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

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

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 • Community Responses (Not in specific Order) • Conditions create a healthy community: • Jobs • Education / schools • Drug / alcohol prevention • Health problems in community: • Alcohol and drug addiction • Obesity • Tobacco use • 3 things to improve community health: • Later in day doctor appointments • More doctors • More health education services • National / State Studies: • Higher death rates related to: • Heart disease • Slightly higher rates of: • Smoking • Heavy drinking - female • Higher percentage of reporting of depression/anxiety and high blood pressure (CP CCO Medicaid data)

20. Poor Or Fair Health

22. Poor Physical Health Days

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

24. Poor Mental Health Days

25. Low Birthweight

26. Leading Cause of Death - Rate Per 100,000 (5 year average) 2007 – 2011 Cause Columbia County Oregon 175.0 163.1 Heart Disease Stroke 40 47.9 Unintentional Injuries 41.9 49.2 15.2 16.2 Suicide

27. Health Behaviors

28. Adult Smoking

29. Tobacco Use Smokeless (By Males)

30. Excessive Drinking

31. Binge Drinking

32. Heavy Drinking

33. DUI Rates Per 100,000

34. Percent Motor Vehicle Fatalities Involving Alcohol

35. Death Rate from Alcohol-Induced Diseases per 100,000

36. Percent of Youth Who Had Drank Alcohol Past 30 Days (11th Grade)

37. Percent of Youth Who Binge Drink in the Past 30 Days (11th Grade)

38. Percent of Youth Who Drove When Drinking Alcohol (11th Grade)

39. Death Rate from Drug-Induced Causes per 100,000

40. Percent Who Used Illicit Drug(s) Other Than Marijuana in Past 30 Days

41. Percent of Youth Who Used Marijuana In Past 30 Days (11th Grade)

42. Death Rate from Suicide per 100,000

43. Percent of Youth Who Attempted Suicide in the Past Year (11th Grade)

44. Percent of Youth Who Had Depressive Episode in the Past Year (11th Grade)

45. Obesity and Access to Recreation

46. Obesity

47. Physical Inactivity

48. Access To Recreational Facilities

49. Limited Access To Healthy Foods

50. Fast Food Restaurants