1. The Central Oregon Health Council (COHC), the Coordinated Care Organization (CCO), and our Regional Health Improvement Plan

3. Who We Serve
Impacts of the Affordable Care Act on Health Insurance Coverage in Oregon: County Results/Statewide Update. Oregon Health Authority, February 2015

4. Who We Serve
Impacts of the Affordable Care Act on Health Insurance Coverage in Oregon: County Results/Statewide Update. Oregon Health Authority, February 2015

5. Why Are We Unique in Central Oregon?
Central Oregon wanted a governance structure to provide PacificSource Community Solutions (CCO) with additional community oversight, involvement, and transparency.
Senate Bill 648
Allows us to be the CCO governing entity in Central Oregon
Requires us to submit a Regional Health Assessment and Regional Health Improvement Plan for Central Oregon
Joint Management Agreement (JMA)
Outlines responsibilities, deliverables, funds

6. Central Oregon CCO Overview Community Governance Structure
Central Oregon Health Council
12 members of Board of Directors
Set policy and have decision-making authority for community investments
PacificSource names one Board member with one vote
Hospital system, three Counties, FQHC, multi-speciality clinic, County Mental Health and Substance Use Disorder clinic, DCO, and Independent Practice Association represented. One community representative and one consumer are also members.
Community Advisory Council
Provider Engagement Panel
Pain Standards Task Force
Operations Council
Finance Committee
RHIP work groups

8. JMA Surplus and QIM Funds
Surplus funds under JMA
2% profit cap for the CCO and is used for COHC surplus investments
QIM performance funds
60% goes back into the global budget
40% kept in a community fund that is managed by the CCO and the COHC

9. QIM Fund Investments
Proposals from community partners/stakeholders are submitted to improve on QIM-related needs and initiatives
Over $6M has been approved for QIM-related projects
Notable projects funded via QIM funds:
ED Improvement Coordinator
Mobile dental unit for sealants
JHIE implementation

10. What is a Regional Health Improvement Plan?
The Centers for Disease Control and Prevention (CDC) defines a health improvement plan as “a long-term, systematic effort to address public health problems on the basis of the results of health assessment activities and the health improvement process.”
It defines the vision for the health of the community through a collaborative process and offers strategies to improve the health status of that community.

11. Benefits of a Health Improvement Plan
Improved organizational and community coordination and collaboration
Increased knowledge about health and the interconnectedness of activities
Strengthened partnerships within local health systems
Identified strengths, weaknesses, and gaps to address quality improvement efforts
Measured benchmarks for public health and healthcare practice improvements

13. Regional Health Assessment (RHA) and Regional Health Improvement Plan (RHIP)
RHA to RHIP (8 pillars)
Behavioral Health – Identification & Awareness
Behavioral Health – Substance Use & Chronic Pain
Cardiovascular Disease
Diabetes
Oral Health
Reproductive, Maternal Child Health
Social Determinants of Health – Housing
Social Determinants of Health – Kindergarten Readiness

14. Factors that Affect Health
A person’s health is determined largely by social and economic factors, although prevention and healthcare services contribute substantially to maintaining health. According to the World Health Organization (1948), “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Where we live, go to school, and work affects our overall health, as does the safety and livability of our communities, whether we are economically stable or struggling to get by, and whether we have strong social connections. These factors are called social determinants of health and help explain why certain segments of the population experience better health outcomes than others. They also explain how external factors influence our ability to live healthy. The public health and healthcare systems implement strategies on multiple levels to improve the health of individuals and families, as well as the population at large. The five-tier pyramid, shown below, illustrates how different types of interventions affect health.
The Central Oregon RHIP necessarily incorporates strategies from all levels of the pyramid. Interventions in the top two tiers of the pyramid commonly occur in a healthcare setting. These interventions are essential to protect and improve an individual’s health, but they often have a limited impact on the population’s achievement of optimal health.
Interventions in the middle and at the base of the pyramid are geared toward improving the health of the entire population by focusing on prevention, making health resources readily available, ensuring the healthcare system is equipped to address health needs, and enacting policy that makes healthy choices the default and addressing socioeconomic factors that affect health. These interventions can have the greatest potential to affect health because they influence the entire population, in contrast to focusing on one individual at a time. However, it may take generations to see the effects of interventions designed to change socioeconomic factors.
Source: Thomas R. Frieden, MD, MPH. A Framework for Public Health Action: The Health Impact Pyramid. American Journal of Public Health April; 100(4): Doi: /ALPH PMCID: PMC

15. The Work Begins
Workgroups have formed (March) to ensure the plan remains alive in Central Oregon
Annual work plans have been developed
Health indicators will be tracked through work plans to monitor progress

16. RHIP Resources Overview of RHIR process
Notable RHIR proposals that have been funded:
OSU Cascades Counseling Center
Pfeifer & Associates Housing for Individuals with Substance Use Disorders

17. Questions?