1. Update on Integration: HCA’s Vision
State of Reform
January 7, 2015

2. Washington’s vision for creating healthier communities and a more sustainable health care system by:
Building healthier communities through a collaborative regional approach
Ensuring health care focuses on the whole person
Improving how we pay for services
Better Health, Better Care, Lower Costs

3. Healthier Washington recognizes that health is more than health care.
Adapted from: Magnan et al. (2010). Achieving Accountability for Health and Health Care: A White Paper, State Quality Improvement Institute, Minnesota.
Better Health, Better Care, Lower Costs

4. Better Health, Better Care, Lower Costs

5. Healthier Washington is more than the State Innovation Models (SIM) grant…
2014 Legislation:
House Bill 2572
Senate Bill 6312
Medicaid Transformation Potential demonstration project within Medicaid
SIM Grant:
$65 million over 4 years from the federal government
Better Health, Better Care, Lower Costs

6. Paths to Purchasing Transformation Regional Service Areas (RSAs)
2014 Legislative Direction: 2SSB 6312
By January 1, 2020, the community behavioral health program must be fully integrated in a managed care health system that provides mental health services, chemical dependency services, and medical care
services to Medicaid clients
2020:
Fully Integrated Managed Care System Across the State
Transition Period
Apple Health Managed Care Plans
Integrated Purchasing in “Early Adopter (EA)” Regions – County Authority elect EA approach
Behavioral Health Organizations
2016
Regional Service Areas (RSAs)

7. Goals of the “Early Adopter” Model
Seamless access to necessary services
Ability to address physical health and behavioral health issues in one system, with better coordinated care
Opportunity for local input to shape program
Better aligned financial incentives for expanded prevention and treatment and improved outcomes
Adequate and sustainable network that ensures access and continuity of care
Flexible models of care that support the use of interdisciplinary care teams
Shared savings reinvested in the delivery system
Improved information and administrative data sharing across systems