Oregon’s creation of Coordinated Care Organizations (CCOs) in 2012 served as a landmark accomplishment in the ongoing effort to better meet the health needs of children and families who qualify for the Oregon Health Plan (Medicaid). By integrating and coordinating health care across multiple areas of a person’s health, CCOs seek to improve patient health while controlling costs.
A greater focus on the connection between early health and school readiness has also been an important part of CCO work. Across the state, CCOs are partnering with educators, social service providers, and other child and school advocates to introduce new ways to meet early health goals. In doing so, they also hope to positively impact academic and lifetime outcomes.
Health and Early Learning Connections
At a recent “Innovation Café” organized by the Oregon Health Authority (OHA), CCOs from across the state gathered to share and discuss efforts they have made to address the health needs of their members.
Café participants highlighted work at multiple levels—from on-the-ground, practical supports for families to provider-focused improvements and systems-level coordination.
HEALTH & EARLY LEARNING INITIATIVES ACROSS THE STATE
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- In Eastern Oregon, a group effort from health, early learning, and school and district staff helped bring oral health services into early grade classrooms. Children now have easier access to dental screenings, fluoride varnish, and sealants to support dental health.
- In the mid-valley, a continuation of work begun by the Oregon Pediatric Improvement Partnership (OPIP) has led to improvements in the referral process thanks to the combined efforts of two pediatric clinics, Willamette ESD, and the Marion and Polk Early Learning Hub.
- A statewide effort to improve care for young children with special health needs aims for a more coordinated approach to care. Public health nurses convene care planning teams that include medicine, education, behavioral health, and other community-based providers.
Rural Health Clinic Opens to Meet Community Demand
As locally-governed organizations, CCOs also have a fundamental responsibility to their communities. When the results of a 2017 Community Health Survey in North Douglas county showed that the most pressing concern of residents was access to health care, Children’s Institute and others worked to bring a new health clinic to the area.
“Families and community members expressed to us that they really wanted a consistent health care provider—someone to build a relationship with,” said Erin Helgren, CI’s Early Works liaison in Yoncalla.
The Umpqua Community Health Center North County opened its doors in mid-July, offering primary care for children and adults. The community has also identified after school appointments, weekend services, addressing transportation barriers, and pharmacology services as future priorities
Incentives Drive Improvement, Innovation
One of the ways that CCOs foster innovation in their work is through the OHA’s unique Quality Incentive Program. CCOs receive bonus payments based on their ability to improve their performance on a defined set of measurements. Through incentive metrics, Oregon has greatly improved its developmental screening rate for children under 3 and reduced avoidable emergency room visits, for example. More Oregonians are also reporting that they are in better health.
These bonus payments can be used in a variety of ways, including to address social determinants of health. Since environmental factors like poverty, trauma, or chronic stress can negatively impact physical health, CCOs recognize that a more holistic approach is needed in order to improve the long-term health and wellness of their members.
CI’s Continuing Work
In May, the work of Children’s Institute and others culminated in Oregon’s Metric and Scoring Committee endorsing a new set of proposed incentive metrics that address kindergarten readiness. That work is now moving into an implementation phase that will involve developing new metrics to track follow-up to developmental screening and CCO efforts to support social-emotional health. Children’s Institute, OPIP, and the OHA will be engaging system leaders, community partners, and families in these efforts, and working to tackle policy and capacity barriers at the same time.
Supporting children’s healthy development is a key part of an ongoing strategy to improve academic and life outcomes. As Oregon’s CCOs have demonstrated through the incentive metric program and related innovations, entire communities stand to benefit.
“If we’re going to make a difference in changing outcomes for kids, it truly does take multiple programs and sectors coming together with a common goal and working together in new ways. These are some great examples of what can be accomplished through collaboration,” says Elena Rivera, senior health policy advisor at Children’s Institute.