Medicaid demonstration underway; ACHs forming project committees that need provider input

April 11, 2017

To: CEOs, CFOs, CMOs, and Government Affairs staff
From: Chelene Whiteaker, Policy Director
Claudia Sanders, Senior Vice President
Staff contact: Chelene Whiteaker, chelenew@wsha.org or 206-216-2545
Subject:  Medicaid demonstration underway; ACHs forming project committees that need provider input
Purpose
The purpose of this bulletin is to ensure hospitals and health systems understand the opportunities for Medicaid transformation under the new state demonstration and the importance of engaging now with their Accountable Communities of Health (ACH). Over the next five years, the state Health Care Authority will be distributing up to $1.1 billion through the Heathier Washington demonstration.  By the end of this year, the Authority has initially indicated it will distribute up to $240 million statewide to jump start this work. Most of the dollars will flow to providers that participate in approved projects through their ACH. The ACHs are forming committees and groups now that will make key decisions on the local projects that will drive this funding. Do not miss this opportunity!


Recommendation
The nine ACHs are each setting up committees or groups, separate from the ACH governing board, to discuss, design and make recommendations on projects. If your hospital wants to be involved in this effort, it is important to be engaged in the design process. The ACH applications for funding and the list of participating providers are due to the Health Care Authority in September, so there is not a lot of lead time. Many ACHs will be selecting and finalizing projects with providers in July and August.


ACH Information on Activities
Each ACH has provided WSHA with information about their timelines and project committees or groups. If you would like to know more about how to engage in these discussions with your ACH,
please click here. Please do not hesitate to contact your ACH’s executive director if you have questions. Click here for the map of the ACH regions.

By September 2017, each ACH will be submitting applications that will contain a description of the project, a timeline for implementation, the target population, the participating providers and the provider’s capacity to complete the project requirements. Projects will be judged in part by the engagement of the providers in the region.


Projects for Accountable Communities of Health: Providers Wanted
Each ACH will have an overall funding limit on what the region can request. The Authority has not yet released that information. The Authority, however, has developed a
project toolkit, which defines eight project options.  An ACH can elect to do all eight options, but must do at least four.  To meet the minimum project requirement, the ACH must select projects from the following categories:

Care Delivery Redesign (must select at least one non-required project):
  • Bi-directional behavioral health integration (required);
  • Care coordination in the community that includes connecting all care coordinators; Transitional care from intensive inpatient or jail settings; and/or
  • Diversion interventions that reduce expensive medical services.
Prevention and Health Promotion (must select at least one non-required project):
  • Addressing opioid use public health crisis (required);
  • Reproductive and maternal/child health;
  • Access to oral health services; and/or
  • Chronic disease prevention and control.
WSHA Work and Next Steps
WSHA will continue to work with local Accountable Communities of Health to find common elements of projects that could benefit from a coordinated approach across regions. We will also share our work with hospitals as we proceed.


Background and References
For more information, visit the
HCA website.
WSHA’s previous bulletin on
Healthier WA and project toolkit.

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