Washington Integrated Care Assessment (WA-ICA)

Note: The request to fund the WA-ICA through the Medicaid Transformation Waiver 2.0 was pended by Centers for Medicare and Medicaid Services (CMS). Thus, the funding source that the work group and HCA had anticipated for continued implementation is not available. HCA continues to prioritize clinical integration and will send out information once options for future sustainability can be identified.

About the Washington Integrated Care Assessment (WA-ICA)

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

To address these issues and support assessment coordination, HCA, ACHs, and MCOs formed the Integration Assessment Work Group, and identified WA-ICA.

The WA-ICA is a continuum-based integration assessment tool meant to:

• Develop an improvement roadmap for clinical practices to advance integration and whole-person care.
• Reduce provider administrative burden by minimizing duplicative assessments.
• Understand the level of and progress towards clinical integration within primary care and behavioral health outpatient practices.
• Improve patient outcomes.
• Publish practice-level data to support quality improvement efforts.

Primary care and behavioral health companion tools

The WA-ICA includes two companion tools tailored to primary care and behavioral health 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.

Visit the corresponding pages to view support and materials on how to use each specific tool:

• Behavioral health WA-ICA page
• Primary care WA-ICA page

Implementation

Beginning in mid-2022, primary care and behavioral health practices that participated in Apple Health had the opportunity to complete the assessment. HCA continues to encourage practices to complete WA-ICA to advance and determine levels of integration.

Frequently asked questions (FAQ)

Who are the partner ACHs and MCOs?

ACHs include:

• Better Health Together
• Choice
• Elevate Health
• Greater Health Now ACH
• HealthierHere
• North Sound ACH
• Olympic Community of Health
• SWACH
• Thriving Together NCW

MCOs include:

• Community Health Plan of Washington
• Coordinated Care of Washington
• Molina Healthcare
• United Healthcare
• Wellpoint Washington (previously Amerigroup)

Who selected the assessment and companion tools?

The Integration Assessment Workgroup, a collaboration of ACHs, MCOs, and HCA, have worked together since July 2020 to identify the WA-ICA and create a standardized assessment and approach to advancing clinical integration.

• View the primary care assessment tool.
• View the behavioral health assessment tool.

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
• Continuum-based Framework for General Health Integration into Behavioral Health

What will happen with the MeHAF or other assessment I was using?

HCA concluded the use of MeHAF and is now encouraging practices to complete WA-ICA for their clinical integration efforts.

Is the WA-ICA a requirement?

Completion of the assessment is voluntary at this time for outpatient primary care and behavioral health practices who provide services to Apple Health enrollees. However, HCA recommends WA-ICA for practices to advance clinical integration. The assessment will assist practices with understanding their level of integration and help identify next steps along the integration continuum.

How long does it take to complete the assessment and how often will I complete it?

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 are encouraged to complete the assessment once per year.

• View the primary care assessment tool.
• View the behavioral health assessment tool.

Who will see the results of my assessment and how will that information be used?

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, challenges, and next steps they can take along the integration continuum. This assessment serves as a quality improvement roadmap.

Can I get help in completing the assessment?

Instructions about how to complete the assessment can be found in the implementation guides. In addition, there is an introductory webinar and tutorial video on how to navigate the domains and subdomains:

• Primary care webinar
• Primary care tutorial
• Behavioral health webinar
• Behavioral health tutorial

What happens after I complete the assessment?

The assessment will allow practices to develop an action plan for advancing clinical integration across one of more of the domains included in the WA-ICA.