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Accountable Community of Health (ACH)

In 2013, The Washington State Health Care Authority launched the Healthier Washington Initiative to transform the payment for, access to and integration of Medicaid services in Washington. Recognizing local communities are best suited for identifying their own needs and solutions, HCA divided the state into nine Accountable Communities of Health (ACH) regions to guide this transformation. The Better Health Together ACH covers Adams, Ferry, Lincoln, Pend Oreille, Spokane and Stevens Counties. Our vision is to create an integrated community health system, accountable to improving health through delivering culturally competent, whole person care to all community members.


Medicaid Transformation Projects

In November of 2017, the BHT Board approved the selection of four projects that we believe will have the greatest impact on our community, particularly populations we have targeted as being most vulnerable:

  • Bi-directional integration of behavioral and physical healthcare for Medicaid patients with both a Behavioral Health issue and a chronic disease;
  • Community-based care coordination for people transitioning out of jail, pregnant women on Medicaid, and foster youth or youth exiting or aging out of foster care;
  • Chronic disease management for Medicaid adults with diabetes, Medicaid children with asthma, and Medicaid beneficiaries with chronic behavioral health issues;
  • Opioid responses for Medicaid beneficiaries who use, misuse, or abuse prescription opioids and/or heroin.

As an ACH, our primary role is to serve as a convening and supporting body for healthcare providers, community health workers, organizations addressing social determinants of health, and insurance providers as they come together to determine the best practices and methods for addressing whole person care in both the rural and urban communities in the BHT region.

Our hope is that at the end of the Medicaid Transformation Project period, the BHT region will have the infrastructure to continue improving community health through a Community Dashboard for monitoring key population health priorities, the maintenance of a Community Resiliency Fund for addressing social determinants, and shared savings to be reinvested on upstream prevention.

To learn more, view our Theory of Action here, and dive deep into our Four-Project Portfolio here.


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Pathways Hub Model

To demonstrate the value of multi-sector collaboration and integration in improving health and reducing costs, the BHT ACH is piloting the Pathfinder Community Hub, to serve as a single point of care coordination in connecting at risk individuals and families to needed services. Based on the Pathways Hub model, our first pilot connected people transitioning out of Ferry County Jail, and their families, to a Community Care Coordinator who will guide them along an evidence based “pathway” to securing the care they need.

Watch our quick set of videos for an explanation on we envision this working for our region.


Recent ACH News