Washington State Advocates Inserting Consumer Voice Into Accountable Communities of Health
(Last year, the Robert Wood Johnson Foundation launched a joint initiative with Community Catalyst called the Value Advocacy Project (VAP). The project is supporting consumer health advocacy organizations in six states in their non-lobbying advocacy efforts to pursue local and state policy and health system changes that increase the value of health care by improving health outcomes and lowering health care costs, especially for populations that have disproportionately poor outcomes. Building on the Center for Consumer Engagement in Health Innovation’s recently released Consumer Policy Platform for Health System Transformation, we will be highlighting our state partners working on issues outlined in the policy platform and encouraging them to share how their work can translate to advocates across the country.)
In Washington state, newly-created Accountable Communities of Health (ACHs) are bringing together stakeholders from across the health care and social service systems (e.g., local governments, public health departments, insurance carriers, housing providers, hospitals, educators, health care providers and consumers) in a collective decision-making process to improve health care and health outcomes. These diverse cross-sectoral partnerships promise to increase collaboration across the health care system, better coordinate care, reduce costs, address social determinants of health (factors such as income, education and housing that are the primary contributors to health disparities within and between regions), and increase equity in health outcomes in nine regions across the state.
The projects are meant to address the unique needs and priorities of the regions from which their members are drawn and thus may differ greatly from one region to another. For example, one ACH has chosen to focus first on youth behavioral health, while another has devoted its initial substantive efforts to care coordination for individuals with multiple chronic conditions. The decisions that ACHs make have the potential to significantly improve health care for low-income people and people of color. Yet despite the fact that reducing health disparities while addressing quality and affordability is part of their mandate, success in these goals is not a given and implementation will require a strong consumer voice.
Too often, decisions by health care institutions are made to maximize efficiency, revenue and profit. That’s why Washington CAN! and Northwest Health Law Advocates (NoHLA) believe the ACHs must include substantial consumer representation, particularly from low-income people, people of color, non-English speakers and older adults, so populations who face the highest barriers to good health and health care will have a voice in the ACH process to ensure their needs and interests are met.
Washington CAN!, NoHLA and our partners will ensure that strong community involvement is a cornerstone of the ACHs, beginning with crafting a best practices report for consumer engagement. An accompanying toolkit will summarize how an ACH can welcome meaningful participation from marginalized communities and make decisions within a racial equity framework.
This work will inform “Principles for Community Participation,” an organizational framework pushing new ACHs to adopt consistent policies and practices. We will increase community engagement with grassroots outreach, technical assistance, such as policy analysis and trainings, and organizing support to low-income consumers and allied organizations. Finally, we will end our work with an evaluative assessment of the ACHs (i.e. a report card). It is our goal that these tools will be useful to advocates in our state and around the nation as models for strong and diverse consumer engagement.
Washington state has been a policy leader and innovator in health care to date, and our state is committed to maintaining that leadership at all levels of the health care system, from state and local government, to insurance carriers and hospitals, to the consumer advocacy groups that have pushed Washington to deliver one of the fullest and most successful state implementations of the Affordable Care Act (ACA) in the country. We know the next steps in health care reform include focusing on improving how care is delivered and how we address social determinants of health. We also know that effective decision makers, strong advocates, and engaged consumers are what make health care advances possible. By elevating a consumer voice in our state’s ACHs, we will strengthen our network of health care activist leaders, improve our health care system and support consumer-driven innovation in this next level of ACA implementation.
Author: Gerald Hankerson, Main Street Alliance Director, Washington CAN!