Transforming community and rural health systems in washington state?s north central region - under the washington community health access to rural transformation (chart) test model, the health care…

Transforming community and rural health systems in washington state?s north central region - under the washington community health access to rural transformation (chart) test model, the health care authority (HCA), as lead organization, will test whether an aligned allpayer capitated alternative payment model (APM) and a community care redesign plan designed by the community will improve access to whole-person care, decrease population health disparities, and reduce costs. If awarded, HCA will test chart in the rural four-county north central region of washington state. HCA?s vision for rural transformation is that by 2028, rural health and hospital systems participating in the washington chart test model will have achieved financial stability and operational efficiency through a realignment of existing resources. This realignment will support outpatient and preventive care, strengthen and increase community partnerships, and ensure delivery of high quality, equitable care that meets the health and social needs of the community. Approximately 120,000 north central residents will be impacted by this model. Despite visionary leadership and a strong history of collaboration, the five participating hospitals (PHS) experience the same issues as other rural communities in washington and nationwide. The combination of volume-based fee-for-service payment structures with regulatory constraints and slim or negative operating margins, hinders north central hospitals? Ability to adopt transformative models of care, apms, workforce innovations, and other community health improvement strategies. HCA, as washington?s medicaid agency, is the largest purchaser, in addition to medicare, in rural communities and is an experienced leader in value-based purchasing. HCA has continually united washington?s major payers and rural hospitals to advance a broad-based, multi-payer, rural transformation plan since 2018. North central participant hospitals share our vision and medicare?s goals for a new system of care in rural communities. The washington chart test model creates a unique opportunity for the centers for medicare & medicaid services and rural health systems to partner with HCA to test and expand upon a new model of care transformation?a model which will serve as a standard for all future rural transformation and sustainability efforts. Under the washington chart test model, HCA will partner with PHS, north central community and tribal leaders, and payers on the chart advisory council to build a community transformation plan (CTP) that meets north central community?s needs. The CTP will feature evidence-informed innovative care delivery models and strategies to improve access to care, quality of care, and health outcomes for all north central residents. The total budget for the washington chart test model is $4,992,810. Cooperative funding will be used to support PH?s care redesign efforts, design the medicaid and aligned-payer APM, and build internal expertise within HCA to support the design and implementation of the washington chart test model.