One of the large projects that the North Sound ACH has responsibility for is the region’s participation in the Medicaid Transformation Project. Understanding the backdrop for the work is critical. The 2019 partnering providers were selected through an application process in summer and fall of 2018. Seventy organizations initiated the application process; 49 partner organizations completed the process to contracting for 2019 activities.
The work of the Medicaid Transformation Project requires that potential partners grasp the relationship between the work of the ACH, Washington’s agreement with the federal government, and work happening across the state with other ACHs.
- We have a link to the HCA Waiver letter received from the Center for Medicare and Medicaid Services (CMS), including the Special Terms and Conditions that Washington must adhere to in order to maintain the waiver: https://bit.ly/2FtJhT0
- “Attachment C” to the Special Terms and Conditions contains the Medicaid Transformation Project Toolkit, which outlines eight potential project areas that an ACH could agree to participate in. Two were required (physical and behavioral health integration and addressing the opioid crisis) and each ACH had to choose a minimum of two of the remaining six. North Sound ACH was the only ACH that chose to move forward in all 8 project areas.
- The Special Terms and Conditions articulated the rules for the contract between the Health Care Authority and Accountable Communities of Health (ACH) across the state. Here is the link for the North Sound ACH Contract: https://bit.ly/2FzdXS4
- The North Sound ACH was required to submit critical documents laying out its approach. Links to those documents are below:
Templates for Agreements between partnering providers and the North Sound ACH:
- Master Services Agreement, agreed to via theClick Agreementin the Financial Executor Portal: https://bit.ly/2srwWX1
- Project-Specific Agreementfor non CCA Partners, addendum to Master Services Agreement: https://bit.ly/2FCWGXU
- Project-Specific Agreementfor CCA Partners, addendum to Master Services Agreement: https://bit.ly/2FqKUkd
- Exhibit A:Template for Scope of Work (For all Partners) https://bit.ly/2FsJAxl
- Exhibit B: Template for MOU for Care Coordination Agencies (CCAs only) https://bit.ly/2FqC6eh
- Exhibit C:Template for Payment Model (CCAs only) https://bit.ly/2SUloHj
Other HCA Resources
- HCA Pay for Performance measures: http://dev.northsoundach.org/wp-content/uploads/2018/10/Toolkit-Metrics-Crosswalk.pdf
- Other resources provided by the Health Care Authority: https://bit.ly/2FcoNd6