After eight months of work involving more than 1,000 contributors and a dozen state agencies, Washington has released a bold five-year initiative to transform health and health care in the state.
The State Health Care Innovation Plan aims to deliver better health, better health care, and lower costs for 80 percent or more of the state’s residents. Implementation of the Innovation Plan has the potential to generate more than $730 million return on investment over the first three years.
The Health Care Authority, which administers Washington Apple Health (Medicaid) and Public Employee Benefits, coordinated the development of the plan in close collaboration with the Department of Social and Health Services, the Department of Health and the Governor’s Office, as well as many other state agencies. Hundreds of health and health care thought leaders were actively engaged throughout the planning process, including care providers, employers, consumers, health insurance plans, county governments, community-based organizations, Tribal representatives, philanthropic partners, policymakers, and public health jurisdictions.
The effort was funded by a nearly $1 million grant from the federal Center for Medicare and Medicaid Innovation. It positions Washington to successfully apply for anticipated future federal funding opportunities to implement the Innovation Plan.
The State Health Care Innovation Plan is a strategic vision for the state that builds upon innovative efforts already initiated in Washington by private and public organizations. It aims to:
· Link clinical and community factors that support health and prevention of disease.
· Spread effective payment and care delivery models that emphasize quality outcomes as opposed to the volume of care provided.
· Ensure integrated and coordinated care from the perspective of patients and their families.
“We’re changing the way we think about health care,” said Dorothy Teeter, HCA director. “This is a defining moment in Washington’s path toward health transformation, and it positions the state to be first-mover on major changes to the way we pay for and receive care.”
The Innovation Plan calls for further collaboration across health care and human services in communities to work toward healthier people in every corner of the state. The plan’s proposed creation of “accountable communities of health” aims to bring together key community participants to link all factors that affect health—from care provided at a doctor’s office to ensuring people have healthy food and a safe place to live.
“Ensuring individuals and families have well-coordinated, effective health and social services requires all parts of the health system to work together at the community level,” said Washington Secretary of Health John Wiesman. “Education, employment, and many other factors all play a role in individual and community health. This work links the key players, from public health and health care to local government and housing providers, to transform health results across the state.”
The Innovation Plan draws together aspects of medicine that are traditionally separated in silos — such as physical health and behavioral health. Just as the head cannot operate without the body, mental health and substance abuse cannot be successfully treated separate from physical health. Consistent with national numbers, Washington residents with serious mental illness die roughly eight to 25 years earlier than the rest of the population, and most of these premature deaths are caused by preventable illnesses such as heart disease. Research suggests significantly better outcomes for individuals when the two are addressed in a coordinated manner.
Recognizing the importance of breaking down care delivery silos to ensure better care, the Innovation Plan sets a path toward fully integrated physical and behavioral health purchasing. This facet of the Innovation Plan aligns with Governor Inslee’s vision of a phased approach to reach full financial and clinical delivery system integration for physical and behavioral health.
“Building on legislation passed in 2013, the Innovation Plan will focus on core performance and outcome measures, such as improved health and fewer hospitalizations,” said Jane Beyer, assistant secretary for the DSHS Behavioral Health and Service Integration Administration. “All parts of our health care system will be held accountable for improving the health of Washingtonians.”
Washington’s Innovation Plan is a living document, intended to be adjusted and informed through ongoing work. While the plan outlines specific aims and strategies, the methods to achieve them are ready to be more fully developed through continued input of the state’s public and private thought leaders.