columbia pacific coordinated care organization (cco) – data summary reedsport

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

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  • Columbia Pacific Coordinated Care Organization (CCO) Data SummaryReedsport

  • Changes in Oregon Health PlanFederal Accountable ActHealthcare Coordination & IntegrationCoordinated Care OrganizationsDual EligibilityGlobal Budgets For AllPrimary Care Health HomesMetrics / Performance MeasuresCommunity Advisory Councils

  • OREGON INTEGRATED & COORDINATED HEALTH CARE DELIVERY SYSTEM

  • Physical HealthMental HealthAddictions TXAssessmentDiagnosisTreatment Plan (EBP)Pre-set rate per serviceMonitor / UpdateOHP ClientAssessmentDiagnosisTreatment Plan (EBP)Pre-set rate per serviceMonitor / UpdateAssessmentDiagnosisTreatment Plan (EBP)Pre-set rate per serviceMonitor / UpdateOral HealthAssessmentDiagnosisTreatment Plan (EBP)Pre-set rate per serviceMonitor / Update

  • 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 accountabilityCommunity Advisory Council Each CCO convenes a CAC to ensure that the health care needs of consumers are being addressedMetrics / Performance Measures Operate under contracted performance standards with clinical, financial and operational metrics

    Global Budget And Shared Saving More flexibility to manage dollars

    Coordinated Care Organizations

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

  • Better Health Care System

    Better Health Outcomes

    Cost Savings

  • All OHP Clients At High Risk - Chronic DiseaseChronic Disease Coordinated case management Reduce high end costsCoordinated case management Reduce likelihood become chronicEarly Assessment & Identification of High Risk For Chronic DiseaseImprove Health System, Improve Health Outcomes, Lower Costs

  • All OHP Clients At High Risk - Chronic DiseaseChronic Disease Coordinated case management Reduce high end costsCoordinated case management reduce likelihood become chronicEarly Assessment & Identification of High Risk For Chronic Disease

  • All OHP Clients At High Risk - Chronic DiseaseChronic Disease Coordinated case management Reduce high end costsCoordinated case management reduce likelihood become chronicEarly Assessment & Identification of High Risk For Chronic Disease

  • All OHP Clients At High Risk - Chronic DiseaseChronic Disease Coordinated case management Reduce high end costsCoordinated case management reduce likelihood become chronicEarly Assessment & Identification of High Risk For Chronic DiseaseSavings = reinvestment into system incentive, etc.REALLY?

  • Cost Impact Sample Using Diabetes for A Single Oregon County:Number of Persons:Number of Deaths:Costs:9,300531$42.6MIf you can prevent 4.67% of people from getting Diabetes:Number Prevented:437Lives Saved:32Financial Cost Savings:$2 MIf you can prevent 20% of people from getting Diabetes:1,860121$8.52 M

  • Cost Impact Sample Using Diabetes for Douglas County:If you can prevent 4.67% of people from getting Diabetes:Number Prevented:437Lives Saved:32Financial Cost Savings:$2 MIf you can prevent 20% of people from getting Diabetes:1,860121$8.52 M$8.52 Million Question:What is the likelihood of preventing 5%, 10%, 20% of population from getting Diabetes?

  • Personal impact cannot be quantifiedCan apply model to other chronic diseases Each has risk factors which increase the likelihood of illness:

    Heart Disease and Stroke Prevention:No tobaccoPhysically activeHealthy weightHealthy food choicesPreventing / controlling high blood pressure12 13 point reduction in average systolic blood pressure over 4 years reduces heart disease risk by 21%, stroke risk by 37%

    Cancer Prevention:No tobaccoLimiting alcoholLimited exposure to ultraviolet raysDiet rich in fruits and vegetablesMaintaining a health weightBeing physically activeSeeking regular medical care

  • PCPOral HealthMental HealthAddictions

  • Health Integration SystemBehavioral Health

    Mental Health Dental HealthPatients Physical HealthNeighborhood HealthFamily

    Spiritual Community

    ProvidersPeers

  • 15 CCO management areas*Community Advisory Councils Ensure health care needs of consumers are being met. Community / consumer focus within CCOs 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

  • Summary of FindingsNational / State Studies:

    Higher death rates related to:CancerHeart diseaseStrokeChronic Lower Respiratory DiseaseDiabetesSuicideAlcohol-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:JobsEducation / SchoolsEnvironment

    Health problems in community:Alcohol / drug addictionNot enough doctorsObesityDiabetesCancerHigh Blood Pressure

    3 things to improve community health:More doctorsDoctor appointments after five oclockExpand OHP

  • Chronic Condition Diagnoses Medicaid-eligible Population (CPCCO Service Area

    Chronic Health ConditionsPercent told they have it by a physician (N= 1,486)Of those percent currently taking RX for itDiabetes9.762.4High cholesterol19.145High blood pressure29.657.8Depression / anxiety44.251.8Asthma18.251.9Emphysema / COPD8.250.4Heart attack / Angina6.650Congestive heart failure269Kidney problem5.133.3Cancer3.750

  • Leading Cause Of Death.

  • Chart1

    193.7

    240.1

    292

    448.4

    Cancer

    Leading Cause of Death CancerRates per 100,000 Avg. 2007 - 2011

    Sheet1

    CancerSeries 2Series 3

    Oregon193.72.42

    Rural OR240.14.42

    Douglas Co.2921.83

    Reedsport448.42.85

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  • Chart1

    163.1

    206.5

    262.7

    408.4

    Heart Disease

    Leading Cause of Death Heart DiseaseRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Heart DiseaseSeries 2Series 3

    Oregon163.12.42

    Rural OR206.54.42

    Douglas Co.262.71.83

    Reedsport408.42.85

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  • Chart1

    47.9

    57.3

    66.7

    117.4

    Stroke

    Leading Cause of Death StrokeRates per 100,000 Avg. 2007 - 2011

    Sheet1

    StrokeSeries 2Series 3

    Oregon47.92.42

    Rural OR57.34.42

    Douglas Co.66.71.83

    Reedsport117.42.85

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  • Chart1

    50.2

    66.8

    89.9

    157.5

    Chronic Resp disease

    Leading Cause of Death Chronic Lower Resp DiseaseRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Chronic Resp diseaseSeries 2Series 3

    Oregon50.22.42

    Rural OR66.84.42

    Douglas Co.89.91.83

    Reedsport157.52.85

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  • Chart1

    41.9

    50.9

    57.2

    90.8

    Unintended Injuries

    Leading Cause of Death Unintended InjuriesRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Unintended InjuriesSeries 2Series 3

    Oregon41.92.42

    Rural OR50.94.42

    Douglas Co.57.21.83

    Reedsport90.82.85

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  • Chart1

    32.5

    36.7

    51.3

    26.7

    Alzheimer's

    Leading Cause of Death AlzheimersRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Alzheimer'sSeries 2Series 3

    Oregon32.52.42

    Rural OR36.74.42

    Douglas Co.51.31.83

    Reedsport26.72.85

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  • Chart1

    27.6

    34.2

    43.8

    69.4

    Diabetes

    Leading Cause of Death DiabetesRates per 100,000 Avg. 2007 - 2011

    Sheet1

    DiabetesSeries 2Series 3

    Oregon27.62.42

    Rural OR34.24.42

    Douglas Co.43.81.83

    Reedsport69.42.85

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  • Chart1

    11.7

    14.1

    14.7

    18.7

    Flu & Pneumonia

    Leading Cause of Death Flu & PneumoniaRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Flu & PneumoniaSeries 2Series 3

    Oregon11.72.42

    Rural OR14.14.42

    Douglas Co.14.71.83

    Reedsport18.72.85

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  • Chart1

    16.2

    18.8

    19.7

    37.4

    Suicide

    Leading Cause of Death SuicideRates per 100,000 Avg. 2007 - 2011

    Sheet1

    SuicideSeries 2Series 3

    Oregon16.22.42

    Rural OR18.84.42

    Douglas Co.19.71.83

    Reedsport37.42.85

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  • Chart1

    14.7

    18

    16.5

    40

    Alcohol induced

    Leading Cause of Death Alcohol InducedRates per 100,000 Avg. 2007 - 2011

    Sheet1

    Alcohol inducedSeries 2Series 3

    Oregon14.72.42

    Rural OR184.42

    Douglas Co.16.51.83

    Reedsport402.85

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  • In Douglas County, this includes the following: 4,553 individuals with 7,632 conditions60% (2,760) with one condition either a physical or mental illness39.4% (1,793) with more than one conditionOf those with more than one condition, 16.5% (751 of the total 4,553) had both a physical and mental health condition

  • Health Behaviors

  • Adult Smoking

    Chart1

    0.26

    0.17

    Adult Smoking

    Sheet1

    Adult Smoking

    Douglas26.0%

    Oregon17.0%

    National Benchmark13.0%

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  • Adult Obesity

    Chart1

    0.31

    0.26

    Adult Smoking

    Sheet1

    Adult Smoking

    Douglas31.0%

    Oregon26.0%

    National Benchmark13.0%

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

    Chart1

    100.6

    59.7

    Premature Death

    Sheet1

    Premature Death

    Reedsport100.6

    Oregon59.7

    National Benchmark6.0%

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

    Chart1

    67.1

    61.8

    Premature Death

    Sheet1

    Premature Death

    Reedsport67.1

    Oregon61.8

    National Benchmark6.0%

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  • A Look At Who We Are

  • Reedsport

    Chart1

    0.0020.017

    0.0110.01

    0.0010.039

    0.0030.001

    0.0260.028

    Reedsport

    Oregon

    Sheet1

    ReedsportOregon

    African American0.2%1.7%

    Indian / Alaskan Native1.1%1.0%

    Asian / Pacific islander0.1%3.9%

    Other Race0.3%0.1%

    Two + Races2.6%2.8%

    white373290.0%

    latino2054.9%

    2 plus1062.6%

    indian461.1%

    asian421.0%

    other110.3%

    black80.2%

    hawaiin40.1%

    4154100%

  • Percent White / Caucasian

    Chart1

    0.9

    0.793

    Adult Smoking

    Sheet1

    Adult Smoking

    Reedsport90.0%

    Oregon79.3%

    National Benchmark

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    1

    188888888

  • Percent Hispanic (all races)

    Chart1

    0.049

    0.112

    Adult Smoking

    11.2%

    Sheet1

    Adult Smoking

    Reedsport4.9%

    Oregon11.2%

    National Benchmark

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    1

    188888888

  • Under Age 18

    Chart1

    0.278

    0.23

    Adult Smoking

    Sheet1

    Adult Smoking

    Reedsport27.8%

    Oregon23.0%

    National Benchmark

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    1

    188888888

  • Percent Male

    Chart1

    0.5

    0.495

    Adult Smoking

    Sheet1

    Adult Smoking

    Reedsport50.0%

    Oregon49.5%

    National Benchmark

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    1

    188888888206049.7%

    209450.5%

    4154

  • Chart1

    0.148

    0.153

    0.16

    0.186

    Alcohol induced

    Population Below Poverty Level$19,090 : year for family of 3 in 2012

    Sheet1

    Alcohol inducedSeries 2Series 3

    Oregon14.8%2.42

    Rural OR15.3%4.42

    Douglas Co.16.0%1.83

    Reedsport18.6%2.85

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  • Chart1

    0.099

    0.107

    0.129

    0.136

    Alcohol induced

    Unemployed

    Sheet1

    Alcohol inducedSeries 2Series 3

    Oregon9.9%2.42

    Rural OR10.7%4.42

    Douglas Co.12.9%1.83

    Reedsport13.6%2.85

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  • Chart1

    0.11

    0.13

    0.132

    0.167

    Alcohol induced

    Population 25+ with High School Diploma

    Sheet1

    Alcohol inducedSeries 2Series 3

    Oregon11.0%2.42

    Rural OR13.0%4.42

    Douglas Co.13.2%1.83

    Reedsport16.7%2.85

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  • Community SurveyN = 131

  • 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:

    PercentNumberHospital64.1%84Urgent care19.1%25Doctors office or other outpatient medical clinic82.4%108Veterans health Administration hospital or clinic6.1%8Addictions treatment center2.3%3Dental services46.6%61Public health department11.5%15Mental health / behavioral health or other counseling7.6%199119.9%13

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

    We have good doctors (They care about patients, provide good health care, etc.)75.6%99We have local access to specialty services(A focus on specific area of care like a heart doctor)31.3%41There are good prevention services that help reduce health problems (Services that help people quit smoking or to eat healthy)50.4%66Citizens make use of recreational activities (Helps with exercising and stress reduction, etc.)42%55

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

    A clean environment34.4%45Mental health treatment16.8%22Access to healthy foods24.4%32Food banks/hunger programs21.3%28Affordable housing29%38Low crime/safe neighborhoods17.6%23Cultural acceptance2.3%3Sports and recreation activities6.9%9Education / Schools36.648Tobacco prevention / treatment services6.9%9Drug/alcohol prevention and treatment19.1%25Job opportunities and a healthy economy55.7%73Health prevention and wellness education21.4%28Better access to health care services26%34

  • 4. What do you think are the three (3) most critical health problems in your community? (those problems which have the greatest impact on overall community health)

    Cancer21.4%28Lack of mental health treatment facilities7.6%10Respiratory/lung disease10.7%14High crime rates0.8%1HIV/AIDS1.5%2High cost of mental health services3.1%4Diabetes25.2%33Not enough doctors and clinics32.1%42Heart disease / stroke15.3%20High cost of health care / lack of health insurance16.8%22High blood pressure19.8%26Too few recreational and exercise facilities3.8%5Tobacco use9.2%12Poor eating habits15.3%20Obesity32.1%42Lack of access to healthy foods3.1%4Mental Illness6.9%9Domestic violence6.1%8Alcohol/drug addiction32.1%42Lack of transportation to medical facilities8.4%11Dental problems5.3%7Too little affordable housing9.9%13Sexually transmitted diseases0.8%1Child abuse5.3%7Suicide3.1%4Too few educational opportunities after high school (college, trade schools, et.)13.7%18

  • 5.

    If you could pick just three (3) things to improve your community's access to health care, what would they be? Please pick only 3 boxes:

    More health education services26.7%35More doctors60.3%79More illness prevention services / Screening20.6%27More alcohol and drug treatment16%21More dentists10.7%14Doctor appointments after 5 pm or on weekends38.9%51More culturally sensitive care2.1%4Transportation assistance16.6%22More mental health services18.3%24Alternative health care28.2%37Expand the OHP (Medicaid)35.1%46More tobacco cessation programs4.6%6

  • 6. Think about the most recent time when you or a family member living in your home went without needed health care. What were the reasons why? Please check all that apply

    It costs too much45%59Dont know where to go to get care3.8%5Dont have insurance36.6%48Afraid of what they might find wrong with me7.6%5Childcare issues1.5%2Do not have a regular doctor13%17Transportation problems16.8%22Couldnt get appointment quickly enough25.2%33Dont like doctors7.6%10Have OHP but no doctor4.6%6Waited for the health problem to go away26%34Doctors office not open not open when needed13%17

  • 7. Age

    Chart1

    0

    7

    19

    20

    17

    68

    Column1

    Sheet1

    Column1

    0-17 yrs0

    18-29 yrs72.42

    30-39 yrs194.42

    40-49 yrs201.83

    50-59 yrs172.85

    60 + yrs68

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  • 8. Gender

    Chart1

    49

    81

    Column1

    Sheet1

    Column1

    Male492.42

    Female814.42

    Category 33.51.83

    Category 44.52.85

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  • IncomeRace / Ethnicity:Less than $5,00011.5%15American Indian or Alaska Native4.6%6$5,000 - $15,00019.8%26Asian0%0$16,000 - $25,00025.2%33Black or African American0%0$26,000 - $40,00015.3%20Latino / Hispanic2.3%3$41,000 - $70,00016%21Native Hawaiian or Other Pacific Islander.8%1$71,000 - $100,0003.8%5White77.1%101More than $100,0003.1%4

  • Summary of FindingsNational / State Studies:

    Higher death rates related to:CancerHeart diseaseStrokeChronic Lower Respiratory DiseaseDiabetesSuicideAlcohol-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:JobsEducation / SchoolsEnvironment

    Health problems in community:Alcohol / drug addictionNot enough doctorsObesityDiabetesCancerHigh Blood Pressure

    3 things to improve community health:More doctorsDoctor appointments after five oclockExpand OHP

  • City-Data.com: Reedsport, OR. 2013.Community Health Needs Survey, - Reedsport 2013. Columbia Pacific Coordinated Care Organization : Community Advisory Council. Oregon.County Health Rankings and Roadmaps a Healthier Nation County by County, 2013. Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute.County Health Calculator, 2013. Robert Wood Johnson Foundation and the Virginia Commonwealth University Center on Human Needs. Data Elements for CCOs Reports, 2013. Oregon Health and Science University. Office of Rural Health.Prevention Chronic Diseases and Reducing Health Risk Factors, 2013. Centers for Disease Control and Prevention. CDC 24/7 : Saving Lives. Protecting People.

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