HealthPath Washington - Washington State Health Care Authority Flipbook PDF

Agenda • Overview of Integration and Health Homes Strategy • Update on Health Home planning and implementation • Discuss

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HealthPath Washington Health Home Forums October 2012

Purpose: *Overview of integration & health homes *Describe how health homes work *Facilitate collaborations among potential partners for health home networks 2

Agenda • Overview of Integration and Health Homes Strategy • Update on Health Home planning and implementation • Discuss Essential Requirements and Rates • Breakout sessions with potential Health Home entities, Care Coordination Organizations and partners • Discuss approaches and concerns

3

Integrated Care Vision Systems must: • Be based in organizations that are accountable for costs and outcomes • Be delivered by teams that coordinate medical, behavioral, and long-term services • Be provided by networks capable of meeting the full range of needs • Emphasize primary care and home and community based service approaches 4

Integrated Care Vision Systems must: • Provide strong consumer protections that ensure access to qualified providers • Respect consumer choices in the supports they receive • Unite consumers and providers in eliminating use of unnecessary care • Align financial incentives to impel integration of care

5

Drivers for Integration • Fragmented service delivery and lack of overall accountability (medical and non-medical) • Service needs and risk factors overlap in high-risk populations • Incentives not aligned to achieve outcomes • Sustainability concerns • High-risk populations • Federal and state legislative direction

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Service need and risk factor overlaps among high risk Healthy Options State Fiscal Year 2009

7 SOURCE: DSHS Research and Data Analysis Division, Integrated Client Database, January 2012.

Service need and risk factor overlaps among high medical need Medicaid Only Disabled clients STATE FISCAL YEAR 2009 GRAND TOTAL

TOTAL AOD = 7,281

30%

ALL HIGH/MED RISK (Dotted Outline)

= 24,006

Shaded Area Between Dotted Outline and Circles = 7,052

29%

AOD ONLY = 2,516

10%

AOD + LTC = 769

3% AOD + SMI = 2,962

12%

AOD + SMI + LTC = 941

LTC ONLY = 2,733

11%

4%

TOTAL LTC = 6,068 SMI + LTC = 1,550

25%

6% TOTAL SMI = 8,867

37%

DD + SMI + LTC = 24