Medicaid Transformation
Learn about HealthierHere’s role in this statewide initiative
“I am only well if you are well” ~ African Proverb
What is HealthierHere’s role?
As part of our work to improve health and well-being in our region, HealthierHere serves as the Accountable Community of Health (ACH) for King County, Washington.
What are Accountable Communities of Health?
Accountable Communities of Health (ACHs) are regional collaboratives committed to improving health and health equity. ACHs bring together health and social service partners, provide local oversight around population health and wellness, and support initiatives such as the Healthier Washington Medicaid Transformation Project (MTP). There are nine regional ACHs in Washington State working to develop the systems and linkages needed to improve the health and social services delivery systems and fully address people’s care needs.
What is the Medicaid Transformation Project?
The Medicaid Transformation Project (MTP) is a five-year agreement between Washington State and the federal government that provides federal investment into regional Medicaid delivery system improvement projects. This effort focuses on large scale system transformation to improve care for the whole person, reduce barriers to care, and use resources more wisely.
As part of the Medicaid Transformation Project, HealthierHere is working to:
- Develop transformation projects that target regional healthcare challenges
- Submit required deliverables to the Washington State Health Care Authority
- Distribute incentive funds to partnering providers for their achievement of defined milestones
- Partner with community members to ensure community voice and equity are embedded in this work
- Coordinate & oversee the work in partnership with local partner organizations
About HealthierHere
HealthierHere is transforming the way health care is delivered to thousands of residents in King County. We work across medical, behavioral health, social service, and community to build a welcoming, accessible, and integrated delivery system that fosters health and wellness for all.
What is our approach?
We are working on a portfolio of projects that have been approved by the Washington State Health Care Authority. We have also identified cross-cutting elements that are foundational to our work. These foundational elements include community-based care coordination, addressing the social determinants of health, improving equity, and reducing disparities. HealthierHere partners with community and clinical organizations to co-design, develop, test and implement innovations and partnerships aimed at improving health outcomes in our Innovation Target areas:
Physical & Behavioral Health
Integration
About
Outcome Metrics – regional health outcome measures that we aim to improve as part of this Innovation Target work
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Reduced Overuse (ED visits, Re-admissions)
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Improved Behavioral Health
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Improved Physical Health
Levers – key methods and tools we’re using to improve outcomes
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Shared Care Plans
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Enhanced Screening
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Evidence-based Best Practices
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Interoperable Data Systems
Project Toolkit Description – click for full details outlined by the Health Care Authority:
Project 2A: Bi-directional Integration of Physical and Behavioral Health through Care Transformation
Safe & Successful
Transitions
About
Outcome Metrics – regional health outcome measures that this Innovation Target aims to improve
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Reduced ED visits
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Reduced Inpatient Utilization
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Reduced Readmissions
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Fewer Released to Homelessness
Levers – key methods and tools we’re using to improve outcomes
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Community Based Care Coordinators
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Peer Support Specialists
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Linkages to Community Organizations
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Interoperable Data Systems
Project Toolkit Description – click for full details outlined by the Health Care Authority:
Project 2C: Transitional Care
Prevent & Manage
Chronic Conditions
About
Outcome Metrics – regional health outcome measures that this Innovation Target aims to improve
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Reduced ED visits
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Reduced Inpatient Utilization
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Improvement on Clinical Measures
Levers – key methods and tools we’re using to improve outcomes
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Self-Management Support
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Population Health Management (Registries)
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Team-Based Care
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Community Health Workers (CHWs)
Project Toolkit Description – click for full details outlined by the Health Care Authority:
Project 3D: Chronic Disease Prevention and Control
Reduced
Opioid Use
About
Outcome Metrics – regional health outcome measures that this Innovation Target aims to improve
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Reduced Mortality / Overdoses
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Reduced Morbidity
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Treatment Penetration
Levers – key methods and tools we’re using to improve outcomes
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Improved Prescribing Practices
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Increased Access to Evidence-Based
Treatment (e.g., MAT) -
Overdose Prevention
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Recovery Coaches for Long-term Stabilization
Project Toolkit Description – click for full details outlined by the Health Care Authority:
Project 3A: Addressing the Opioid Use Public Health Crisis
What is our goal?
At the end of the day, HealthierHere and its partners want to make transformative change in our region to prevent disease, promote well-being, and improve the quality of life for Medicaid members in our region.
If we are successful, HealthierHere and our partners will have catalyzed transformational change in our region to build a welcoming, accessible, and integrated delivery system that fosters health and wellness for all.
