Community-Based Care Coordination (Pathways Community HUB)
The Pathways Community HUB model uses a comprehensive risk identification and reduction mechanism in combination with a centralized infrastructure to coordinate care across a network of agencies serving at-risk clients. This allows communities to use resources more efficiently and effectively to address risk and improve health outcomes. The Pathways Community HUB does not replace, but rather supplements and supports, existing case managers, nurses, social workers, community health workers, care coordinators, etc. partnering with multi-sector community stakeholders.
At the foundation of the model the primary components of the Pathways Community HUB are:
1. Core Pathways: measurement tools to define the problem to be addressed (health or social issue), the desired measureable outcome, and the key intervention steps to achieve the outcome.
2. Community HUB: a regional point of registry and outcome tracking that networks together health care providers, social service agencies, and health care payers that implement these Pathways.
3. Pathway Payments: care coordination payments based on outcomes instead of activities.
At the foundation of the model the primary components of the Pathways Community HUB are:
1. Core Pathways: measurement tools to define the problem to be addressed (health or social issue), the desired measureable outcome, and the key intervention steps to achieve the outcome.
2. Community HUB: a regional point of registry and outcome tracking that networks together health care providers, social service agencies, and health care payers that implement these Pathways.
3. Pathway Payments: care coordination payments based on outcomes instead of activities.
Workgroup Resources
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12-11-2019 HUB Advisory Board Meeting

draft-hub_advisory_board_agenda_12_11_2019.pdf | |
File Size: | 149 kb |
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uwcophp_final_presentation_community_development_ahp_and_cis_december_2019.pdf | |
File Size: | 1328 kb |
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cc-ahp_pw_hub_september_2019_monthly_deliverable_report.pdf | |
File Size: | 1667 kb |
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November 2019 HUB Advisory Board Online Updates

11.01.19_pathways_hub_report_final.pdf | |
File Size: | 813 kb |
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cc-ahp_pw_hub_september_2019_monthly_deliverable_report.pdf | |
File Size: | 1667 kb |
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draft_september_2019_hub_advisory_board__meeting_minutes.pdf | |
File Size: | 160 kb |
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09-11-2019 HUB Advisory Board Meeting

hub_advisory_board_agenda_09_11_2019.pdf | |
File Size: | 142 kb |
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08_14_2019_hub_advisory_board_meeting_minutes.pdf | |
File Size: | 182 kb |
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ahp-hub_july_2019_monthly_deliverable_report.pdf | |
File Size: | 535 kb |
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ahp_hub_ab_cc_definition_08-14-2019.pdf | |
File Size: | 67 kb |
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08-14-2019 HUB Advisory Board Meeting

hub_advisory_board_agenda_08_14_2019.pdf | |
File Size: | 142 kb |
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07_10_2019_hub_advisory_board_meeting_minutes_.pdf | |
File Size: | 184 kb |
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hub_project_workgroup_monthly_update_june_2019.pdf | |
File Size: | 365 kb |
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07-10-2019 HUB Advisory Board Meeting

07_10_2019_hub_advisory_board_meeting_minutes_.pdf | |
File Size: | 184 kb |
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cc-ahp_hub_presentation-07-10-2019.pdf | |
File Size: | 1205 kb |
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05_08_2019_may_hub_advisory_board_meeting_minutes_klm.pdf | |
File Size: | 162 kb |
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july_10_hub_advisory_board_meeting_agenda.pdf | |
File Size: | 151 kb |
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05-08-2019 HUB Advisory Board Meeting

may_2019_hub_advisory_board_agenda.pdf | |
File Size: | 149 kb |
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04_10_2019_april_hub_advisory_board_meeting_minutes.pdf | |
File Size: | 173 kb |
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april_2019_pathways_hub_advisory_board_data__1_.pdf | |
File Size: | 245 kb |
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04-10-2019 HUB Advisory Board Meeting

04_10_2019_april_hub_advisory_board_agenda.pdf | |
File Size: | 156 kb |
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03_13_2019_hub_advisory_board_meeting_minutes.pdf | |
File Size: | 202 kb |
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april_2019_pathways_hub_advisory_board_data.pdf | |
File Size: | 237 kb |
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chelan-douglas_county_resources_from_ccs_04-03-2019.pdf | |
File Size: | 248 kb |
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grant_county_resources_from_ccs_04-03-2019.pdf | |
File Size: | 230 kb |
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okanogan_county_resources_from_ccs_04-03-2019.pdf | |
File Size: | 178 kb |
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03-13-2019 HUB Advisory Board Meeting

hub_advisory_board_agenda_2019.3.13__1_.pdf | |
File Size: | 194 kb |
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february_2019_hub_advisory_board_meeting_notes.pdf | |
File Size: | 160 kb |
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march_2019_pathways_hub_advisory_board_data.pdf | |
File Size: | 163 kb |
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rolling_pathways_risk_scorecard-march_2019.pdf | |
File Size: | 61 kb |
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social_service_pathway-detail.pdf | |
File Size: | 64 kb |
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medical_referral_pathway_detail-oct_2018-feb_2019.pdf | |
File Size: | 63 kb |
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education_pathway_detail-oct_2018-feb_2019.pdf | |
File Size: | 61 kb |
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top_5_pathways_initiated.pdf | |
File Size: | 162 kb |
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hub_zone_map.pdf | |
File Size: | 143 kb |
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ahp_hub_zones.pdf | |
File Size: | 132 kb |
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client_letters_-_final_2_28_19.pdf | |
File Size: | 138 kb |
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brochure_v5_all_03-2019.pdf | |
File Size: | 127 kb |
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02-13-2019 HUB Advisory Board Meeting

february_2019_hub_advisory_board_meeting_agenda.pdf | |
File Size: | 152 kb |
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due_diligence_p_p_draft.pdf | |
File Size: | 130 kb |
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advisory_board_meeting_summary_february_2019_final.pdf | |
File Size: | 336 kb |
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january_2019_hub_advisory_board_meeting_notes.pdf | |
File Size: | 191 kb |
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01-09-2019 HUB Advisory Board Meeting

january_hub_advisory_board_meeting_agenda_final_draft.pdf | |
File Size: | 511 kb |
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ahp-hub_process_improvements_01-2019.pdf | |
File Size: | 424 kb |
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advisory_board_meeting_summary_january_2019_final.pdf | |
File Size: | 565 kb |
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rolling_social_service_scorecard-q4_2018.pdf | |
File Size: | 415 kb |
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rolling_pathways_risk_scorecard-ytd_2018.pdf | |
File Size: | 529 kb |
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rolling_med_ref_scorecard_ytd-2018.pdf | |
File Size: | 403 kb |
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hub_contact_list.pdf | |
File Size: | 254 kb |
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12-17-2018 HUB Advisory Board Meeting

hub_advisory_board_meeting_agenda_12-17-2018.pdf | |
File Size: | 449 kb |
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advisory_board_meeting_summary_12-17-2018.pdf | |
File Size: | 477 kb |
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ahp-ph-pdsa-01__quality_improvement-improving_contact_with_referred_clients_km_12-17-2018.pdf | |
File Size: | 491 kb |
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08-09-18 HUB Advisory Board Meeting

hub_advisory_board_meeting_agenda_08-09-2018.pdf | |
File Size: | 450 kb |
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hub_advisory_board_minutes_8-9-18.pdf | |
File Size: | 684 kb |
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07.12.18 HUB Advisory Board Meeting
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06.28.18 HUB Advisory Board Meeting
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06.28.18 HUB Advisory Board Meeting Materials | |
File Size: | 904 kb |
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06.27.18 Workgroup Meeting
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06.27.18 HUB Workgroup Meeting Materials | |
File Size: | 1092 kb |
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05.23.18 Workgroup Meeting
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05.23.18 HUB Workgroup Meting Materials | |
File Size: | 765 kb |
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04.25.18 Workgroup Meeting
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03.28.18 Workgroup Meeting
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03.28.18 HUB Workgroup Meeting Materials | |
File Size: | 1122 kb |
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02.23.18 Workgroup Meeting
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