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What we're working on

In the past, many health care providers completed integration assessments through their Accountable Community of Health (ACH) or a managed care organization (MCO). The purpose of these assessments was to determine levels of integration within a practice and identify where coaching support may be needed. However, without a standard assessment tool, providers may have been completing different assessments for multiple stakeholders and information may have been inconsistent or redundant.

To address these issues and support assessment coordination, the Health Care Authority (HCA), ACHs, and MCOs worked together to identify a standard assessment for clinical integration for the outpatient physical health and behavioral health settings. 

About the Washington Integrated Care Assessment (WA-ICA)

The WA-ICA is meant to:

  • Develop an improvement roadmap for clinical practices to advance integration and whole-person care.
  • Reduce provider administrative burden by minimizing duplication of assessments.
  • Understand the level of and progress toward clinical integration within behavioral health and primary care outpatient practices.
  • Improve patient outcomes.
  • Provide regional and statewide data to support and influence policy and funding decisions.

Primary care and behavioral health companion tools

The WA-ICA includes two companion tools tailored to primary care and behavioral health (mental health and substance use disorder) settings. The tools will help providers track, measure, and advance their clinical integration progress across a set of domains. The domains include:

  • Screening, referral to care, and follow up 
  • Ongoing care management
  • A multi-disciplinary team (including patients) with dedicated time
  • Self-management support adapted to patient
  • Systematic quality improvement
  • Linkages to community and social services

Implementation

Beginning in mid-2022, primary care and behavioral health practices that participate in Apple Health can complete the assessment. Other practices will be phased in over time.

Frequently asked questions (FAQ)

The Integration Assessment Workgroup, a collaboration of ACHs, MCOs, and HCA, have been working together since July 2020 to identify the WA-ICA and create an implementation plan.

The WA-ICA companion tools are based on the assessment tools developed in New York State by Dr. Henry Chung and colleagues. Their work is summarized in these reports: Continuum-based Framework for Behavioral Health Integration into Primary Care and Continuum-based Framework for General Health Integration into Behavioral Health.

Those who complete the WA-ICA will not be required to fill out another integration assessment from ACHs or MCOs. HCA, along with the ACHs and MCOs, are working to include lessons learned from past assessments (i.e., the MeHAF) to ensure the progress made toward integration is accurately portrayed for all partners and providers.

Starting in mid-2022, primary care and behavioral health providers who have experience in completing the MeHAF (or similar integration assessment tools) will begin using the WA-ICA. After that, cohorts of providers will complete the WA-ICA in six-month increments.

The assessment will initially be voluntary but will ultimately be required for outpatient primary care and behavioral health providers who provide services to Apple Health enrollees. The assessment will assist practices with understanding their level of integration and help identify next steps along the integration continuum. Practices will be eligible for coaching support and technical assistance to help them make progress on integration.

We encourage practices to convene a team (with broad representation) to gather multiple perspectives and complete the assessment. It should only take a few hours to complete the assessment. Practices will complete the assessment once per year.

The assessment is meant to be a learning tool. Practices that complete the assessment will be able to see their results immediately—their strengths in integration as well as challenges. Identifiable data about specific providers will be used to provide training and technical assistance to individual practices to advance clinical integration and improve patient outcomes.

De-identified aggregated data will be used to assess provider, regional, and state progress toward clinical integration and to monitor MCO and ACH performance. This data will assist the state to identify statewide improvement strategies and ensure resources are targeted where they are needed most.

Instructions about how to complete the assessment will be available. In addition, practices will be able to attend office hours to ask questions. There will also be limited individual technical assistance available to help with completing the assessment.

The assessment will allow practices to develop an action plan for advancing integration within their practice. Free technical assistance and coaching from a trusted entity will be available to help practices improve.

No. Practices will be notified well in advance before completing the assessment. Practices will learn more about how to complete the assessment through trainings and technical assistance, which includes webinars, office hours, and online tutorials.

HCA is the sponsor, in partnership with Washington’s ACHs and Medicaid MCOs. The goal is to:

  • Define a standardized process and logistics around the assessment to streamline data collection and reduce duplication.
  • Determine how the data and assessment results are used.
  • Recommend a sustainable way for ongoing assessment and continuous quality improvement to occur.

ACHs include Better Health Together, Cascade Pacific Action Alliance, Elevate Health, Greater Columbia ACH, HealthierHere, North Central ACH, North Sound ACH, Olympic Community of Health, and SWACH.

MCOs include Amerigroup, Community Health Plan of Washington, Coordinated Care of Washington, Molina Healthcare, and United Healthcare.