Update on Integration: HCA’s Vision State of Reform January 7, 2015

Washington’s vision for creating healthier communities and a more sustainable health care system by: Building healthier communities through a collaborative regional approach Ensuring health care focuses on the whole person Improving how we pay for services Better Health, Better Care, Lower Costs

Healthier Washington recognizes that health is more than health care. Adapted from: Magnan et al. (2010). Achieving Accountability for Health and Health Care: A White Paper, State Quality Improvement Institute, Minnesota. Better Health, Better Care, Lower Costs

Better Health, Better Care, Lower Costs

Healthier Washington is more than the State Innovation Models (SIM) grant… 2014 Legislation: House Bill 2572 Senate Bill 6312 Medicaid Transformation Potential demonstration project within Medicaid SIM Grant: $65 million over 4 years from the federal government Better Health, Better Care, Lower Costs

Paths to Purchasing Transformation Regional Service Areas (RSAs) 2014 Legislative Direction: 2SSB 6312 By January 1, 2020, the community behavioral health program must be fully integrated in a managed care health system that provides mental health services, chemical dependency services, and medical care services to Medicaid clients 2020: Fully Integrated Managed Care System Across the State Transition Period Apple Health Managed Care Plans Integrated Purchasing in “Early Adopter (EA)” Regions – County Authority elect EA approach Behavioral Health Organizations 2016 Regional Service Areas (RSAs)

Goals of the “Early Adopter” Model Seamless access to necessary services Ability to address physical health and behavioral health issues in one system, with better coordinated care Opportunity for local input to shape program Better aligned financial incentives for expanded prevention and treatment and improved outcomes Adequate and sustainable network that ensures access and continuity of care Flexible models of care that support the use of interdisciplinary care teams Shared savings reinvested in the delivery system Improved information and administrative data sharing across systems