Build the Local Infrastructure for Accountable Medicaid and Population Health
Counties are positioned to organize the local systems that shape Medicaid outcomes: managed care, public health, behavioral health, safety-net care, human services, hospitals, community organizations, housing, and social services.
EHP helps counties align those systems around defined populations, shared outcomes, value-based care, usable data, and accountable implementation.
Download the County Medicaid & Accountable Health Transformation Brief
See the complete 8-part model, detailed partner roles, implementation considerations, and four practical ways a county can start.
Have an Immediate County Transformation Need?
Schedule a 20-minute conversation with EHP.
The County Opportunity
Countywide accountable transformation organizes the partners, information, financing, and delivery capabilities that influence outcomes for a defined population. It creates a common way to align county departments, managed care plans, providers, hospitals, behavioral health, public health, community organizations, housing, social services, and community voices around shared results.
Build, strengthen, or adapt the local model
EHP can build an accountable transformation model from the ground up, strengthen an existing county collaborative or delivery-system initiative, or adapt proven accountable-community, whole-person care, regional Medicaid, and ACO-like structures to local priorities, authority, partners, data, and financing.
The EHP Accountable Transformation Model
One countywide transformation approach connects eight building blocks. The executive brief explains how each component functions, how roles are divided across the ecosystem, and how the pieces work together in practice.
Population + Outcomes
Accountable Partners
Governance
Data + Information
Financing + Accountability
Local Capability
Implementation
Measure Value + Scale
Download the brief for the complete 8-part model and implementation detail.
When Counties Bring EHP In
These are the kinds of operational and performance conditions that typically create urgency for county health and human-services leaders.
NEW MEDICAID OR WAIVER REQUIREMENTS
New care models, local implementation responsibilities, provider deadlines, or accountability expectations require coordinated execution.
NEW FUNDING OR PROGRAM LAUNCH
Transformation, behavioral health, rural health, workforce, equity, or provider-capacity funding needs a scalable deployment strategy.
PERFORMANCE BELOW TARGET
Quality, access, utilization, equity, experience, or population-health results are below objectives or improving inconsistently.
PROVIDER + CBO READINESS GAPS
Providers or community organizations need support with contracting, program requirements, workflows, reporting, care management, or participation.
VALUE-BASED CARE, DATA, OR CROSS-SYSTEM ALIGNMENT PRESSURE
New expectations for population health, total cost, incentives, risk readiness, data sharing, referrals, or cross-system accountability require stronger local infrastructure.
Start With the County's Most Immediate Priority
A focused starting point can build toward countywide transformation
EHP can begin with a readiness assessment, stakeholder initiative, data challenge, provider/community-partner need, or priority population and build toward the broader accountable transformation model. The executive brief details four practical starting approaches.
Why the Model Matters
Counties increasingly sit at the intersection of Medicaid, public health, behavioral health, safety-net care, social services, housing, and community infrastructure. Accountable transformation gives those partners a shared way to define populations and outcomes, organize responsibilities, use data, align financing, build local capability, and measure value.
EHP brings the stakeholder, data, value-based care, provider transformation, technical assistance, and implementation capabilities needed to turn that countywide structure into operating practice.
Experience Across the Accountable Health Ecosystem
EHP's work spans county public agencies, managed care, public health, safety-net providers, community organizations, data infrastructure, and value-based care.
LOS ANGELES PRACTICE TRANSFORMATION NETWORK | ACCOUNTABLE PROVIDER TRANSFORMATION
L.A. Care Health Plan, an independent local public agency serving Los Angeles County, engaged EHP as lead practice transformation coaching firm for 23 FQHCs and 800+ providers. EHP built value-based care readiness across empanelment, risk stratification, team-based care, population management, utilization, data/QI, access, and care coordination. Twenty-one of 23 health centers completed all phases; clinical quality improved 5%-33%; all adopted risk stratification and empanelment; and the initiative reported more than $160 million in savings.
LOS ANGELES MATERNAL MENTAL HEALTH ALLIANCE | COUNTY DEMONSTRATION TO STATEWIDE SCALE
The California Health Care Foundation funded this Los Angeles County demonstration of a University of Washington Collaborative Care model for perinatal mental health. EHP co-developed and implemented the model across 16+ community health center sites through recruitment, workflow redesign, care-team roles, training, coaching, data/QI, and a regional learning collaborative. The foundation has approved another five years for statewide expansion.
IMPERIAL COUNTY | CROSS-SECTOR ACCOUNTABLE COMMUNITY + DATA INFRASTRUCTURE
EHP convened public health, more than a dozen rural clinics, two medical centers, a regional FQHC, housing, schools, employers, and advocacy organizations around an evidence-based pediatric asthma model. EHP also built the data-capacity and data-sharing strategy, common measures, data-capture approach, and an offline tablet solution for community health workers.
LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES | PUBLIC DELIVERY-SYSTEM CAPABILITY
Most recently, Health Net funded EHP support to LA DHS through its provider quality-improvement program. EHP delivered intensive training and follow-up on clinical leadership, standing orders, standard work, huddles, central network data dissemination and action, and depression screening/follow-up workflows.
LOS ANGELES COUNTY | MEDICAID DELIVERY + VALUE-BASED CARE REFORM
Since 2021, EHP has helped Los Angeles County health centers implement California's statewide Medicaid delivery and payment reform. Through the Community Clinic Association of Los Angeles County, EHP has led readiness assessments, cross-sector workgroups, direct coaching, and implementation support on contracting, care management, workflows, metrics, operations, and sustainability. Direct coaching cohorts have supported 20 FQHCs.
STATEWIDE MEDICAID TECHNICAL ASSISTANCE | COMMUNITY-PARTNER CAPABILITY AT SCALE
As a selected vendor in California's statewide, publicly funded Medicaid technical-assistance marketplace, EHP has completed 50+ customized engagements spanning readiness, workflows, policies, data/documentation, billing/compliance, referrals, workforce training, care management, implementation planning, and financial sustainability.
The executive brief connects these experiences directly to the eight components of the Accountable Transformation Model.
Data Transformation + Value-Based Care Are Built Into the Model
Accountable transformation depends on usable information, aligned economics, and the local operating capability to act on both. EHP brings these capabilities together within the county model.
DATA TRANSFORMATION | SHARED INFORMATION FOR ACCOUNTABILITY
EHP brings 20+ years of health information technology experience across EHR optimization, interoperability, health information exchange, population-health platforms, structured clinical data, quality reporting, analytics, referral data, and cross-system integration. Across nearly a decade of HCCN work, EHP supported 27-47 community health centers at a time with EHR/registry optimization, data integration, analytics, interoperability, and care-gap reporting. EHP helped establish the Inland Empire and Central Oregon health information exchanges from the ground up, including governance, operating models, data-sharing requirements, business/sustainability planning, and implementation. EHP also supported San Joaquin County HIE implementation and evaluated linkage of community-service referral and health information for 2-1-1 San Diego.
VALUE-BASED CARE | CONNECT PAYMENT TO OPERATIONS
EHP helps organizations translate value-based contracts into operating priorities and sustainable delivery models. Work spans quality incentives, shared savings, total cost of care, downside-risk readiness, PMPM/PUPM arrangements, utilization and specialty spend, care management, staffing/caseload economics, billing, and performance improvement. In Michigan Community Health Network's High Impact Performance Program, EHP aligned seven directly coached FQHCs within a 33-health-center network to multiple Medicaid value-based agreements. Comparable measures improved 4.6%-17.9%, averaging about 11%; by December 2024 coached health centers were outperforming non-coached centers on five of six active measures. Meridian quality bonus payments increased 30% from 2022 to 2023 despite a 6% membership decline.
How These Capabilities Support Accountable Transformation
Data + financing + transformation
Data identifies populations, reveals gaps, supports care coordination, and creates a common performance view. Value-based financing aligns incentives with those outcomes. Provider and community transformation turns information and incentives into reliable workflows, care models, and measurable results.
Go Deeper: Download the Executive Brief
The brief provides the complete 8-part Accountable Transformation Model, detailed roles across the countywide ecosystem, implementation considerations, the full business-trigger diagnostic, and four practical ways a county can begin.
Download the County Medicaid & Accountable Health Transformation Brief
See the complete 8-part model, detailed partner roles, implementation considerations, and four practical ways a county can start.
Have an Immediate County Transformation Need?
Schedule a 20-minute conversation with EHP.