July 6, 2016
Helena, Mont., – Mountain-Pacific Quality Health is one of six organizations chosen to participate in Transforming Complex Care, a multi-site demonstration aimed at refining and spreading effective care models that address the complex medical and social needs of high-need, high-cost patients. This national initiative, made possible with support from the Robert Wood Johnson Foundation and led by the Center for Health Care Strategies (CHCS), will work with six organizations to enhance existing complex care programs within a diverse range of delivery system, payment, and geographic environments.
Health care policymakers, payers, and providers increasingly recognize the need for integrated care models for patients with complex needs, a population that accounts for disproportionate health care costs. These patients frequently have multiple medical, mental health, and substance use treatment needs, and face social and economic challenges that further complicate their health outcomes.
“Mountain Pacific is working closely in several communities around the state. Places like Kalispell, Helena, Billings and Missoula are actively seeking collaborative, community approaches to deploy newly developed teams addressing high needs, high cost patients,” said Lara Shadwick, program director with Mountain-Pacific. “Through efforts made possible by this grant and with funding from CMS, there is more learning and sharing of best practices across the state. Our hope is to develop “ReSource” teams to take care beyond the walls of the clinics and hospitals to wrap both medical and community services around the patients to help them regain their ability to manage their medical care. We are grateful to be working with partners through the Governor’s Council on Healthcare Innovation including, the Montana Department of Health and Human Services and Medicaid, insurance companies, foundations, health systems and providers to look for ways to implement changes beyond the term of this grant,” said Shadwick.
“Health care providers and delivery systems across the country are looking to implement complex care models based on emerging best practices,” said Allison Hamblin, MSPH, vice president of strategic planning at CHCS. “Transforming Complex Care will enable leading health organizations to more effectively address the social determinants of health for high-need, high-cost patients, and will offer lessons for replication that maximize existing community strengths.”
Mountain-Pacific was competitively selected to participate in the initiative, along with five additional sites intentionally drawn from small- to mid-sized cities. Each site will receive funding support and participate in a learning collaborative offering 1:1 and group technical assistance, peer exchange, and tools.
Additional sites are:
- AccessHealth Spartanburg; Spartanburg County, South Carolina
- OneCare Vermont; State of Vermont
- Redwood Community Health Coalition; Northern California
- ThedaCare; Eastern Wisconsin
- VCU Health System; Central Virginia
“Caring for patients with complex needs requires innovative programs that go beyond medical issues to address unmet social needs,” said David Adler, MPA, senior program officer at the Robert Wood Johnson Foundation. “The Transforming Complex Care sites will support a Culture of Health by building the evidence base on improving care for high-need, high-cost patients.”
Over two years, the sites will refine targeted strategies across six key domains for improving complex care, including: (1) care model enhancements; (2) data and analytics; (3) workforce development; (4) financing and accountability; (5) governance and operations; and (6) policy and advocacy. As the program progresses, CHCS will share lessons and tools from the sites’ experiences. Look for more information at www.chcs.org.
About Mountain-Pacific—Mountain-Pacific holds federal and state contracts that allow them to oversee the quality of care for Medicaid and Medicare members. Mountain-Pacific works within its four-state region (Montana, Wyoming, Alaska, Hawaii, and the jurisdictions of Guam, American Samoa and Saipan) to help improve the delivery of health care and the systems that provide it. Mountain-Pacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve.
www.mpqhf.org
About the Center for Health Care Strategies
The Center for Health Care Strategies (CHCS) is a nonprofit policy center dedicated to improving the health of low-income Americans, especially for individuals with complex, high-cost needs. CHCS works with state and federal agencies, health plans, providers, and consumer groups to advance innovative and cost-effective models for organizing, financing, and delivering health care services. For more information, visit www.chcs.org.
About the Robert Wood Johnson Foundation
For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit www.rwjf.org.