1. North Sound ACH Board Alignment with Approach to Design Funds
July 28, 2017

2. Agenda Goal for today Introductions Discussion: Next Steps
NSACH “True North” Statement
Approach/Timeline to Sustainability and Transformation
Next Steps
Goal for today
Board review and alignment on approach for Phase II
I think you have the agenda items

3. DRAFT From June Board Discussion (facilitated by John Kitzhaber, MD)
Defining the ‘True North’ - To improve health of the people who live in Island, San Juan, Snohomish, Skagit and Whatcom counties.
To achieve this goal, the North Sound ACH will:
Work with private, public sector and tribal partners to create innovative and sustainable community-led solutions. 
Use strategies that advance equity and reduce disparities in operations, decisions and governance.
Look upstream, midstream and downstream to identify solutions that include, and go beyond, traditional healthcare approaches.
Embed the perspectives of clients, patients, and community members in operations, decisions and governance.
Use ACH partnerships to leverage other opportunities for federal, state investments
Operate in a lean, efficient manner that optimizes the ability of our partners to carry out the work toward transformation.
DRAFT
Liz will describe the interplay between last month’s Board meeting and slides 3-4
The North Sound ACH uses the WHO definition of health, which states that health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

4. From June Board Discussion (facilitated by John Kitzhaber, MD)
Lenses that will drive the ACH work include:
Acknowledge the conflict that exists with the North Sound’s desire to work upstream, and the Demonstration’s focus on clinical outcomes
Acknowledge and respect the sovereignty of our Tribal partners
Focus on communities most impacted by disparities/inequities
Leverage evidence and emerging data
Be innovative, and allow flexibility across the region
Avoid duplication/reduce waste
Create system-level, sustainable changes
Agree to first seek understanding, then seek agreement
Is there a better word than “lenses” – not sure I want to call them principles unless someone pushes for that …
DRAFT

5. ACH Purpose and Sustainability?
I think you had these notes; if possible I would include the Manatt logo at the bottom, so folks know this was a slide prepared for the HCA, not a slide we put together.

6. How we get there matters
TARGETED ALIGNMENT Stakeholders pool and distribute funds, and monitor progress against agreed upon strategic goals
DEEP PARTNERSHIP
Leverage provider and payer need to optimize/transform; Decrease PMPY cost, and increase appropriate utilization to drive cost savings and improved health outcomes
UPSTREAM TOGETHER Stakeholders leverage resources towards research, focused intervention, evaluation and policy change

7. NSACH Approach to Sustainability and Transformation
2020-
Future State?
Primary partners - health system and health plans and tribal systems
Secondary partners - community and social service providers
Deepen partnership with health system and health plans and tribal systems
Strengthen partnership with upstream community based providers
Primary relationships are shared with community based providers, tribal systems health systems and health plans
Hub for health system, health plans and community based providers
Leverage and allocate Design and Planning $$
Invest in capacity for partners to lead projects
Funding shifts to 70% Demonstration, 30% other
Funding shifts to 50% Demonstration, 50% other
Demonstration focused
Continue SIM work to build regional health equity coalition
Medicaid focus
Report on Demonstration milestones/deliverables
Decrease PMPY costs
Make decisions about investments in cost-savings
ACH invests in capacity for partners to lead projects
Leader in strategies to embed equity
Identify root causes
Resource community systems to change policy and attract revenue to the region to move upstream investments
Measure outcomes
Identify other opportunities to partner with federal and state
TARGETED ALIGNMENT
DEEP PARTNERSHIP
UPSTREAM TOGETHER
COMMUNITY HEALTH
COLLABORATION
SUSTAINABILITY
PROGRAM PORTFOLIO