FIMC Mid-Adoption Regional Briefing Recap

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Thank you to everyone that attended or called Thursday with the Spokane County Regional Behavioral Health Organization to give your input on questions for the Request for Proposal, which the HCA will be using to select MCOs for our region! It will definitely be helpful as we move forward as a mid-adopter region for FIMC and make the transition into Medicaid payments being contracted via the MCOs. We are currently in Phase 2 on the HCA Mid-Adopter RFP & FIMC Implementation Timeline, which you can view the draft of here. 

WA State Senior Citizens’ Foundation Panel Helps to Understand Health Homes Care Coordination Services

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At the Washington State Senior Citizens’ Foundation’s 2017 Fall Conference, a panel was hosted to talk about Health Homes and provide a deeper understanding of the services that they provide as well as the results that the program has experienced.

A sizable number of citizens in Washington state are currently receiving Medicaid and/or Medicare. Health outcomes have not been great for these populations. Health Home is a person-center care coordination reaching statewide that helps either high risk individuals on Medicaid or dual eligible individuals figure out things such as the following:

  • What is important to their health
  • How to get connected to providers in the community
  • What additional resources they need
  • What their person-centered goals are
  • What they need help with to be successful

This range of services provided through care coordinators help stabilize these individuals’ situations so they can achieve better health outcomes. For more information, watch the panel presentation here or read more about Health Home here. 

Spokane City Council votes to ‘ban the box’ for private employers, removing barrier for population transitioning out of jail

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At this week’s Spokane City Council meeting, the Council voted to 'ban the box' in Spokane. After hearing testimony from felons who had difficulty finding work and social justice groups after their release, it was decided that the policy would lift the initial barrier for those hoping to avoid relapses into crime. This decision will enforce fines for businesses asking about an applicant’s criminal history before an interview, either on an application or over the phone. Fines will not be enforced until 2019 to allow local businesses time for transition and the law does not prevent businesses from conducting background checks.

At BHT, we strongly support the removal of barriers that lead to better, whole person health and self improvement. Individuals transitioning out of jail are one of the most underserved populations and face extreme barriers to receiving whole person care—access to housing, employment, etc. These barriers are a major contributing factor to the City of Spokane’s high recidivism rates. 'Ban the box' is a positive step forward in helping to stabilize the population transitioning out of jail and equip them with better access to resources that will help meet their needs, ultimately, leading to healthier individuals and a healthier society.

Read more about City Council’s decision to 'ban the box' in The Spokesman-Review here.

Request by HCA for Regional Input on MCO's by Dec. 1

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The Health Care Authority (HCA) is preparing to release a final Request for Proposals (RFP) to secure Managed Care Organizations (MCOs) that will implement Integrated Managed Care in the remaining regions across the state of Washington. As part of this RFP, HCA will include the number of MCOs it intends to contract with, within each Regional Service Area (RSA).

Please provide any recommendations to this approach by December 1, 2017. Recommendations can be sent to Alice Lind via email at alice.lind@hca.wa.gov. Read the full request here.

BHT Selects 4 Projects for Transformation Plan

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An unexpected change to the scoring methodology for project plans was the final influencer in the Board's decision. HCA announced Friday October 27, that ACHs who take on four projects would now be eligible to earn 100% of their allotted funds. In the original scoring, ACHs took a penalty up front for not selecting more than 4 projects. HCA made this change in response to the recent cut in Up to Transformation project funding, to allow ACHs to choose a more focused approach now that we will be operating with potentially 30% fewer dollars. 

Choosing four projects made sense to us for a lot of the same reasons choosing six did. Our region feels a commitment to all eight project areas, which represent valuable strategies for achieving improved community health. Not to mention, elements of all these projects areas are so interconnected, that strategic implementation planning can address multiple areas at once. However, choosing a project commits the entire region to addressing those metrics, which is a big risk in some areas. Projects will be asking some providers to make big changes, and more project reporting will be a bigger burden. We are choosing to not select Transitions or Diversion Intervention, Oral Health, and Reproductive, Maternal and Child health. However, we will direct our Collaborative planning teams to look for opportunities to weave in strategies from the above projects to the project areas we are selecting.

  1. Bi-Directional Integration of Care
  2. Care Coordination
  3. Opioid Response
  4. Chronic Disease Management.

After all, once we earn the dollars in these areas, we can spend them however we want. This will allow us greater capacity to focus on success in our projects, and more flexibility to weave in complementary strategies as they best support the region. 

Learning from New York's DSRIP

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We recently had the opportunity to participate in a collaborative learning session with Joe Conte, a leader in New York’s Delivery System Reform Incentive Payment (DSRIP) Program. Joe works with Staten Island’s Performing Provider Systems (PPSs), the equivalent of ACHs in New York, and we were excited to share in some of what they have learned along the way.

New York PPSs are almost in Year 4 of their demonstration, and their partners include over 75 fully engaged organizations and 20 population health practice partners which include 100 percent contracted healthcare providers, agencies, schools and community-based organizations. Their goal, similar to our own, has been to improve quality of care and transform the healthcare delivery system of Staten Island as well as ready providers for VBP contracting. Staten Island currently has 180,000 Medicaid beneficiaries, and Joe stated that combining cultural competency into their PPS work has been extremely important.

By Year 5 of their demonstration, they anticipate that 80 percent of funds in New York will be by performance and 20 percent by reporting. A priority for them has been minimizing overhead expenses while maximizing the amount of funds used for:

1.     Project implementation
2.     Incentive payments
3.     Lost Revenue/Innovation Funds/Cost of Services Not Offered

Joe also emphasized that it was important to give a voice to SDOH organizations and smaller practices for equivalent payments for units of work regardless of organization size. 97 percent of provider satisfaction for Staten Island was reportedly due to financial engagement. They found that if there was a network-wide loss, then everyone was affected. “You don’t want to lose partners just because they are unable to make a financial commitment,” said Joe. Creating necessary partnerships and supports for participating organizations has been crucial.

Lastly, Joe openly shared some unanticipated issues with DSRIP, which we found very relevant. These issues included:

1.     Working with the plans should be a top priority.
2.     Understanding the best way to gather data from different sources is necessary with community consent.
3.     Co-located services could be talked about more at a state-level and earlier on.

While much of DSRIP in New York looks very different than in Washington, we are so grateful for this chance to share in lessons learned. It is inspiring to compare efforts of folks across the nation as we work to improve the health system in our respective regions.

You can download more detailed notes from the webinar here, and watch a recording below.

  

17,946 Miles Driven: Celebrating ACH Program Manager, Justin Botejue's One Year with BHT

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1. What does your role as ACH Project Manager entail?

A little bit of everything – I see the role I play as an assister to realizing and implementing the vision and goals of our partners within the BHT ACH. This can look like anything from staffing rural county health coalitions to seeking input from the community (both the provider and the recipient of services) for our ongoing strategy maps on the Social Determinants of Health and Population Health. The role also provides staff support to the BHT Executive Director and Associate Directors which includes data and policy research, project support for the Pathfinder Hub and continued community engagement.

2. You have driven 17,946 miles since starting at BHT in August of 2016. What do those miles driven show in respects to your job and how does community engagement fit into the effectiveness of your role?

Yes, I’ve driven almost 18,000 miles within one year of working for BHT! It’s not really about how many miles I’ve driven, but more about the time I get to spend with partners around our region. Relationships are built better face-to-face and I can say that whenever I go and meet with partners, I come in with an understanding that we’re friends and I’m here to help however I can. I always offer a carpool to those based out of Spokane and when you’re in the car for a couple of hours, you tend to partake in good conversation (and hopefully it’s not just work related). I’m grateful that BHT actually encourages us to do face to face meetings and I consider myself lucky that I get to see the sheer beauty and ruggedness of Eastern Washington that I wouldn’t otherwise see!

3. What is one thing that you have learned while out in the community that has been valuable to you or a game changer in how you fulfill your role as BHT’s ACH Project Manager?

A game-changing pearl of wisdom I’ve learned over the past year is “framing the narrative”. Let’s face it, change and learning new lingo (virtually a new language) related to healthcare is difficult and the early morning phone calls and long meetings can be tiring, but set in the context of transforming lives for the better gives me new energy and drive to keep on pushing. Healthcare transformation is real and imminent especially when the narrative is framed toward meaningful impact on silo-ed systems, efficient distribution of resources, and most of all – an improved quality of life for our community.

4. What has been a major highlight in your one year at BHT?

Uh, all of it? Working for BHT through the Accountable Community of Health has been a fascinating experience! Doing healthcare transformation in this way is new and different and we are all learning together. 

In pursuit of radically improving the health of our region.

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“Darkness cannot drive out darkness; only light can do that.  Hate cannot drive out hate; only love can do that.” -Martin Luther King Jr.

In the wake of the tragic events in Charlottesville this past week, we believe that hate and racism has no place in America, in Eastern WA, or in any healthy community.  It is in these key moments that all of us, whether individuals or organizations, need to express our values.  So that our neighbors and partners and children do not interpret our silence as agreement with those who act on hate. 

While we may not have any Confederate monuments to tear down, our community is sadly not immune to hateful action.   In the past year, Spokane headlines have included racist vandalism scrawled on the Martin Luther King childcare center, desecrating a Sikh temple being mistaken for Muslim, anti-Semitic and racist flyers posted multiple times on the Community Building, hateful words of “Get out!” spray painted on the garage of a refugee family, and hateful graffiti on the Salish School.  While the community and leadership have come together in support in each incident, we all go back to our busy lives the next day.  Never stopping to notice that what used to be a once a year headline is now nearly monthly - are hate crimes now normal in our community?

As non-profits with health missions, we believe that advancing healthy communities means advancing equity.  At our leadership team meeting this week, we asked the question:  it’s not if but when the next tragic incident happens either nationally or locally, and will we sit back and wait for it, or will we be proactive and do something to advance equity?  And if we are proactive, what does that mean? We didn’t come up with any answers that made us feel like we had the right answer, but a deep commitment to take action. What are your thoughts?  We would love to hear from you.

Better Health Together selected to manage in-person assistance for Eastern Washington

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The Washington Health Benefit Exchange today announced the selection of Better Health Together to oversee in-person assistance provided to residents of Ferry, Stevens, Pend Oreille, Lincoln, Spokane, Adams and Whitman Counties during the upcoming open enrollment period scheduled to begin on Nov. 1.

Better Health Together is one of nine public health agencies, regional health networks, and community organizations selected to provide free support to individuals and families signing up for coverage through Washington Healthplanfinder and one of two in the state with an active storefront.

“Given the uncertainty currently surrounding healthcare, the support and communication Better Health Together and all other lead organizations provide is especially essential,” said Pam MacEwan, CEO of the Washington Health Benefit Exchange. “Their outreach and education efforts offer reliable assistance at a time when many residents may have questions about their coverage.”

Better Health Together is responsible for building and managing a network of navigators who are available to guide individuals and families through the enrollment process, determine how well their current health plans worked, and explore new coverage options.

During the previous open enrollment period, more than 225,000 Washingtonians utilized resources provided by Better Health Together and other lead organizations located across the state to enroll in health coverage through Washington Healthplanfinder.

“Being selected has given us the ability to provide this service and stability to the community twelve months a year in our new enrollment center, instead of what used to be three months,” said Curt Fackler, Navigator Program Manager of Better Health Together.

Better Health Together’s Navigator Network launched in 2013 with the goal of enrolling 10,000 people in health insurance through Washington Healthplanfinder. Today, Better Health Together’s Navigator Network has enrolled and re-enrolled over 100,000 people, dropping the uninsured rate to less than 5% in the region.