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Initiative 1: transformation through ACHs and IHCPs

Initiative 1 is about improving the Apple Health (Medicaid) health care delivery system in Washington State. Within this initiative, Accountable Communities of Health (ACHs) and Indian health care providers (IHCPs) are working to improve the health of the people in their communities and regions. They earn incentive payments for implementing projects that change how people access and receive health care and social supports.

What are ACHs working on?

  • Helping more people get access to care by:
    • Addressing regional needs (e.g., building a workforce that includes more primary care providers or nurses in a region or community).
    • Offering infrastructure and alternative technologies, such as telehealth and health information technology, so patients and providers can meet virtually and share health-related information.
    • Helping communities respond to emergencies by distributing masks and funding food banks during the COVID-19 pandemic.
    • Focusing on health equity and helping marginalized groups. 
  • Changing the health care system to one that:
    • Supports providers as they transition to value-based payment, rather than getting paid based on volume of services provided.
    • Coordinates care, so a patient’s health care providers have the same information and are working together.
    • Transitions to whole-person care, where a person can access care for their mind and body.  This includes access to health care, social services, substance use disorder (SUD) treatment, and other supports in one system through a network of providers. (This is also called integrated care.)

Learn what IHCPs are working on.

How are incentive payments earned?

ACHs and IHCPs receive incentives for their work through the Delivery System Reform Incentive Payment (DSRIP) program.

  • ACHs earn incentives by demonstrating milestone achievement through:
    • Progress reporting.
    • Pay-for-performance, which is tied to specific outcome and quality metrics.
  • IHCPs earn incentives based on milestone achievement and progress reporting.

More information

  • Read the Project Toolkit to learn what ACHs are required to do for their projects and how incentives are earned.
  • See the quarterly incentive reports for more information on incentives that have been earned to date.
  • Visit each ACH’s page to view their project and implementation plans, semi-annual reports, and quality improvement strategies.
  • View the DSRIP Measurement Guide to learn how ACHs and IHCPs are accountable and how their projects are measured. Visit the MTP metrics page to view the DSRIP Measurement Guide by chapter, measurement updates, guidance documents, and more.