System Transformation

We develop and implement practical strategies for whole-person health system redesign.

We have years of experience leading system transformation.

With years of experience leading health system initiatives that align policy, payment, and clinical practice transformation, we are a dependable partner in guiding organizational change. We adapt to the needs of each project and integrate seamlessly into practice improvement efforts.

Waterwheel Health Consulting uses evidence-based methods for change management, practice facilitation, and quality improvement, offering effective support that fits your context.

We work closely with capacity builders and care providers to design and implement strategies for integrated, person-centered health services.

We work with our partners to:

Develop strategies for aligning practice, payment, and policy change
Lead program implementation
Facilitate learning communities
Provide practice coaching to organizational leaders and care teams
Offer technical assistance to care providers and capacity builders

We offer a reliable and thoughtful approach to system transformation.

Our goal is to maintain easy partnerships and produce excellent results. You can count on us to be a flexible, dependable, and proactive contributor to the success of your project.

Collaborator Experiences

“This is the best experience I’ve ever had (in 32 years of practice!) with a contract project director. Ariel has somehow managed to deeply understand the issues that relate to our work, the heart and importance of this effort, and to keep a highly complicated project moving forward.”

— Janice Garceau, Director of Deschutes County Health Services

“I have counted on Ariel to manage the project from conceptualization to implementation, addressing both the broad vision and the minute details. I really enjoy collaborating with her on this project – I can step back from having to lead, knowing our work is in good hands.”

— Cherryl Ramirez, Executive Director of the Association of Oregon Community Mental Health Programs

“Nothing ever exists entirely alone; everything is in relation to everything else.”

— Gautama Buddha

Read about how we’ve supported organizations with System Transformation.

Projects

Person-Centered Intake in Oregon Community Behavioral Health

The process for getting people started in community behavioral health services has many rules and requirements. This innovation pilot generated significant momentum for changing the state administrative rules to create a more flexible, person-centered approach to intake in community behavioral health settings.

Health-Related Social Needs Practice Facilitation

The Learning Health System program, led by the Center for Accelerating Care Transformation at the Kaiser Permanente Washington Health Research Institute, partnered with care delivery leaders to facilitate the launch of universal social needs screening in two primary care clinics in Olympia and Spokane, Washington.

Primary Care Association Leadership Council

Craig Hostetler is the former director of the Oregon Primary Care Association. When he was called on to help primary care association (PCA) directors from around the country consider redesigning their approach to collaboration, he invited Ariel to help. After years of talking about change, PCA leaders were looking for some help to articulate a clear plan of action and get unstuck. After extensive listening and engagement with key stakeholders, we helped this group of leaders take decisive action.

Population Health Management Implementation Guides

Community health centers, Regional Associations of California, California Primary Care Association, Department of Health Care Services, and Kaiser Permanente are partnering to transform care for Medi-Cal beneficiaries through the Population Health Management Initiative. Ariel served as a partner to the series editor for this set of implementation guides to support health centers on Building the Foundations for population health management, and worked with a multidisciplinary team to produce these guides.

System Transformation Resources

Resources

Designing Person-Centered Screening Systems: Action Plan

The System Design Planning Tool helps you identify and plan next steps for creating organizational systems that support person-centered screening.

Rapid Engagement Executive Summary

This Executive Summary provides an overview of key accomplishments and findings from the Rapid Engagement pilot, a community behavioral health system change initiative facilitated by the Association of Oregon Community Mental Health Programs, in partnership with the Oregon Health Authority.

Removing Barriers to Care: Voices of Lived Experience

This is a summary of recommendations for removing barriers to care in community behavioral health that we created for the Rapid Engagement pilot, based on input from consumers and members of the peer workforce.

Design Principles for Person-Centered Screening

The Collaborative Screening Design Principles are a curated summary of collective wisdom on implementing health screenings in a person-centered style that draw on key insights and ideas from stakeholder input and peer-reviewed literature.

Coming Soon! Communicating about Health Equity with Policymakers in Conservative States

This article summarizes key takeaways from interviews with primary care association and behavioral health state association leaders in five politically conservative states, focused on how they communicate effectively with policymakers to advance health equity. The article is currently under peer review and we look forward to sharing the results in 2025!