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 (HCA), behavioral health agencies that have contracted with the Behavioral Health Organizations (BHO), 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 is any organization who has turned in a Collaborative MOU.
In this phase of planning, only behavioral health and primary care Partnering Providers will be working towards pay-for-performance outcome payments by implementing Transformation Plans in their respective settings. These Partnering Providers will have to register with the ACH Financial Executor to receive payments.
It is important to note that all other members of the Collaborative will not submitting Transformation Plans and are not eligible for pay-for-performance outcome funding. However these are organizations should be aligning with the behavioral health and primary care Partnering Providers to support their Transformation Plans. An potential example in the Spokane Collaborative may be YMCA partnering with CHAS in their Chronic Disease project work.
For Partnering Providers outside of the primary care and behavioral health settings, what does a commitment look like?
Partnering Providers from all settings were asked to submit an MOU. After that, the level of commitment from Partnering Providers outside of those settings will be based largely on the individual contribution they will make to support Transformation Plans of individual Partnering Providers in the Collaborative.
Are assessments for all settings or just primary care and behavioral health?
The first round of assessments released will be only for primary care and behavioral health Partnering Providers.
Were the assessments conducted by individual Partnering Providers or by each Collaborative?
Assessments were conducted by individual Partnering Providers 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 needs based on the data from the assessments Partnering Providers submitted in April.
Why would a Collaborative include measures in addition to required state and BHT measures?
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 members accountable to the effort.
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 Partnering Providers for success in the value-based payment landscape.
What happens when a Collaborative member 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 is committed to work closely with Partnering Providers to assess the best way to support both high performing and low-performing organizations, and to do so fairly and transparently.