Medicaid Demonstration Toolkit Overview

To the best of our abilities in a 45 minute time slot, at our 1/25/17 Leadership Council meeting, Alison gave an overview of the projects outlined in the Medicaid Demonstration Toolkit. This Toolkit is open for public comment until 5PM February 2nd, we strongly encourage you to get together with some peers (it's 78 pages...), explore the listed projects, and make a public comment to the Health Care Authority. BHT is also requesting feedback on our regions interest and readiness in these projects in a survey below. We will post any feedback we share, or receive from the community on our blog. Here are some useful links from our discussion:

In response to feedback from our January 25th meeting, we are attempting to schedule more opportunities to deep dive into the toolkit. Stay tuned. In the meantime, BHT staff are available for questions. 

Shared Learning: Michigan Hub

We were so lucky to host this webinar from a Pathways HUB in Muskegon Michigan who has been using Pathways to run a Jail Transition Program very similar to what we are designing with partners in Ferry County. They gave a very clear and impressive overview of the model and their program, and showed they've seen great success in reducing recidivism. Watch it below!

Dr. Sarah Redding

We were so lucky to have Dr. Sarah Redding, co-founder of the Pathways Model, join us for two days in Spokane presenting to our community on the model and helping us better understand how our region could benefit from a centralized care coordination HUB. You can view one of her presentations on the model below. 

Hood River Site Visit Canceled

A couple months ago, we chatted with our friends in Hood River about a site visit to see the Pathways work in action. We were excited to meet with local partners who had come to a similar conclusion that “coordinating the coordinators” and organizing community assets to improve health was a noble and achievable community goal.

However, the team in Hood River has been selected for a large investment from an important funder. They are under a tremendous amount of pressure to be ready for this big announcement. Most of us in this field can relate to the pressure that can put on non-profits and community efforts, and we know big investments are few and far between. Hood River graciously asked if we could delay our visit. We could not, in good conscience, ask them to power through on this, and so we are canceling the site visit. 

We know this is a let down, however there will be another opportunity to get up close and personal with Pathways at the Pathways to Community Care Coordination Summit in Ohio on September 29th and 30th. 

While we were excited about the site visit to Hood River, we think the technical assistance and networking with many of the regions implementing the Pathways model may even be better! More info below:

Pathways to Community Care Coordination Summit

Register today! Click here to complete the Enrollment Link
Date: September 29-30, 2016
Location: Akron Children’s Hospital, Akron Ohio

Scholarships are available to cover travel costs and the registration fee for this event. Scholarships will be available on a first-come, first-served basis. Click here to request a scholarship.

For questions, please contact

More on the Pathways HUB

On Tuesday July 19th, we hosted a second presentation on the Pathways HUB, this one from Dr. Sarah Redding. This webinar more specifically looked at the process of building a HUB and achieving certification, as well as some examples of specific Pathways and how to build or bundle one's own Pathways. Once again this was a lively discussion with ample question and answer time from Dr. Redding, and we are so grateful she took the time to share with us. You may watch the webinar or download the slides here in case you missed it. 


Presentation from the Pathways HUB

We would like to extend a huge thank you to Bob Harnach and MIke Bonetto for presenting on the Pathways HUB to our Regional Project Team. Their presentation gave us a lot to explore, and we look forward to continuing conversations within the community action team around the viability of this model for our region. 

If you would like to know more about the Pathways HUB, Mike & Bob were gracious enough to share their slides and a recording of the presentation. 

Pathway to our Regional Health Improvement Project

We’ve been eagerly awaiting news on the Medicaid Transformation Waiver but, since we aren’t ones to just sit around, we’re moving full speed ahead.

We’ve spent months synthesizing the wealth of information generated in our Idealized Design and Community Linkage mapping sessions to develop and inform our Regional Health Improvement Plan and the selection of a Regional Health Improvement Project. During our focus group conversations, our community worked together to inventory existing linkages between community resources, and identify where linkages were broken or non-existent. Across those conversations, one need presented itself over and over again: the need to “coordinate the coordinators.”

The diversity of partners in our ACH Leadership Council members demonstrates the leadership and dedication needed to radically improving the health of our region. We agree the most emergent need is not to scale any one community resource or service but to build stronger and more navigable connections between the coordinators and resources already available.

This was realized in our design sessions as a need for “air traffic control” or a patient-centered workforce that helps coordinate services across all sectors. Independent organizations need the flexibility to explore their own models and develop their strengths, but to nurture healthy community, patients need services that communicate, collaborate, and speak the same language of care.

From this idea, we’ve pulled together a workgroup to explore the Pathways HUB model and serve as the steering committee for our Regional Health Improvement Project. Alisha Fehrenbacher from Empire Health Foundation, presented on to the ACH Leadership Council in March on her experiences implementing the Pathways HUB model (view her slides here) in Oregon. It is an evidence-based model currently deployed in over 20 regions of the US, that positions care organizations around a centralized HUB, and has been shown to effectively address risk factors, improve health and reduce costs.

We feel confident this model has a lot to offer our region and are excited to explore it further. The workgroup will continue to develop our plan throughout the summer, with the hope that we will be in position to hit the ground running once we hear about the waiver. If you are interested in joining the Leadership Council, please email Alison@betterhealthtogether