Washington StateRethinking Care ProjectJuly 22, 2008

2

WHERE WE HAVE BEEN Chronic Care Management

Medicaid only, Fee-for-service SSI adults 60,000 people potentially eligible Highest 20% risk Voluntary enrollment 3 Distinct Approaches tailored to 3

populations

3

WHAT WE WANTED TO ACCOMPLISHChronic Care Management

Improved health literacy and self- management of chronic conditions

Interruption of the spiral of increasing cost and decreasing health status

4

WHERE WE ARE NOW Chronic Care Management

Evaluation Cost analysis, clinical measures and clinical file review

Report to the Legislature Dec 2008 Information will be very preliminary,

especially the cost analysis Will have both qualitative and quantitative

measures

5

EFFORTS TOWARDMedical Home Development

King County Care Partners have built a Medical Home network as part of local care management

Using Washington State definition Accessible and Continuous Coordinated and Comprehensive Client-Centered Compassionate and Culturally Effective

complete WA State Medical Home definitionhttp://www.medicalhome.org/ 4Download/ keymessages2007.pdf

6

Medical Home EffortsWorkgroup

Cross-agency workgroup and steering committee convened in 2007

Goal to expand medical home for aged, blind & disabled adults & children

RFI to providers completed and being analyzed/compiled now

7

MEDICAL HOME EFFORTSCross Agency and National

Commonwealth grant supporting a multi-stakeholder work group to improve medical home (08 - 09)

NASHP and NASMD both sponsoring conferences on medical home

Participate with DOH on collaborative development for 2009

Participate with HCA on reimbursement study

Shaping the Future

Rethinking Care – Opportunity to Integrate Two Approaches

9

CHCS RETHINKING CARETaking it to the Next Level

Build upon current efforts and existing infrastructure

Target 5% of clients driving 50% costs Interventions –

Medical home improvement Care management New focus on mental health & CD services

Utilizing current Workgroups Steering Committee composed of Cross

Administration Directors Use national resources for learning

(Commonwealth, NASHP, CHCS)

10

MULTIPLE STRATEGIES to Build Synergy

Medical Home CCMP ER Grant – Directs $$ to CHC’s Health Navigator Children’s Health Improvement Project May Expand Managed Care for SSI Kids GAU-MH Pilot WMIP

11

RETHINKING CARENext Steps

HRSA EC has endorsed project Will recommend two project sites to

Steering Committee Kick off meeting planned for

September Target 1st project start January 1,

2009

12

Rethinking CareNext Steps

Rethinking Care Steering Committee

Rethinking CareWorkgroup

Medical Home TeamChronic Care

Management Evaluation Workgroup