Edge of Amazing Summit Innovations in Medicaid

Healthier Washington is the state’s vision for transforming the health care system to achieve better health, better care and lower costs for the

people of Washington State.

The Healthier Washington Initiative

The goals of Healthier Washington are simple:

• Healthier people and communities

• A transformed health care system that treats the whole person

• Affordable care

The Healthier Washington Initiative

• Healthier Washington is employing three overarching strategies to achieve its transformation goals:

• Supporting multi-sector engagement

• Integrating care and social supports

• Paying for value

Medicaid’s Influence in Health Care

• Kali Klein, Health Policy Project Manager, Health Care Authority

• Jon Brumbach, Senior Health Policy Analyst, Health Care Authority

• Dean Wight, Interim Executive Director, Whatcom Alliance for Health Advancement

• Karen Fitzharris, Project Director, Home and Community Services, Department of Social and Health Services

Today’s Presenters

Update on Medicaid Transformation Waiver

• Application submitted to CMS on August 24, 2015 for a 5-year waiver demonstration.

• Proposed demonstration provides an opportunity to accelerate changes in our Medicaid program that support the goals of Healthier Washington.

Medicaid Transformation Waiver

• Reduce avoidable use of intensive services and settings

• Improve population health

• Accelerate the transition to value-based payment

• Ensure that Medicaid per-capita cost growth is below national trends

Washington’s Medicaid Transformation Goals Achieving the Triple Aim

Initiative 2 Initiative 1 Initiative 3 Enable Older Adults to Stay at Home; Delay or Avoid the Need for More Intensive Care

Transformation through Accountable Communities of Health

Targeted Foundational Community Supports

Benefit: Tailored Supports for Older Adults (TSOA)

Benefit: Medicaid Alternative Care (MAC)

Benefit: Supported Employment

Benefit: Supportive Housing

Medicaid Benefits/Services Pay-for-Performance Transformation Projects

Delivery System Reform

Medicaid Transformation Initiatives

Paying for value

Medicaid Transformation Waiver: Timeline

Supportive Housing and

Supported Employment

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• Supportive Housing & Supported Employment • Targeted Medicaid benefits

• Key distinctions • 1115 Demonstration Waiver

• State-wide

• “No wrong door”

Washington’s Approach: Foundational Community Supports

Medicaid

HCA

MCOs

SE – Physical Health

Conditions

BHA

BHOs

SE – Behavioral Health

Conditions

ALTSA

HCS/AAAs

SE - LTSS

Tribes

SE – Tribal Members

Initiative 3: Medicaid Funds Flow

Purchaser

Payer

Provider

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Data

• Housing transition services that provide direct support to help individuals obtain housing, including:

• Housing assessment and development of a plan to address barriers.

• Assistance with applications, community resources, and outreach to landlords.

• Housing tenancy sustaining services that help individuals maintain their housing, including:

• Education, training, coaching, resolving disputes, and advocacy.

• Activities that help providers identify and secure housing resources.

Supportive housing services do not include funds for room and board or the development of housing.

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Supportive Housing—Eligible Services

• An evidence-based approach to supported employment for individuals with significant barriers to employment

• 23 randomized controlled trials (Dartmouth, 2015)

• Principles of Supported Employment: ‒ Open to anyone who wants to work ‒ Focus on competitive employment • Rapid job search • Systematic job development • Client preferences guide decisions • Individualized long-term supports • Integrated with treatment • Benefits counseling included

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Supported Employment Individual Placement and Support (IPS) Model

Join the Healthier Washington Feedback Network:

healthierwa@hca.wa.gov

Learn more: www.hca.wa.gov/hw

Questions: medicaidtransformation@hca.wa.gov

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