1. Benton-Franklin Health District Board of Directors July 26, 2017
SE WA
Benton-Franklin Health District
Board of Directors
July 26, 2017
Greater Columbia ACH
Transformation Demonstration Update

2. Certification Phase 1 - May
GCACH Milestones

3. Medicaid Transformation Objectives
through services that improve health outcomes and reduce the rate of growth in the overall cost of care
such as acute care hospitals, nursing facilities, psychiatric hospitals, traditional long-term services and supports, and jails using payment methods that take the quality of services and other measures of value into account
prevention and management of diabetes, cardiovascular disease, mental illness, substance use disorders, oral health and more
Medicaid Transformation Objectives
Improve population health
Reduce avoidable use of intensive services and settings
Accelerate the transition to value-based payment
Ensure that Medicaid cost growth is 2% below national trends

5. Greater Columbia by County Population & Medicaid %**
County Population
Healthier WA Dashboard
% of County Population
Population on Medicaid**
% on Medicaid
Asotin
22,138 3%
6,863
31%
Benton
188,474
26.5%
58,427
Columbia
4,058
.6%
1,177
29%
Franklin
88,239
12.5%
36,178
41%
Garfield
2,216
0.3%
665
30%
Kittitas
43,483 6%
10,436
24%
Walla Walla
61,268
8.6%
17,155
28%
Whitman
46,622
6.6%
8,392
18%
Yakima
252,463
35.6%
116,133
46%
GCACH Population
708,961
100%
255,326
36%
WA State Population
7,170,351
1,909,374
 26.6%
** - measurement period to

6. Benton & Franklin in top 5 for Potentially Avoidable ED Visits

8. Disparities of Greater Columbia ACH

9. Percentage of uninsured population has declined since 2013

10. Initiative Funds will flow to Participants through Several Distinct “Pools”

11. $119 Million in Provider Incentives
Bi-Directional Integration of Physical & Behavioral Health
$38M
Community-Based Care Coordination
$26.2M
Domain 2: Care Delivery Redesign
Transitional Care
$15.4M
Diversions Interventions
$15.4M
Addressing the Opioid Use Public Health Crisis
$4.7M
Reproductive and Maternal and Child Health
$5.9M
Domain 3: Prevention and Health Promotion
Access to Oral Health Services
$3.6M
Chronic Disease Prevention and Control
$9.5M

12. Benton & Franklin Counties have many measures worse than the State Average
Washington Health Alliance Community Check-up 2016

13. Source: RWJF County Health Rankings
2A: Bi-Directional Integration of Physical and Behavioral Health through Care Transformation (Required)

14. Bi-Directional Goals FIMC
We’ve extracted data from a lot of places but we still have not come up with data on all of the MTD metrics
There are 60 measures or more that we are being held accountable to. Some are still under development and some will be hard to assess (e.g. ROI)
Bi-Directional Goals
Goal 2
FIMC
Increase access to integrated primary care-behavioral health services by maximizing tenants of the Bree Collaborative (increasing access) Collaborative Care Model (maximizing patient tracking), internal and external co-location.
Goal 4
Goal 1
Goal 3
Identify a regional approach to data collection / registries to improve population health (PHQ-9, SBIRT, PAM).
Fully integrate physical health, mental health, and substance use services in order to provide the right care, in the right place, at the right time.
Increase interoperability between providers and systems to increase efficiencies, improve communication, and reduce redundancies.

15. Integrated managed care is evolving and spreading!

16. 3A: Addressing the Opioid Use Public Health Crisis (Required)
We’ve extracted data from a lot of places but we still have not come up with data on all of the MTD metrics
There are 60 measures or more that we are being held accountable to. Some are still under development and some will be hard to assess (e.g. ROI)
3A: Addressing the Opioid Use Public Health Crisis (Required)
Goal: To reduce opioid-related morbidity and mortality through strategies that target prevention, treatment, and recovery.

17. Opiate Related Deaths: 1999-2015
WA State Dept. of Health, Center for Health Statistics
Opiate Related Deaths:

18. 2012-2015: Deaths per County (opioid related)
: Rate per 100,000 population
Asotin 12
10.8
Benton 84
9.3
Columbia 2
too few to calc.
Franklin 17
4.4
Garfield
Kittitas
9.1
Walla Walla 25
8.5
Whitman 13
8.1
Yakima 65
5.5
From 2002 to publicly funded treatment admissions involving an opioid, statewide, went up 196.5%. Three counties in the GCACH increased over 250%.* *

19. Project Selection Process

21. Five Conditions of Collective Impact
Collective Impact is a framework to tackle deeply entrenched and complex social problems. It is an innovative and structured approach to making collaboration work across government, business, philanthropy, non-profit organisations and citizens to achieve significant and lasting social change.
The Collective Impact approach is premised on the belief that no single policy, government department, organisation or program can tackle or solve the increasingly complex social problems we face as a society.  The approach calls for multiple organisations or entities from different sectors to abandon their own agenda in favour of a common agenda, shared measurement and alignment of effort.
Unlike collaboration or partnership, Collective Impact initiatives have centralised infrastructure – known as a backbone organisation – with dedicated staff whose role is to help participating organisations shift from acting alone to acting in concert
Five Conditions of Collective Impact

22. Questions?
For more information: Carol Moser, ED Wes Luckey, PM Website:
Thank you for the opportunity to discuss Healthier WA with you today, and we look forward to a continued partnership as Healthier WA further develops throughout the state.
Thank you!