Transformation Talks - Episode 2

Transformation Talks - Episode 2

In our second episode of Transformation Talks, Charisse Pope interviews Torney Smith, Administrator of the Spokane Regional Health District. The two discuss how Medicaid Transformation allows us to address upstream causes of medical need, value-based care in a capitalist society, and the role privilege plays in health equity.

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Transformation Talks - Episode 1

Transformation Talks - Episode 1

In the inaugural episode, Charisse interviews Dr. Anna Foucek Tresidder, Program Director and Assistant Professor Public Health, College of Health Science and Public Health, at Eastern Washington University. That’s a mouthful! Their conversation is equally robust.

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Medicaid Transformation Learning Symposium: Managing Change and Advancing Equity

Medicaid Transformation Learning Symposium: Managing Change and Advancing Equity

Hosted by the Washington State Health Care Authority's Healthier Washington team, the Learning Symposium is a full-day conference focusing on Medicaid Transformation in Washington State, and is specifically tailored for you as our partner in community and health systems change.

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Draft Medicaid Transformation Toolkit

The Health Care Authority released a draft of the Medicaid Transformation Toolkit for public comment period at the beginning of 2017. All comments will eventually posted and addressed on the Health Care Authority's website. For now, if you would like to read the comments that Better Health Together submitted on behalf of our Board of Directors, you can view our letter here

Press Release: 1115 Waiver Signed!

The following news release was published January 9th 2017 from Health Care Authority

Washington gets final go-ahead from federal partners to begin next phase of health care transformation

OLYMPIA – Gov. Jay Inslee and the Washington State Health Care Authority announced today a final contract that ensures the state can continue transforming health care to achieve better health, reward high-quality care and curb health care costs.

“This agreement is critically important to Washington and comes at a time when many people are feeling great uncertainty about their health care,” Gov. Jay Inslee said. “As we work to protect the great gains our nation has made in ensuring access to affordable, high-quality health care, we know that health transformation will continue in our state.”

The five-year Washington State Medicaid Transformation Project provides up to $1.1 billion of incentives for rewarding high-quality care. It takes a patient-centered, holistic approach to care, creates partnerships with communities to address social determinants of health, and holds down cost increases; as well as $375 million to support critical services for Apple Health clients.

“This step represents an important opportunity to demonstrate that we can transform health care to better serve the needs of working families, children, seniors, and people with disabilities by helping providers work with each other and with their communities,” U.S. Sen. Patty Murray said. “It will lead to a smarter, more efficient delivery system that works to keep people healthy in the first place. This project is a testament to the flexibility of Medicaid and I am proud to continue giving my full support to our state’s efforts to coordinate care and improve outcomes for so many families across Washington.”

“With this demonstration, Gov. Inslee has set a course that enables Washington to deliver smarter, better care,” HCA Director Dorothy Frost Teeter said. “This ongoing, innovative work dovetails with the goals of Healthier Washington, exemplifying a systemic and thoughtful approach to providing high-quality care, controlling costs, and realizing better health outcomes. We have the desire, drive and momentum to stay on the path of transformation.”

“Improving the health of our children and their families through better medical, mental and substance use treatment is fundamental to improving the economic and social well-being of our citizens,” Acting DSHS Secretary Pat Lashway said. “This demonstration project will provide support to all areas of the state to improve the effectiveness of care and enable mental health services to reach all of our communities. And it helps us address the rapid growth in the aging population by providing innovative ways of delivering long-term care services."

The demonstration is a collaborative effort to streamline the health care system. Fundamental components of the transformation effort were designed with input from health care leaders, providers, community advocacy groups, public health representatives, and citizens, among others.

Locally-led efforts will engage and support clients, providers, and communities through:

  • Delivery system transformation strategies led by regional Accountable Communities of Health.
  • A broader array of service options to enable older adults and individuals with disabilities to stay at home and delay or avoid need for more intensive care.
  • Key foundational community support services for Medicaid clients with the most critical needs.

“Making sure people get healthy and stay healthy is the backbone of a thriving population,” Cassie Sauer, president and CEO of the Washington State Hospital Association said. “This demonstration positively impacts the people of Washington by ensuring they get the right care at the right time, in the right care setting. This allows Washington hospitals to focus not only on the people who walk through our doors, but to provide innovative approaches to care for the whole community."

“Putting our patients’ interests first is the focus of every physician,” Shane Macaulay, MD, president of the Washington State Medical Association said. “Complete health care requires care for both physical needs and mental health. Providing patients access to necessary services in the community helps them remain healthy. This effort gives our state the opportunity to bring the community together so that all Washingtonians have resources and access to 'whole-person' care that addresses their health needs and enables them to live healthy lives."

In a speech today, HHS Secretary Sylvia Burwell said, “Today we approved a Washington waiver that will improve health and bring down costs by improving coordination of behavioral and physical health services.”

For more information about the demonstration, visit


As you can see, staff was pretty excited about this announcement...

As you can see, staff was pretty excited about this announcement...

After months and months on the edge of our seats, we were thrilled to hear on Monday that CMS and Health Care Authority have come to principle agreement on the Medicaid 1115 Demonstration Waiver. The five-year demonstration provides up to $1.1 billion of incentives for delivery system reform and $375 million to support critical services for Apple Health clients over five years. 

Significant stakeholder and community input informed the four goals of this demonstration plan:

  • Reduce avoidable use of high-cost services such as acute care hospitals, psychiatric hospitals, and nursing home facilities.
  • Improve population health, with a focus on prevention and proactive management of diabetes and cardiovascular disease, pediatric obesity, smoking, mental illness, and substance abuse for Apple Health clients.
  • Accelerate Medicaid payment reform to pay providers for better health outcomes.
  • Bend the Medicaid cost curve below national trend.

The specific terms and conditions will be negotiated over the coming months, so it will still be some time before those dollars start flowing to health improvement projects across the state, but we've just leaped a major hurdle on the track to a Healthier Washington. 

You can read more from the Governor's media release here.