Washington State Health Care Innovation Plan
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Washington State Health Care Innovation Plan The Washington Way JANUARY 2014 Acknowledgements INNOVATION PLAN PROJECT GOVERNANCE Health Care Authority, Coordinating Department of Social and Health Department of Commerce Agency Services Brian Bonlender Dorothy Teeter Kevin Quigley Department of Early Learning Nathan Johnson Jane Beyer Bette Hyde Dan Lessler Bill Moss Office of the Superintendent of Public MaryAnne Lindeblad Governor’s Health Policy Office Instruction Lou McDermott Bob Crittenden Greg Williamson Department of Health Department of Labor & Industries State Board of Community and John Wiesman Gary Franklin Technical Colleges Sue Grinnell Leah Hole-Marshall Marty Brown Kristin Peterson Office of Financial Management Washington Health Benefit Exchange Carole Holland Richard Onizuka Office of the Insurance Commissioner Pam MacEwan Mike Kreidler INNOVATION PLAN STAFF CONTRIBUTORS Contracted Project Director Department of Health Governor’s Policy Office Karen Merrikin Maxine Hayes Jason McGill Health Care Authority Karen Jensen Andi Smith Laura Kate Zaichkin Drew Bouton Department of Early Learning Jenny Hamilton Juliet VanEenwyk Kelli Bohanon Kat Latet Department of Social and Health Office of Financial Management Kari Leitch Services Joe Campo Rachel Quinn Rhoda Donkin Thea Mounts Rhonda Stone Kara Panek Richard Pannkuk Rebecca Burch Jennifer Bliss Office of the Insurance Commissioner Lucy Crow Chris Imhoff Emily Brice Karol Dixon Barbara Felver Molly Nollette Charissa Fotinos Karen Fitzharris Jason Siems Juan Alaniz David Mancuso Janet Cornell Dan Murphy Washington Health Benefit Exchange Tim Dyeson Melanie Pazolt Molly Voris Thuy Hua-Ly Bea-Alise Rector Mary Fliss David Reed Steve Lewis Beth Luce Dennis Martin Cheryl Moore Josh Morse Melodie Olsen Jim Stevenson Anne Wahrmund INNOVATION PLAN PROJECT CONSULTANTS Cedar River Group Mercer Consulting University of Washington Tom Byers David Frazzini Doug Conrad Jack Thompson James Matthisen Sue Skillman MacColl Center for Health Care The Dr. Robert Bree Collaborative Washington Health Alliance Innovation Terry Rogers Susie Dade Michael Parchman Steve Hill Mary McWilliams Elizabeth Lin Strategies 360 Washington Park Consulting Manatt Health Solutions Jonathan Seib Richard Marks Deborah Bachrach Andrew Detty Jonah Frohlich Sandra Newman Washington thanks the Bill and Melinda Gates Foundation for its support of Cedar River Group’s contributions, the National Governors Association for its support of the Workforce Summit, and the Empire Health Foundation and Foundation for Health Care Quality for their support of Washington’s 2012 State Innovation Models grant application. Thanks as well to the hundreds of contributors who have generously contributed their ideas, passions, and expertise to the development of the Innovation Plan. This report was funded by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, grant number 1G1CMS331184-01-02. Photos throughout this report are royalty free, courtesy of Microsoft. Testimonials: Washington State’s Innovation Plan “This is exactly the right moment to take a fresh look at our state’s current health care delivery and financing systems and to examine new ideas capable of improving the health of all Washington residents. UW Medicine supports the Innovation Plan taken as a whole, and in particular SHCIP’s commitment to the further integration of care provided to individuals with multiple healthcare needs: physical health, behavioral health, substance abuse and community services. Our mission at UW Medicine is to improve the health of the public, and we look forward to our continued partnership in creating and executing this new vision for improving the health of the residents of our state.” — Paul G. Ramsey, MD, CEO UW Medicine “Virginia Mason is a proud supporter of Washington’s Innovation Plan. The Innovation Plan is a necessary road map to more accountable, higher quality, patient-centered health and health care in Washington State. Virginia Mason was an active participant in the planning process, and looks forward to working with Washington state and other health care stakeholders toward better health, better care, at lower costs.” — Gary S. Kaplan, MD, Chairman and CEO Virginia Mason Medical Center “As a major insurer and delivery system in Washington State and contractor for Washington's Public Employee Benefits program, we support the Public/Private Transformation Action Strategy. We look forward to working collaboratively with the state to refine the details and with our payer, provider and purchaser partners to make further strides on value-based payment reform, transparency of quality and cost, common performance measures and innovative consumer engagement strategies. Alignment of payment and delivery system reform strategies across stakeholders is critical to achieving meaningful transformation in health care, and we look forward to doing our part.” — Scott Armstrong, President and CEO Group Health Cooperative “Legacy Health looks forward to working with fellow health systems and payer organizations to take the innovation plan and its key transformative elements from theory to practice in Southwest Washington. We strongly support movement toward more accountable delivery systems with community involvement and greatly appreciate the plan’s focus on integrating physical and behavioral health, at a financing and delivery system level.” — George Brown, MD, CEO Legacy Health “PeaceHealth supports the concept of regional purchasing for Medicaid that promotes greater collaboration and community accountability for health outcomes. The Public/Private Transformation Action Strategy provides a clear roadmap for innovation and we are committed to working with the state toward achieving a high-performing, accountable health delivery system in SW Washington.” — Alan Yordy, President & Chief Mission Officer PeaceHealth “The Plan’s core strategy for the State to take a lead role as ‘first mover’ is vitally important to creating a strong primary care system, which is needed as the foundation for accountable care.” — Cindy Robertson, President RHCAW, Northshore-Medical Group & Rural Health Clinic Association of Washington (RHCAW) “As a large hospital system serving Washington State, Providence Health & Systems applauds Washington’s Innovation Planning effort. We look forward to partnering with the State on strategies that will move the needle on creating better value and a more accountable delivery system. We also look forward to collaborating with providers, payers, and purchasers on additional strategies that will improve quality and reduce costs for the entire community.” — Joseph Gifford, MD, CEO ACO of Washington, Providence Health and Systems "Integrating physical and behavioral health and addressing social determinants of health (including Adverse Childhood Experiences) are components of the plan that the WA Chapter of the American Academy of Pediatrics strongly supports. We believe that aligning the SHCIP with other initiatives in WA State, such as the Early Learning Plan and Frontiers of Innovation, is a smart strategy that will maximize the potential of all of these efforts. Further, the plan recognizes the need to focus on payment models, outcomes, and health disparities, all complex issues, in order to achieve the Triple Aim. We appreciate the hard work and vision so apparent in the plan." — Washington Chapter American Academy of Pediatrics “Thank you again for seeking to address the needs for health care reform in such a comprehensive manner. While developing a final plan will be challenging, the draft’s prioritization of remedying health inequities, addressing the social determinants of health, and integrating physical and behavioral health with LTSS give Washington a real opportunity for broad-based improvements in community health to benefit all residents.” — Children’s Alliance, Neighborhood House, and Northwest Health Law Advocates (NoHLA) “The formation of the regional Accountable Communities of Health (ACH) as a key strategy for fostering cooperative action for improvements in health, care and costs is of key interest to us. We welcome the opportunity to come to the table with other community health partners to plan, act, evaluate and learn together.” — Randall H. Russell, CEO Lifelong AIDS Alliance “Mental health and chemical dependency services need to become better integrated with each other; any further separation would be a step backwards. These service systems should be integrated in a single payment and management structure. More effective service coordination is also needed with physical healthcare, through bi-directional integration approaches and care coordination.” — Ann Christian, CEO Washington Community Mental Health Council “The Washington State Hospital Association is pleased the state is moving forward on integrating care for individuals with physical and behavioral health co-morbidities, a group currently not well served by our system. We have appreciated being part of the innovation planning process and look forward to continued collaboration as we move toward implementation.” — Claudia Sanders, Senior Vice President, Policy Development Washington State Hospital Association "At the Washington State Medical Association our vision is to make Washington the best place to receive care and to practice medicine. The goals outlined in the state’s innovation grant are bold steps toward achieving that vision. There is much to be done to transform our state’s health care