Columbia Pacific Coordinated Care Organization (CCO) – Data Summary Reedsport

1. Columbia Pacific Coordinated Care Organization (CCO) – Data SummaryReedsport

3. Changes in Oregon Health Plan Federal Accountable Act Coordinated Care Organizations Healthcare Coordination & Integration Dual Eligibility Metrics / Performance Measures Community Advisory Councils Global Budgets For All Primary Care Health Homes

4. Oregon Integrated & Coordinated Health Care Delivery System

5. OHP Client Oral Health Physical Health Mental Health Addictions TX • Assessment • Diagnosis • Treatment Plan (EBP) • Pre-set rate per service • Monitor / Update • Assessment • Diagnosis • Treatment Plan (EBP) • Pre-set rate per service • Monitor / Update • Assessment • Diagnosis • Treatment Plan (EBP) • Pre-set rate per service • Monitor / Update • Assessment • Diagnosis • Treatment Plan (EBP) • Pre-set rate per service • Monitor / Update

6. Coordinated Care Organizations Primary Care Health Homes – Center of patients’ coordinated care. Includes a team that works on keeping patients at their healthiest. • Local Control (different CCO models) • Coordination – Integrate Physical health, mental health, dental health– single point of accountability • Metrics / Performance Measures – Operate under contracted performance standards with clinical, financial and operational metrics • Global Budget And Shared Saving – More flexibility to manage dollars Community Advisory Council – Each CCO convenes a CAC to ensure that the health care needs of consumers are being addressed

7. CCO created a culture which allowed providers to bring these local activities into the next generation of integration Why This Why Now?

8. Better Health Care System Better Health Outcomes Cost Savings

9. Improve Health System, Improve Health Outcomes, Lower Costs At High Risk - Chronic Disease Chronic Disease All OHP Clients Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management – Reduce likelihood become chronic Coordinated case management – Reduce high end costs

10. At High Risk - Chronic Disease Chronic Disease All OHP Clients Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management – reduce likelihood become chronic Coordinated case management – Reduce high end costs

11. At High Risk - Chronic Disease Chronic Disease All OHP Clients Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management – reduce likelihood become chronic Coordinated case management – Reduce high end costs

12. At High Risk - Chronic Disease Chronic Disease All OHP Clients Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management – reduce likelihood become chronic Coordinated case management – Reduce high end costs REALLY? Savings = reinvestment into system – incentive, etc.

13. Cost Impact Sample – Using Diabetes for A Single Oregon County: Number of Persons: 9,300 Number of Deaths: 531 Costs: $42.6M If you can prevent 4.67% of people from getting Diabetes: If you can prevent 20% of people from getting Diabetes: 437 Number Prevented: 1,860 32 121 Lives Saved: Financial Cost Savings: $2 M $8.52 M

14. Cost Impact Sample – Using Diabetes for Douglas County: The risk of Type 2 Diabetes can be reduced by 50-70% by control of obesity And by 30-50% by increasing physical activity $8.52 Million Question: What is the likelihood of preventing 5%, 10%, 20% of population from getting Diabetes? If you can prevent 4.67% of people from getting Diabetes: If you can prevent 20% of people from getting Diabetes: Number Prevented: 437 1,860 Lives Saved: 32 121 Financial Cost Savings: $2 M $8.52 M

15. Personal impact cannot be quantified • Can apply model to other chronic diseases – Each has risk factors which increase the likelihood of illness: • Heart Disease and Stroke Prevention: • No tobacco • Physically active • Healthy weight • Healthy food choices • Preventing / controlling high blood pressure • 12 – 13 point reduction in average systolic blood pressure over 4 years reduces heart disease risk by 21%, stroke risk by 37% • Cancer Prevention: • No tobacco • Limiting alcohol • Limited exposure to ultraviolet rays • Diet rich in fruits and vegetables • Maintaining a health weight • Being physically active • Seeking regular medical care

16. PCP Addictions Mental Health Oral Health

17. Health Integration System Family Behavioral Health Mental Health Spiritual Community Patients Providers Dental Health Peers Physical Health Neighborhood Health

18. 15 CCO management areas Community Advisory Councils – Ensure health care needs of consumers are being met. Community / consumer focus within CCO’s work to accomplish vision – Improve Health Care System, Improve Health Outcomes, Lower Costs Current Goal – Identify 3 priority areas to improve health then identify strategies to reach that goal

19. Summary of Findings • National / State Studies: • Higher death rates related to: • Cancer • Heart disease • Stroke • Chronic Lower Respiratory Disease • Diabetes • Suicide • Alcohol-Induced Deaths • Higher Rates of Inadequate Prenatal Care • Higher percentage of reporting of depression/anxiety and high blood pressure (CP CCO Medicaid data) • Community Responses: • Conditions create a healthy community: • Jobs • Education / Schools • Environment • Health problems in community: • Alcohol / drug addiction • Not enough doctors • Obesity • Diabetes • Cancer • High Blood Pressure • 3 things to improve community health: • More doctors • Doctor appointments after five o’clock • Expand OHP

20. Chronic Condition Diagnoses – Medicaid-eligible Population (CPCCO Service Area

21. Leading Cause Of Death….

32. In Douglas County, this includes the following: • 4,553 individuals with 7,632 conditions • 60% (2,760) with one condition – either a physical or mental illness • 39.4% (1,793) with more than one condition • Of those with more than one condition, 16.5% (751 of the total 4,553) had both a physical and mental health condition

33. Health Behaviors

34. Adult Smoking

35. Adult Obesity

36. Inadequate Prenatal Care Rate (2007-2011 Avg. Rate : 1,000 Births)

37. Low Birthweight Rate (2007-2011 Avg. Rate : 1,000 Births)

38. A Look At Who We Are…

39. Reedsport

40. Percent White / Caucasian

41. Percent Hispanic (all races)

42. Under Age 18

43. Percent Male

47. Community SurveyN = 131

48. In the past year, have you or anyone living in your home used health services at any of the following locations? Please select all that apply:

49. 2. What conditions exist now in your community to help create or foster good health? Please select all that apply:

50. 3. What do you think are the three (3) most important ways to create a healthier community? Please select only 3