How was the initial batch of Collaborative members determined?
We created the initial list based on three things; a list of Medicaid high billers provided by the Health Care Authority, behavioral health agencies that have contracted with the Behavioral Health Organizations, and/or those who have expressed an interest or otherwise have engaged with us through the BHT Leadership Council, Health System Inventory, or Care Coordination Inventory. At this point, we feel confident we have identified the organizations that should be at the table will leave it up to the Collaboratives to make final decisions about who is ready to commit to the work.
Who is a Partnering Provider?
A Partnering Provider of the ACH is any provider who has turned in a Collaborative MOU and will be working towards Pay for Performance outcome payments by implementing Transformation Projects in their respective settings. These Providers will have to register with the ACH Financial Executor to receive payments.
It is important to note that some partners may be members of the Collaborative as partners but not Partnering Providers. We are calling these members “Key Partners”. These are organizations who are supporting Partnering Providers in their projects, or in meeting their metrics, but are not eligible for Pay for Performance outcome funding. An potential example in the Spokane Collaborative may be YMCA partnering with CHAS in their Chronic Disease project work.
For partners outside of the Primary Care/Pharmacy/Behavioral Health settings, what does a commitment look like?
Partners from all settings will be asked to submit an MOU. After that, the level of commitment from partners outside of those settings will be based largely on the individual contribution they will make to support implementation plans of individual Partnering Providers in the Collaborative.
Are assessments for all settings or just Behavioral Health /Primary Care settings?
The first round of assessments released will be only for Behavioral Health and Primary Care providers.
Will Assessments be conducted by individual partners/ providers or will it be one assessment coming from each County Collaborative?
Assessments will be conducted by individual partners and tailored to setting.
How much, and what kind, of Technical Assistance will be provided by BHT?
It is our expectation that Collaboratives will provide feedback on their individual needs. We are in service to the Collaboratives and will explore any opportunity to meet those needs, but will not be driving the search for solutions. If necessary, BHT staff and Technical Advisory Councils will engage external subject matter experts to develop technical assistance and shared learning opportunities as identified by the Collaboratives. BHT will conduct a gap analysis to identify potential areas of TA need after partners complete an assessment in April.
Why would a Collaborative include measures in addition to required state and BHT metrics?
This is an opportunity for Collaboratives to address local issues and potentially earn them additional funding to start acting on those local issues. Collaboratives may view this as an opportunity to have the seed money for initiatives not covered under the state requirements, where they could have opportunity to seek additional funding sources. This could also be an area where Collaboratives create measures specific to holding their partners accountable to the effort.
What will be the role and responsibility of the "Collaborative Administrator"?
We are still working on what this will mean and could potentially be defined by each individual Collaborative. This could include convening Collaborative meetings, following up with BHT on behalf of the Collaborative, and other administrative functions. At the very least, we intend Collaborative Administrators to be the individual/organization responsible for submitting the Collaborative Implementation Plan on behalf of the Collaborative to BHT.
Will there be components in the Transformation Plan that calls for a “listing of partners in this work”?
We are still working on exactly what will be required within each Transformation plan, which will largely be guided by a combination of meeting state reporting requirements and needs identified from the assessments.
How does the Transformation make our businesses sustainable?
A shift in the health care landscape is coming, and soon providers will take on more financial risk for positive health outcomes of their patients. Recognizing that it takes multiple sectors to improve health of a community, Transformation Projects are an opportunity to demonstrate how thoughtful partnerships between sectors can create a smoother continuum of care for patients, and more efficient and effective workflows for agencies. BHT believes success in these projects will position participating providers for success in the Value Based Payment landscape.
What happens when a partner isn’t contributing?
It is expected that our Funds Flow model will reward participation and achievement of metrics at a Provider and Collaborative level. This model allows for us to ensure broad Medicaid provider engagement throughout the region and reward performance. As we embark on the Collaborative planning process, BHT ACH is committed to work closely with partners to assess the best way to support both high performing and low-performing organizations, and to do so fairly and transparently.