Released January 11, 2018 from the Washington State Health Care Authority:
Improving care for people enrolled in Washington’s Apple Health (Medicaid)
How will the Medicaid Transformation Project improve care in Washington State?
A few years ago, the Washington Health Care Authority (HCA) started looking for new ways to improve the care given to Apple Health (Medicaid) members. This work is part of a statewide effort (called the Healthier Washington Initiative) to build healthier communities by working together at the local level.
Some of this work is being done through Washington’s Medicaid Transformation Project. By working directly with community members and across departments in state government, the HCA arrived at the following goals for improving the care provided by Medicaid:
- Provide people served by Apple Health with healthcare that is coordinated among care providers, in particular physical health providers (primary care, pediatrics, specialty care, etc.) and behavioral health providers (counseling, psychiatry, substance use treatment, etc.).
- Change the way doctors and other care providers are paid by measuring and rewarding the quality of care people receive.
- Focus on caring for the whole person, including a person’s physical, emotional, and social health.
- Make care equally available to all Washington residents, including the most vulnerable, for example, those who are homeless, unemployed, or incarcerated.
- Provide more and better support to people as they grow older.
How will this work support transformation?
The Medicaid Transformation Project is focused on three areas:
- Supporting local solutions by creating community organizations called Accountable Communities of Health, (ACHs), described in more detail below.
- Strengthening local resources so people can get the care they need in their own communities, including receiving care in their own homes.
- Helping people in need find housing and jobs.
What is an Accountable Community of Health (ACH)?
An ACH is a local organization made up of people from different parts of the community. They may work in hospitals, clinics, schools, city, county or tribal governments, housing assistance programs, or emergency services. Apple Health members play a key role by attending meetings and work groups, answering surveys, and helping plan health projects that are important to their families and communities.
ACHs bring all of these people together to focus on how best to improve the health of everyone in the community, especially those who are most in need.
Find a map of the nine ACH regions on the HCA website.
How are ACHs improving health?
In the fall of 2017, the ACHs each chose a minimum of four projects from a total of eight – all of them approved by HCA and federal partners at the Centers for Medicare and Medicaid (CMS).
Projects focus on critical areas of health such as managing diabetes, improving care for mothers and children, addressing the opioid crisis, and providing access to oral health services. All of the projects are designed to fit together, so that the work of each project builds on and supports the others. (List of projects and ACH selections)
How will Medicaid Transformation affect me?
Most of the work is happening behind the scenes; people with Apple Health may not notice any difference at first. In other Medicaid transformation projects around the country, many individuals were not even aware that they were receiving care within a Medicaid transformation project. But when asked about their care, they often noticed that it was easier to get the care they needed, and that providers in different settings were more familiar with their needs and life situations. Because providers were working together – coordinating with each other – people reported better service and better outcomes.
The long-term goal of Washington’s Medicaid Transformation work is that everyone in your community will experience improved health and wellness.
How can I be a part of the work?