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Washington State Rethinking Care Project July 22, 2008. 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.
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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
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
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
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 definition http://www.medicalhome.org/ 4Download/ keymessages2007.pdf
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
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
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)
MULTIPLE STRATEGIES toBuild 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
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
