to effectively address risk factors, improve health and reduce costs.

We feel confident this model has a lot to offer our region and are excited to explore it further. The workgroup will continue to develop our plan throughout the summer, with the hope that we will be in position to hit the ground running once we hear about the waiver. If you are interested in joining the Leadership Council, please email Alison@betterhealthtogether. 

May ACH Leadership Council Update

Thank you to all who joined us to talk next steps for our ACH. And a special thank you to the Health Care Authority for driving all the way across the state to help bring some additional clarity on our role as an ACH.

This was a big meeting that produced some concrete action items for Leadership Council members. In case you missed it, here is the recap and documents:

We started the morning with a presentation from Kali Morris from the Health Care Authority on the role of the ACH in Medicaid Transformation. You can view those slides here. In her presentation, Kali made some comparisons to Medicaid transformation work happening in New York, and shared some lessons learned from their efforts. If you are interested in learning more, you can read this report on New York's DSRIP Program put together by The Commonwealth Fund. On the topic of Value Based Payments, HCA also shared this helpful visual on Alternative Payment Models.  

After that we looked at our refined Community Strategy maps. Consider these our first draft as we synthesize the wealth of information that came out of our Idealized Design Sessions. The next step will be to form workgroups, each chaired by a BHT Board Member, to validate strategies, develop metrics, and finalize our community linkage maps. We will be forming a workgroup for each strategy map, reflecting our three ideal states of design. For more information, please review the following charters:

1. Integrated Care
2. Population Health
3. Community Determinants of Health

Additionally, we've made some headway on selecting our regional health improvement project around the development of a centralized community referral system ("air traffic control") based on the Pathways Community HUB model. We will be forming one additional workgroup to explore this model and serve as the steering committee to launch our project. You can take a look at the ACH Project Team Charter here. 

We are looking for volunteers to join one (or many!) workgroups, with the intent of meeting through the summer, to have Strategy Maps finalized by September 20th. If you are interested in joining one of these workgroups, please read through the above charters and consider which group best fits your expertise, and email your interest to Alison@betterhealthtogether.  

We also shared with everyone Empire Health Foundation's new Oral Health Access document. Please take a look and feel free to share!

That was a big update! But we are thrilled to have some actionable to-dos as a group. Thank you all for your willingness to jump aboard. 

Hello Rubber, Meet The Road!

Hello road, meet rubber!

Over the past 18 months, we have worked hard as a region to prepare for health transformation. We’ve established the right partners at the ACH table, selected priorities, imagined our ideal state of health, and now it feels like the forces of opportunity and hard work are aligning to create the ideal environment for big impact.

In some ways it feels like a long road, in other ways, just a start. Either way, the BHT team and I are more energized and enthusiastic than ever before. We see the potential of this work to unleash radical improvement the health of our region.

It’s clear we’ve been talking about the right things: Payment Reform, Investment upstream and in community determinants of health, regional decision making and the need to make stronger community linkages. And now we are ready to take this ACH for a test ride. In the coming 90 days we’ll be selecting our regional project, hearing a (hopefully positive) announcement about the Medicaid Waiver and launching further education on the state’s effort to accelerate the change from fee for service to value based purchasing. These big initiatives are about to move from talk to action. I’m proud of our region for embracing this, even when many of us weren’t sure if there was any there-there, but now we’re ready. It’s going to be a wild ride. I’m glad to be here with this amazing group of partners.

PS- Our blog is chocked full of great resources on Payment Reform, Access to Care and Prevention news. Don’t forget to check it out.

DENT Story: "...for the first time in months, I was able to eat solid food."

Christina, a student at WSU and a Apple Health patient, had a filling fall out in late November. She made the calls and found an Apple Health accepting dentist, but had to wait two months for the appointment.

When the day finally came, her dentist noticed two other teeth that needed work done, in addition to the lost filling. Even though those two teeth had not been bothering her, the dentist chose to work on them instead of addressing the missing filling. Over the course of the appointment, the doctor ended up injuring a bone around Christina's eye socket with his pneumatic drill, causing damage to her optic nerve and resulting in her vision being severely affected in her left eye. Christina spent several days in hospital following this procedure, and after recovering she understandably was too scared to go back to his clinic.

Now in even more pain, Christina began to make the calls again looking for another Apple Health accepting dentist. The earliest available appointment was May 30th, nearly four months away! Unable to chew solid foods and in tremendous pain, Christina was desperate for relief. One clinic told her she could try an emergency appointment to have a dentist extract the teeth, but this seemed extreme when at first she just needed the filling replaced.

A provider at WSU’s Health and Wellness Services referred Christina to DENT. She called Rita, and was able to get an appointment that same day! Her new Dentist replaced the missing filling that had been plaguing her for months, and together they made a treatment plan to repair the two additional teeth injured by the previous dentist. Here is what Christina has to say about her experience:

I honestly cannot tell you how incredibly grateful I am to you for your help. I was nearly crying with happiness after my appointment because last night, for the first time in months, I was able to eat solid food. I cannot begin to say how grateful I am. [My dentist] is completely wonderful and I honestly cannot even begin to tell you how thankful I am to have been put in touch with him and especially, to have been scheduled in for a same-day appointment. So thank you so much and please pass on my gratitude to the amazing woman responsible for scheduling me! If I could give you all a big hug, I certainly would! I owe you my health and my sanity....Better Health Together gave me a lifeline and I could not be any more grateful for it.  

Christina, we are so happy we could help!