1. Update on Medicaid Integration in SW Washington January 7, 2016 Erin Hafer, MPH Director, New Programs Integration & Network Development

2. Community Health Plan of Washington Overview Formed in 1992, Community Health Plan of Washington was started by the community and migrant health centers throughout the state of Washington that serve as the safety net for the underserved. Community Health Plan is the only not-for-profit health plan serving Medicaid in Washington State. Operate from core belief that increasing access to health care translates into healthy families and strong communities. Through State-Sponsored, Medicaid and Medicare programs, Community Health Plan has offered at least one medical care product in all 39 counties in Washington State serving more than 311,000 members (including Medicaid, Medicare Advantage and Health Benefit Exchange members).

3. System of Care Comprehensive assessment and risk stratification process Person-centered, recovery and resiliency oriented care planning, with an integrated and coordinated care team. – Level 1 – Care Coordination Services provided by the CHPW Care Coordinator including staff based at our local office in Southwest Washington – Level 2 – Intensive Care Management provided our community-based contracted Health Home Care Coordinators Deploy & scale evidence-based & promising practices – Bi-directional integrated care models supported through technical assistance and training – Peer bridger models/supportive housing

4. Principles for Integrated Care Person Centered Collaboration Primary care, behavioral health and community providers collaborate effectively using shared care plans. Population-Based Care A defined group of clients is tracked in a registry so that no one falls through the cracks Measurement-Based Treatment to Target Treatments are actively changed until the clinical goals are achieved. Evidence-Based Care Providers use treatments that have research evidence for effectiveness or have been identified as promising practices. Accountable Care Providers are accountable and reimbursed for quality care and outcomes.

5. Promising Trends Evaluation of CHPW’s Mental Health Integration Program showed: Reduced inpatient admissions Smaller increases in inpatient psychiatric costs Lower increases in homelessness in clients receiving services through MHIP Reduced arrest rates in clients receiving MHIP services http://chammp.org/Program-Evaluation/Reports/General-Assistance-Disability- Lifeline-(DL).aspx Demonstrated clinical outcomes -- Pay-for-performance-based quality improvement cuts median time to depression treatment response in half Hospital savings of over $11.2 million in initial 14 months of statewide MHIP implementation – net savings of $66 pmpm

6. Collaborative Approach to Implementation Weekly Implementation Meetings with HCA, CHPW & Molina Weekly implementation meetings with CHPW & Molina Bi-weekly meetings with BH Provider Alliance, CHPW & Molina Workgroups and Committees convened by Counties/HCA/ACH – Consumer Advisory Board/ Behavioral Health Advisory Board – Early Warning System Steering Committee – Care Coordination Workgroup – Access Workgroup – Data Workgroup – Ad hoc workgroups focused on Western State, Criminal Justice and Housing Coordination and more

7. Questions? For more information, please contact: Erin Hafer, MPH Director, New Programs Integration & Network Development Erin.hafer@chpw.org