State Makes Major Adjustment to Medicaid Transformation Demonstration Project Plan

Late Friday, October 27, the Washington State Health Care Authority (HCA) notified the nine Accountable Communities of Health (ACH) that it has revised the scoring framework of the Medicaid Transformation Demonstration Project Plan. The change will allow the ACHs an opportunity to earn their full valuation if they chose four projects, instead of six. Originally, ACHs that chose four projects could only score up to 90 percent on their Project Plans. This was originally intended to encourage ACHs to take on more than four projects. The HCA said that it made the change after meetings with the leadership of the ACHs, following an announcement by the HCA that it had miscalculated the total funds available for the projects. “We are expected to do more with less money,” said Elevate Health Chief Executive Officer Alisha Fehrenbacher. “This adjustment will help us target the funds to ensure successful outcomes for our regional community.” The Medicaid Transformation Demonstration is a collaborative, performance-based method of funding health system transformation. ACHs contract with the HCA to develop specific, transformation projects over a five-year period. Up to $1.5 billion will be distributed over the five-year period to ACHs to fund the projects. Given the fast-approaching deadlines for project submission, the Elevate Health (PCACH) Board of Trustees held a vote at their regularly scheduled October meeting the following business day. They unanimously chose four projects:

• Bi-directional Integration of Care
• Community-based Care Coordination
• Opioid Crisis
• Chronic Disease

Two of the projects, Bi-directional Integration of Care and Opioid Crisis are required by the State. “Our plan is to approach system transformation through settings that roll all projects into four project areas. We are essentially doing all eight projects in the Pierce County region, but we are only being scored by the State on four,” said Fehrenbacher. These additional projects include Transitions, Diversion, Oral Health and Reproductive Maternal Child Health Activities. Fehrenbacher noted that the councils will still be able to provide input during the two Write-back Periods during December and January. This will provide the Regional Health Improvement Plan (RHIP) Council, Providers Integration Panel (PIP) and the Community Voice Council (CVC) opportunities to make last minute changes to the plan. At the Board meeting, liaisons from the RHIP, PIP and CVC emphasized the need to roll in all eight projects into the Board-approved four project areas. An update will be provided at the next meeting of each council. A first draft of the plans for these projects is slated for Nov. 2. The final project plan is due to the State on Nov. 16. The next phase of the community and council work will be the implementation planning period from February through June 2018. The projects are scheduled to roll out in July 2018.