As the backbone organization supporting the Collaboratives in health systems change, BHT believes part of that responsibility is ensuring that as many dollars go to our partners as possible. We can stay narrow because our role is of a coordinator; we believe our community has the experts it already needs to get the work done.
Read MoreAt our January 24th BHT Board meeting, the Board approved the first round of Funds Flow allocation for Year 1 Project Funds. Our intent is to push out as many dollars as we can now to support our partners in planning and preparation for transformation in their settings, while holding back a portion of funds to target investments based on our partner gap assessments.
The first set of Funds Allocations includes two streams of ACH Funding: Year 1 Project Funds: Collaborative, and the first payout of the FIMC Incentive dollars.
Year 1 Project Funding will be distributed to partners within our Community Health Transformation Collaboratives in three ways:
Please note that partners not in Primary Care or Behavioral Health settings (aka partners who do not bill Medicaid directly) will only have access to base funding pool.
FIMC Incentive Funding became available to the region when we voted to become a mid-adopter of Integrated Managed Care. The year one payment total will be $3,120,000. BHT is prioritizing our first round of funding to Contracted BHO Providers delivering mental health and substance use disorder services and Tribal Behavioral Health providers, to support a core set of transitional efforts required for financial managed care integration.
This is our first run of funds flow allocation. Once we have completed assessments with our partners and are more informed around Domain 1 areas where investment may be needed, the Waiver Finance workgroup will begin building recommendations for the next round of funds flow. See the materials below for more information.
Year 1 Project Fund Executive Summary
The Provider Champions Council met last Monday evening. Robbi Kay Norman from Uncommon Solutions began the meeting with a brief presentation on the role of the ACH moving forward. Where BHT has previously had a heavy hand in helping to build partnerships and build a framework for regional health improvement, it will now serve as a high-level governance structure to provide support, facilitation, data collection and analysis. Alison Carl White, BHT Executive Director, walked the council through some of the reasoning behind the funding allocations that have been decided up to this point in the funds flow model.
Brian Sandoval of Yakima Valley Farm Workers Clinic then gave an overview of the differences and similarities between the Bree Collaborative and Collaborative Care models for bi-directional integration of Primary Care and Behavioral Health, and led a discussion on which concepts of each model might promote best practices for providers in our region. While both models are evidence-based approaches for integrating behavioral health into the primary care setting, each model brings different strengths into the care system. The Collaborative Care Model is a team-based model that adds a behavioral health care manager and psychiatric consultant to support the primary care provider and can be practice-based or telehealth-based, an important concept for our region. The Bree Collaborative’s Behavioral Health Integration Report and Recommendations focuses on routine, same day access to a shared care plan at the point of care and places a heavy emphasis on psychiatric services, including for those patients who are not improving or require a higher level of care. Both models rely on screening and tracking to monitor patient progress.
The discussion around best practices for integration of behavioral health and primary care will be ongoing in this council, and Monday’s discussion was an important introduction of what will be a significant topic for future work of the Collaboratives.
Special guest and friend from Buffalo, NY, Ann Monroe shared lessons she and other PPSs have learned from being one year ahead of us in year 3 of DSRIP.
Read MoreAnn Monroe, a friend from Buffalo, New York, will be joining us to present on her experiences with the health transformation taking place in New York. Ann works in a PPS, the equivalent of ACHs in New York, and will be sharing some of what she as well as other PPSs have learned during their Transformation Project, which is currently in Year 3. She will be giving a short presentation and there will be a large period of time dedicated to Q&A after. This will be a great opportunity to ask questions to someone that is a little further ahead in their health systems transformation experience and we hope it can be utilized to its fullest. We look forward to seeing you at the Spokane Regional Health District for our first Leadership Council of 2018! If you plan to attend, register here.
Thank you to everyone that was able to attend one of our Collaborative 101 learning sessions! If you didn't get a chance to make one of the learning sessions this week, there are still two dates left - one in Spokane County and one in Lincoln. View dates and details here. You can also view the slides for the presentation here as well as the Collaborative Work handout here and the background data for BHT Collaboratives here. It was great to start talking about Year 2 and beyond for BHT ACH's Medicaid Transformation Project (MTP) and we really appreciate all of the time that our partners and community members have taken to make it possible. A lot of great questions were asked at these learning sessions and in further efforts to keep consistent communication and understand each other's work, we thought it would be good to share a couple of questions and answers.
Q: Who gets to decide on the Collaborative participants?
A: We have set the structure of Collaborative to include participants from the following settings; primary care, behavior health & SUD, oral, pharmacy, social determinants of health, county, hospitals, and tribal. We have also complied a list of suggested partners, but it will be up to the Collaborative members to make the connections to bring the individual partners to the table from each setting.
Q: What’s the next step? What are the expectations for partner organizations moving forward?
A: The most immediate action we need is a signed commitment form. This is a soft commitment (the final date to withdraw is June 30), but there will be an incentive payment for this commitment form due on February 22. From that point forward, the Collaborative work really kicks in. BHT is here to support all Transformation efforts, but our stewardship will be to assist you and your county partners in determining the most important metrics and goals for your county, and in taking the initial steps to transition to VPB and integrated care.
Happy New Year from BHT! We are so excited for Year 2 of the Medicaid Transformation Project (MTP) and its kickoff with Collaborative work and the Collaborative 101 Learning Sessions. The Community Health Transformation Collaboratives will be comprised of Health System and Social Determinant partners serving as the activation network for Transformation Projects. Collaboratives will form in each of our counties, and will be responsible for developing an implementation plan to meet project requirement of MTPs.
During the month of January, the focus will be on developing members for these, bringing everybody up to speed on where MTP work will be taking us next and outlining Collaborative responsibilities. We hope to see you at one of the Collaborative 101 Learning Sessions! See dates and details below, and please RSVP to Chelsea@BetterHealthTogether.org if you plan to attend. We hope to see you there!
Adams County- Tuesday, January 9th, 10:00 am – 12:00 pm; Columbia Basin Health Association Othello Clinic, 1515 E. Columbia St, Othello WA 99344
Ferry County- Tuesday, January 9th, 10:00 am – 12:00 pm; First Presbyterian Church, 605 S. Keller St, Republic WA 99166
Lincoln County- Tuesday, January 16th, 2:00 pm – 4:00 pm; Lincoln County Courthouse – Commissioners’ Chambers, 450 Logan St, Davenport, WA 99122
Pend Oreille County- Thursday, January 11th, 8:00 am – 10:00 pm Camas Center for Community Wellness, 1821 LeClerc Rd N, Cusick, WA 99119
Spokane County
To date, we've authorized $118,000 in payments to partners who completed our Health Systems and Care Coordination Inventories. These inventories have provided helpful data to shape project and Community Health Transformation Collaboratives recommendations and planning to inform implementation. We offered a performance payment for completion of the inventories. We are in the process of authorizing payments; the total anticipated payout is $181,000. We are excited to make another set of transformation Performance payments to the region.
The BHT team is delighted to welcome Charisse Pope as our new Director of Clinical Integration! We feel like we’ve scored the jackpot on recruiting her to our ACH efforts. Charisse will bring on the ground clinical experience as both a provider and an administrator, and her work with the RSN/BHO will be invaluable as we move to integrated care. She will hit the ground running, as BHT only knows one speed full speed ahead, on January 2nd. Here’s a bit of bio on Charisse, if you don’t already know her.
Charisse grew up in Eastern Wasington and has 20 years of non-profit and social service experience. She has a Masters in Counseling Psychology and started out in social services as a therapist working with adolescent girls. She then went on to earn a Masters in Business Administration to support the work of others as an administrator. Charisse continued in administration working for the Spokane County Regional Support Network overseeing a provider network, contracting, fiscal allocations, utilization, and working with other counties and regions as chair of County Human Services for several years. She then returned to her roots at Excelsior and served as Chief Business Officer. In her free time, she loves being at home with family, weekend outings, and playing with her sidekick dog. Welcome, Charisse!
The Provider Champions Council met on Tuesday night for the first time and it was a great success. The Provider Leadership Council represents a group of provider champions and practitioners from the region necessary to improve the community health of our region. We discussed the Medicaid Transformation timeline, the BHT Integration Framework and the 2018 Collaborative work. View the slides from the meeting here as well as the Provider Champions Council Charter here for more information on the council and its goals.
The Practice Transformation Support Hub hosted four webinars, Preparing for Integrated Billing: An Assessment for Behavioral Health Agencies, in December. 175 providers, stakeholders, governmental staff and others registered participated in the webinars and received the self-assessment and other planning tools provided prior to the webinar, which you can see below.
Practice Transformation is making a special request to all BHOs, ACHs and provider organization stakeholders to provide feedback on the tools so that they can modify and improve them for final statewide publication in early 2018. Completing the survey will take 5 minutes and is an opportunity to provide them with essential user feedback. You can also access a recording of the webinar here.
Also, they invite you to join them for the scheduled office hours to hear answers to commonly asked questions and to ask your specific questions related to the Integrated Billing tools.
You can also contact them via the Practice Transformation Help Desk at HubHelpDesk@qualishealth.org and by phone at (206) 288-2540 or (800) 949-7536 ext. 2540. It is important to prepare early for a successful transition to MCO billing processes, so take advantage of this current opportunity for resources!
BHA Billing Readiness Checklist
BHA Billing Self-Assessment Annotated
Last Wednesday, Susie Dade, Deputy Director of the Washington Health Alliance, came to Spokane to present the 2017 Community Checkup, a comprehensive report on health care quality in our state. It includes results for dozens of measures of quality and patient experience, and results cover four million insured lives, both commercial and Medicaid, as well as 39 counties and all 9 ACHs. Excitingly, we got to explore and focus on results for the greater Spokane area and BHT region, and there was definitely no shortage of new information.
Something that we were unaware of is that Washington is actually one of only three states in the country that has earned an ‘A’ for healthcare reporting. Although this unfortunately does not correlate with the actual quality of health care in Washington state, this transparency helps us know what we are doing well and where we need to target improvements. As a state, we strive to be in the top 10 percent in the nation on the most important measures of quality, and this report helps to inform us on how to get there.
So, how do we get there? Some things discussed during the presentation were collaboration as well as aligning efforts, implementing effective strategies and aligning payment with outcomes. Transparency is also a foundational step on a long journey that involves various different publics and stakeholders. While transparency remains the foundational step for success, action is the critical one. In addition, fostering honest dialogue about the challenges ahead and what needs to change is essential to drive improvement.
At the end of the day, it is important to celebrate our successes, stay positive and look ahead. We are thankful for all of our partners and are extremely excited about where this work will be taking us together. It’s been a great Year 1 in our Medicaid Transformation and BHT is definitely looking ahead as we move into Year 2.
Read more about the Community Checkup as well as its 2017 report here.
Come be the first to review the results from the 2017 Community Checkup with Susie Dade, Deputy Director with the Washington Health Alliance, who will be in Spokane to present this comprehensive report on health care quality in our state. It includes results for dozens of measures of quality and patient experience, including the WA State Common Measure Set on Healthcare Quality. This presentation will focus especially on results for the greater Spokane area and BHT, so we encourage you to attend. All are welcome!
When: Wednesday, December 13, 2017, 10:30am - 12pm
Where: The Philanthropy Center (1020 W. Riverside Ave., Spokane, WA)
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.
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:
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.
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.
Another milestone for BHT! We had a busy few days here last week, but were so incredibly excited to submit our regional project portfolio to the HCA on Thursday afternoon. Download and read over the portfolio below!
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.
We are seeking your input as to what the role of the Leadership Council should be as we move into project implementation. Take the survey to let us know what you think.
Read MoreAn 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.
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.
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