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Rural transformation

HCA has been partnering with providers, health plans, CMS, and others to explore a new payment approach to drive delivery system transformation in rural communities. These new models of care will build on and align with existing transformation efforts, including the Healthier Washington Medicaid Transformation and Accountable Communities of Health.

Our goal is to improve the health of rural Washingtonians and preserve access to care in rural areas in a manner that is sustainable and better serves the health needs of local populations.

Why redesign the rural payment system?

The sustainability of rural healthcare delivery depends on fundamental transformation. By redesigning rural health through new health system financing, population health management, addressing the health care workforce, and leveraging health information technology, Washington State will ensure that rural residents achieve greater health and wellbeing and can readily access care when needed.

We are working with stakeholders to develop a payment model that:

  • Provides predictability to payers, providers, and patients
  • Rewards the right care, at the right time, at the right place
  • Better meets the needs of the local community
  • Supports rural providers through health transformation, and advances the work currently enacted through legislation

What are the principles that guide this work?

  • Alternative payment will be tailored to the provider’s capacity to take on risk and will be phased in over time.
  • Participating rural health systems will customize care redesign and transformational approaches within a general framework that meets the needs of their communities.
  • Moving to a value-based model should support – rather than add to – rural providers’ existing transformational efforts.
  • Rural health transformation should contribute to better patient outcomes and better population health.
  • Rural health transformation should preserve access to local health services in rural settings.
  • We must consider the unique circumstances of each rural facility, and ultimately offer a flexible path toward transformation.
  • Acknowledge the up-front costs and investments for implementation of new payment models.
  • Consider the effects of reduced volumes, increased costs, and changes in health care delivery methods when assessing the transition to new payment.
  • Use the best and most current data available to guide our work and decision making.

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