If you are new to the ACH movement and looking to get up to speed on where we are today, we’re sharing some of BHT’s history and many links to supporting documents and videos on our website.
Better Health Together launched in 2013, seizing an opportunity to increase our community’s access to care by developing the Navigator Network - In-Person Assisters trained to help folks sign up for health insurance through the Washington Health Benefit Exchange. They launched with an initial goal of signing up 10,000 people for qualified health plans but enrolled 100,000 instead. This success came from relying on a robust network of diverse partners rooted and trusted within local communities. While we have since grown and added new projects, this nurturing of community linkages and the collaborative spirit in this region continues to drive the work we do.
And, we see it as our biggest value-add as the lead organization for our region’s Accountable Community of Health (ACH). In this backbone role, we convene community organizations across 6 counties from all sectors that impact health (not just hospitals and health plans, but schools, faith-based communities, public transportation, and a whole lot more!) to collaborate on projects meant to break down work silos and transform our health system to empower a healthy community.
The ACH governance structure includes a governing board which serves as the decision making body; the Leadership Council comprised of 50+ organizations (and growing), whose broad participation helps us synthesize local priorities into regional strategies; and finally our Health Champions, who include Rural Health Coalitions and other topical taskforces and coalitions that operate like “mini-ACHs” convening around county or topic-specific issues, and feeds information to the Leadership Council.
We spent our first year and a half getting to know the many organizations that impact health in our region as well as discovering our community’s top health priorities. Through a year of community work sessions, we identified our regional health priorities and began to map out emerging strategies for some of the most pressing issues related to Population Health and Social Determinants of Health.
One need we heard echoed across nearly all the communities we spoke too was the need to “coordinate the coordinators.” We know there are a wealth of passionate people and organizations working to improve health in our region, and we know not one of them can effectively move the needle alone. Rather than scaling any one intervention, our community called for better linking of resources in a centralized, standardized fashion so that care can be provided in a way that meets the whole needs of a client.
This lead us to explore the Pathways Hub Model for our first pilot project as an ACH: The Pathfinder Jail Transitions Pilot in Ferry County. We’ve produced two videos on this project, one from the perspective of a client, and one from the perspective of a care coordinator. We hope to demonstrate that as returning citizens complete their “Pathways” through the Hub model, then the rates of recidivism will drop, as was shown in a similar project in Michigan.
On January 9th 2017, our Medicaid Demonstration Waiver was approved by CMS, announcing $1.1 Billion dollars made available for ACH’s to earn for their region by implementing specific evidence-based projects (outlined in this Medicaid Transformation Project Toolkit) to transform the health system. Projects are tied to specific outcomes designed to support the triple aim of health, and as outcomes are met ACHs earn payments.
Of the 11 projects in the toolkit 5 are required and 6 are optional (however at minimum we must select 1 of the optional projects from each domain.) This slide deck includes an overview of the projects in the toolkit. Our process for selecting projects will extend from March – September of 2017. Currently we are seeking community feedback on which of the optional projects seem like the best fit for our region through this survey, and we welcome your input. We must submit project portfolios to the Health Care Authority in October, outlining which of the projects we will implement and how, and then in January 2018 we get to work!