The Times - Serving Waitsburg, Dayton and the Touchet Valley

DAYTON—The state Health Care Authority is providing Columbia County Health System with an initial award in the amount of $150,000 to help focus on the elements needed to achieve accreditation in Patient Centered Medical Home care, said CEO Shane McGuire in an interview last Thursday.

“We’re getting quite a large sum of money that can actually influence change,” said McGuire. “The good news here is that we generally funded these efforts out of our operations budget, and figured out the reimbursement part as we went.”

“We’ve been trying to do Patient Centered Medical Home for over three years now. It will be nice to have some support to offset associated costs for patient care,” he said.

McGuire noted the fact that University of Washington neighwborhood clinics are Patient Centered Medical Home clinics and he wants CCHS clinics to be held to the same high standard.

McGuire said the Patient Centered Medical Home care is team-based care for behavioral health, primary care and chronic care and includes the patient as an active partner in a whole-person care environment.

“It is about where you go to receive care. It is about collaboration amongst caregivers and it’s about chronic disease management,” McGuire said. “These folks are concerned with the Medicaid population, so the goal is to reduce those costs per beneficiary.”

One way to cut costs is by coordinating care.

He said this award, and possible future awards, could expand Medicare care coordination to include Medicaid, so the Medicaid population receives the same level of care as Medicare patients do.

McGuire said coordination of care also prevents costly duplication of services.

“Why perform another chest x-ray, if the patient had one the day before; or labs, if the patient had them the day before?” he said. “Even if you need a specialist you come to us because we’re going to coordinate that care.”

“It’s about efficiencies,” he said.

Patient Centered Medical Home is also about chronic care management for people with medical issues such as diabetes, and Chronic Obstructive Lung Disease. He said it is about transitional care management, as well.

“If you’ve been discharged from a hospital somewhere, we’re going to call you within 24 hours and schedule a visit with your primary care provider to see if we can start addressing how you ended up in the hospital, and how you can stay out,” he said.

This award can help with substance abuse screening and medication-assisted treatments, as well as getting health workers integrated into the community and providing care in the home.

McGuire said he is currently working with a Practice Transformation Navigator, the Sheriff’s Department and Blue Mountain Counseling to see whether some of the award can be used to help opioid addicted prisoners receive counseling and medication while they are incarcerated, followed by treatment upon release.

McGuire said the initial award will help with upfront costs associated with IT infrastructure, recruiting, and subsidizing the cost of hiring a care coordinator, along with getting a team of consultants on board to help with technical application challenges.

CCHS could receive additional merit-based awards, on a quarterly basis, if certain measurements and objectives are met, he said.

There are nine Accountable Communities of Health in Washington State with boundaries aligning with the state’s Medicaid regional services.

The goal is to improve health at the local level because working with community-based cross-sector coalitions is an effective and efficient way to transform the health system in the state.

The Southeastern Washington Rural Health Network, comprising Columbia, Asotin and Garfield counties, is administered by Martha Lanman, the director for Columbia County Public Health, and she is on the board of the Greater Columbia Accountable Communities of Health (GCACH).

The state Health Care Authority, working with the Department of Social and Health Services and the Department of Health provides support to the GCACH, using money from the state Innovation Model grant issued by the federal Centers for Medicare and Medicaid.

The Health Care Authority establishes the grant criteria, evaluates applications and makes awards.

McGuire said $1.2 billion was made available to the GCACH by the Centers for Medicare and Medicaid, to be disbursed in 2019 for innovation or demonstration projects like Patient Centered Medical Home care.