Health Share of Oregon The health care you know and trust. APMs for SBHC Michael Anderson-Nathe October 28, 2014.

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Presentation transcript:

Health Share of Oregon The health care you know and trust. APMs for SBHC Michael Anderson-Nathe October 28, 2014

Health Share is: A not-for-profit tax-exempt coordinated care organization Managing Physical, Mental and Dental Health Largest CCO in Oregon Serving 238,000 OHP members --26% of total 65% of OHP members in Tri-County A regional system of care reducing costs and improving outcomes Founded by the health care organizations you know and trust Driven by over 16,000 providers

Oregon Health Authority Health Share Washington County Multnomah County Clackamas County Tuality Health Alliance Providence Health Plan Kaiser Permanente CareOregon Access Dental Kaiser Dental Willamette Dental ODS Dental Managed Dental Capitol Dental CareOregon Family Dental

Physical Health Networks CareOregon Adventist FQHCs Legacy OHSU Kaiser Permanente Providence Providence Medical Group FQHC Tuality OHSU FQHC 67% 10% 16% 7%

Mental Health Networks Clackamas County Community Mental Health Agencies Multnomah County Community Mental Health Agencies Washington County Community Mental Health Agencies 17% 57% 26%

Dental Health Networks Access Dental Gentech and Dental Care Today Clinics Capital Dental Community Dentists/Clinics CareOregon Dental Community Clinics Family Dental Family Dental Clinics Managed Dental Community Dentists/Clinics ODS/Moda Community Dentists/Clinics Permanente Dental Kaiser Dentists/Clinics Willamette Dental Willamette Dentists/Clinics Advantage Dental Community Dentists/Clinics 7% 22% 8% 20% 17% 7% 1% 18%

Financial aspects to consider Our funds can only be used for OHP members Any model will have to work for different payers OHP, private insurance, etc You will have to work with each health plan Possible role for Health Share – help you gain access/convene to our RAEs

Other considerations What data will you track to show your impact? This is the age of accountability so how will you document your efforts? We are interested in integration – how are you connecting to Behavioral and Dental health? What is the connection between SBHC and those providing treatment?

Metrics SBHCs could move Adolescent Well Child check ups ages SBIRT Currently for 18+, but 12+ in 2015 Dental Sealants ages 6-14, new in 2015 Depression screening ages 12+ Physical, Mental and Dental Health Assessments for kids in DHS Custody (dental added in 2015)

Q&A One question I have – is how can Health Share be most useful to you and this process? What should our role be? Convener? Data needs? Access to RAEs?