1. Budget and Funds Flow Committee Retreat
October 9, 2017

2. B&FF Committee Goals: Level Setting
Understand GCACH’s role in Healthier Washington
Better understanding of the Mission and Vision of Greater Columbia ACH
Understanding the foundational principles driving the Project Plan Scoring
Understand Funds Flow from the State
Understand role of the Budget and Funds Flow Committee to the success of the Demonstration.
Come to an agreement on a Funds Flow Distribution to Partner Organizations
Understand the target population
Have a quick look at potential partnering providers

3. Better Health, Better Care, Lower Costs

4. Healthier Washington recognizes that health is more than health care.
- Health systems transformation is not just health care reform--this really is about all the systems that affect health, not just medical care.
- The current system:
- Separates the “head” from the “body” —no integration between services for physical health, mental health and chemical dependency.
- Focuses on volume of services provided, not quality of outcomes.
- Is expensive, and getting more so, without producing better results.
Health is more than health care.
HW is grounded in an understanding that health is more than health care – that 80% of the factors that affect a person’s health occur outside of the health care system.
Improving people’s health outcomes (and lowering costs) will depend on addressing those factors and linking supports for them to the health care delivery system.
- Health encompasses community (nutritious food, housing, public health), system supports (measurement, consumer engagement, workforce development) and health & recovery efforts (mental health, long-term care, oral health).
Adapted from: Magnun et al. (2010). Achieving Accountability for Health and Health Care: A White Paper, State Quality Improvement Institute.. Minnesota. 3
Better Health, Better Care, Lower Costs

5. ACHs are a forum for regional collaborative
decision making

6. Systems Collaboration and Integration Foundational to Budget and Funds Flow

7. Dorothy Teeter, State of Reform, 2015 “Truisms”
HCA North Star: Better Health, Better Care, Lower Costs (Triple Aim)
Use dollars in the best way you know. There is an 80% overlap in delivery system partners, so the potential for savings is the integration of systems.
Build your healthcare delivery system around the measures.
."

8. MTD Toolkit: Pay for Performance Metrics

9. GCACH Guiding Principles
Create Equitable Communities (Improve Health Disparities)
Integrate Systems (Behavioral, Dental, Primary Care, Social Services)
Cross Sector Collaboration (Clinical-Community Linkages)
No wrong door
Reinvest savings for sustainability
Build around measures
Try to keep everyone whole and shift dollars
Scalability and spread of programs

10. Vision & Mission of Greater Columbia Adopted March 19, 2015, Leadership Council
Vision Statement The Greater Columbia Region is a vibrant, healthy community in which all individuals, regardless of circumstance, have the ability to achieve their highest potential. Mission Statement The Mission of the Greater Columbia ACH is to advance the health of our population by decreasing health disparities, improving efficiency of health care delivery, and empowering individuals and communities through collaboration, innovation, and engagement.

11. Population & Medicaid # by County
OFM
Population on Medicaid*
% of Population on Medicaid
% of GCACH Pop
on Medicaid
Asotin
22,150
6,863
31%
2.7%
Benton
190,500
58,427
22.9%
Columbia
4,050
1,177
29%
0.5%
Franklin
88,670
36,178
41%
14.2%
Garfield
2,200
665
30%
0.3%
Kittitas
43,710
10,436
24%
4.1%
Walla Walla
60,730
17,155
28%
6.7%
Whitman
47,940
8,392
18%
3.3%
Yakima
250,900
116,133
46%
45.5%
Population GCACH
710,850
255,426
35.9%
100%
Population WA
7,183,700
1,909,374
26.6% **

12. Regional Needs Assessment
Measures for which all counties in the region had outcomes worse than the state
Access to dentists
Access to exercise opportunities
Access to mental health providers
Children in poverty
Healthy community design
Median household income
Poor academic performance

13. Data looked at Medical & Social Needs

14. High-cost, high-utilizing patients our target population

15. What was Medicaid Thinking?

16. Medicaid Transformation Distribution
Robert Wood Johnson Foundation County Health Rankings: “Clinical care is only one fifth of the factors determining health. Healthy Behaviors (e.g. tobacco use, diet and exercise, alcohol and drug use, sexual activity) comprises 30% of factors determining good health
Social and Economic Behaviors (e.g. education, employment, income, family and social support, & community safety) comprise 40% of factors determining good health.
Physical environment (e.g. air & water quality, housing & transit) comprises 10% of the factors determining good health.
Healthy People 2020  developed a “place-based” organizing framework for SDOH
Economic Stability
Education
Social and Community Context
Health and Health Care
Neighborhood and Built Environment

17. Social Service Spending Comparisons

18. DSRIP Calculator provides risk assessment tool

19. Risks can be assessed across all Metrics

20. Carol Moser, Executive Director: cmoser@greatercolumbiaach.org
Wes Luckey, Program Manager: