Disclosures Successful completion of this continuing education activity includes the following: Signing into the conference and providing your email address Attending the entire CE activity Completing the evaluation You will receive an emailed copy of your certificate This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Institute for Medical Quality/California Medical Association (IMQ/CMA) through the joint providership of Cardea and the Washington Chapter of the American Academy of Pediatrics. Cardea is accredited by the IMQ/CMA to provide continuing medical education for physicians. Cardea designates this live activity for a maximum of 5.5 AMA PRA Category 1 Credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.

Disclosures Faculty: Jay Fathi, MD CME Committee: David Couch; Kathleen Clanon, MD; Johanna Rosenthal, MPH; Pat Blackburn, MPH; Richard Fischer, MD; Sharon Adler, MD. Richard Fischer, MD is a member of an Organon speaker’s bureau. Dr. Fischer does not participate in planning in which he has a conflict of interest, and he ensures that any content or speakers he suggests will be free of commercial bias. None of the other planners and presenters of this CE activity have disclosed any conflict of interest including no relevant financial relationships with any commercial companies pertaining to this CE activity. There is no commercial support for this presentation.

Disclosures This conference was supported by: Amerigroup, Coordinated Care, Mary Bridge Children’s Hospital, Molina Healthcare, Seattle Children’s, Swedish Pediatrics, and United Healthcare Community Plan

Disclosures Following completion of this session, learners should be able to: Discuss the implications of behavioral health integration in the Washington Medicaid system. Describe opportunities for pediatric primary care providers moving forward.

Questions? If you have any questions about this CE activity, contact Margaret Stahl at seattle@cardeaservices.org or (206) 447-9538

Pediatric Population Health Forum November 4, 2017 Value-Based Purchasing in Washington State: Lessons Learned, Addressing the Future – A Health Plan’s Perspective November 4, 2017

Medicaid Managed Care 101 Historically ‘unmanaged care’ Plans’ employees: Social workers, nurses, care managers, community health workers, behavioral health specialists, etc Member (patient) engagement incentives 5 plans in Washington Lower costs, higher quality than traditional FFS

First Five Years Serving over 250,000 Washingtonians Coverage includes Medicaid, Foster Care, Health Benefit Exchange 360 Employees statewide, offices in Seattle, Tacoma, Wenatchee, & Yakima Integrated Behavioral Health in North Central region of Chelan, Douglas and Grant counties, 2018

Innovative Programs

Apple Health Core Connections Apple Health Foster Care (AHFC) managed care program, called Apple Health Core Connections. Launched April 1, 2016. 24,000 members Have offered over 500 free trainings, helping to educate more than 7,000 partners (foster parents, providers, and other stakeholders). Launched our Zero Suicide and Emergency Department Diversion Programs. Added over 2,300 new providers to our network to ensure our foster care children get the care they need.

Apple Health Core Connections https://YouTubeLink

Behavioral Health Integration Funded through separate, distinct managed care system for >25 years Siloed; separate funding stream, separate ‘payor’ Must be ‘integrated’ (funds, management w/ Medicaid plans) via legislative mandate by 2020 HCA with phased/regional approach, w/ RFPs

Contracting Full range; from FFS to downside risk Larger organizations=better able to manage risk (ultimate ‘motivator’--$$) HCA-contracts w/ plans withhold funding, mandate improved quality scores on select measures Pediatric asthma (2), WCC, Combo 10 Foster: Adol. well care, ADHD meds (2)

Opportunities Plans need you!! Competition Reimbursement based on quality, vs. volume Influence policy-legislature, HCA Challenges

jfathi@coordinatedcarehealth.com | CoordinatedCareHealth.com Contact Information Jay Fathi, MD President and CEO 1145 Broadway, Suite 300 Tacoma, WA 98402 Direct: 253-442-1466 Toll Free: 1-877-644-4613 ext. 69766 Fax: 1-877-644-4602 jfathi@coordinatedcarehealth.com | CoordinatedCareHealth.com