Specialists: High performing Retire Decide to become PCPs Less opportunities available as med students think about their specialties PCPs More NPs & PAs Specialist conversions More med students going into primary care
Southwest Washington RegionalHealth Alliance (RHA)
Serious changes are underway inWashington and across the Country asHealthcare Reform begins to unfoldPage 2
“Follow the Money”(Deep Throat quote from Bob Woodward’s account of Watergate)• Need to invert the ResourceAllocation Triangle• Prevention Activities mustbe funded and widelydeployed• Primary Care must becomea desirable occupation and• Decrease Demand in theSpecialty and Acute CareSystems• These are dramatic shiftsthat will not magically takeplacePage 3
A Key Part of the Equation: Addressingthe Social Determinants of Health• There is a distinct relationship between an individual’s health statusand the social and environmental conditions in which he or she lives• The US healthcare system is not currently structured to address theseproblems, separating health from human services4
Which requires the Customization of thePatient-Centered Health Home5
But, what about theunfolding HCA/DSHSdesign?7• All Medicaid enrolleesmove into managed care• Reducing RegionalSupport Networks• Payment reform pilots• 2014 Medicaid expansioncover additional300,000+ individuals(29,000 in Clark County)• Medicare/Medicaid Dualeligibles plan-HealthPathWashingtonHCA /DSHS DesignExpansion ofmanaged care?
• Two-Part Idea startedSept 2010:– A Regional HealthAlliance to organizethe payors/fundersto create asupportive paymentand regulatorysystem– In order to supportorganizing thedelivery system intoaccountable systemsof care 8
Key RHA Tasks1. Community-wide needsassessment and improvementplan2. Multi-Payer “virtual” budgetdevelopment3. Community health improvementprojects/hot spotting4. Multi-Payer payment, contracting,and performance measure models5. Person-Centered HealthcareHome development support6. Local ACO development support7. Support Patient Registry, EHR,Health Information Exchangedevelopment8. Community-wide performancemeasurement 9
Governance Board15 members – recommendation to keep board small andmanageable and should be executive level representatives able tomake policy and budget decisions12(4) Counties-Clark, Cowlitz, Skamania, Wahkiakum(1) Cowlitz Tribe(3) Health systems-Kaiser Permanente, Legacy, & PeaceHealth(4) Health Plans(2) Members at Large(1) Education representing SWWDC, WSU, Clark College,Lower Columbia, ESD112 & Head Start
RHA Steering CommitteeResponsible to help set & manage the identified community priorities .13• FQHCs, Free Clinics & Rural Health Clinics• County Public Health• County Human Services• SW Area Aging and Disability• Hospitals/health systems• Health plans• Cowlitz Tribe• Clark College• ESD 112• Consumer representative
Advisory BoardConsists of provider representatives and would report to RHAGovernance Board and provide expertise to staff and SteeringCommittee on various issues.Design TeamCommunity process that includes all stakeholders wanting to beinvolved to include state agencies, service providers, consumers,steering committee members, advisory board members, etc.These meetings are always public with the purpose of identifyingcommunity needs and service delivery system changes.14
Current Work GroupsOrganizationFacilitators: Vanessa Gaston &Geoff KnappResponsible for organizing the“nuts and bolts” of the RHAinfrastructure. Thisincludes identifying funding,developing the interim planfor operation, identifyingany legislative issues,developing job descriptionsand any other related tasks.Health InformationWork GroupFacilitators: Tom O’NealResponsible to support thedevelopment of a RegionalHealth InformationExchange for SW WA thatsupports the collection anddissemination of key clinicaland performance data.
Current Work GroupsWorkforceDevelopmentFacilitators: Mark GaitherResponsible for developing thecurriculum and training planfor the health advocatepositions. Identifystrategies to addressrecruitment, retention &retraining efforts.Integrated HealthHomeFacilitators: Julie NyeResponsible to identifyevidence best practices andpractical strategies toimplement integratedperson centered healthhomes in primary care andbehavioral health settings.
Interim PlanExisting non-profit serve as fiscal agent onshort-term basis 12-24 mos.• Cowlitz Family Health CenterRHA will have separate board, staff and budgetRHA will create separate 501C3 as part of long-term plan
Recent ActivitiesClark College working with RHA partners developedthe job description and certificate training programfor Patient Health Advocates. RHA formallyrequested Clark College approve and implement thisprogram using existing college courses.
Recent ActivitiesMerger Plan for 2 Regional Support Networks inSW WA• Clark RSN, Southwest Washington RSN andSkamania County are applying to merge into oneBehavioral Health Organization• Counties involved- Clark, Cowlitz and Skamania,• New Southwest Behavioral Health RSN opensOctober 1, 2012.
Recent ActivitiesEstablish Core Features for Health Home• Empanelment-assignment to a primary careprovider• Patient centric• Integrated, coordinated care• Multi-disciplinary & team based• Enhanced & expanded access• Quality outcomes & safety
For More Information: http://www.clark.wa.gov/commserv/RHA/index.htmlPresenter: Vanessa GastonVanessa.email@example.com