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

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 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.

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193.7

240.1

292

448.4

Cancer

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

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CancerSeries 2Series 3

Oregon193.72.42

Rural OR240.14.42

Douglas Co.2921.83

Reedsport448.42.85

To resize chart data range, drag lower right corner of range.

Chart1

163.1

206.5

262.7

408.4

Heart Disease

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

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Heart DiseaseSeries 2Series 3

Oregon163.12.42

Rural OR206.54.42

Douglas Co.262.71.83

Reedsport408.42.85


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47.9

57.3

66.7

117.4

Stroke

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

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StrokeSeries 2Series 3

Oregon47.92.42

Rural OR57.34.42

Douglas Co.66.71.83

Reedsport117.42.85


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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

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Chronic Resp diseaseSeries 2Series 3

Oregon50.22.42

Rural OR66.84.42

Douglas Co.89.91.83

Reedsport157.52.85


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41.9

50.9

57.2

90.8

Unintended Injuries

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

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Unintended InjuriesSeries 2Series 3

Oregon41.92.42

Rural OR50.94.42

Douglas Co.57.21.83

Reedsport90.82.85


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32.5

36.7

51.3

26.7

Alzheimer's

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

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Alzheimer'sSeries 2Series 3

Oregon32.52.42

Rural OR36.74.42

Douglas Co.51.31.83

Reedsport26.72.85


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27.6

34.2

43.8

69.4

Diabetes

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

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DiabetesSeries 2Series 3

Oregon27.62.42

Rural OR34.24.42

Douglas Co.43.81.83

Reedsport69.42.85


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11.7

14.1

14.7

18.7

Flu & Pneumonia

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

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Flu & PneumoniaSeries 2Series 3

Oregon11.72.42

Rural OR14.14.42

Douglas Co.14.71.83

Reedsport18.72.85


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16.2

18.8

19.7

37.4

Suicide

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

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SuicideSeries 2Series 3

Oregon16.22.42

Rural OR18.84.42

Douglas Co.19.71.83

Reedsport37.42.85


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14.7

18

16.5

40

Alcohol induced

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

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Alcohol inducedSeries 2Series 3

Oregon14.72.42

Rural OR184.42

Douglas Co.16.51.83

Reedsport402.85


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

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0.26

0.17

Adult Smoking

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Adult Smoking

Douglas26.0%

Oregon17.0%

National Benchmark13.0%


Adult Obesity

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0.31

0.26

Adult Smoking

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Adult Smoking

Douglas31.0%

Oregon26.0%



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

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100.6

59.7

Premature Death

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Premature Death

Reedsport100.6

Oregon59.7



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

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67.1

61.8

Premature Death

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Premature Death

Reedsport67.1

Oregon61.8



A Look At Who We Are

Reedsport

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0.0020.017

0.0110.01

0.0010.039

0.0030.001

0.0260.028

Reedsport

Oregon

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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

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0.9

0.793

Adult Smoking

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Adult Smoking

Reedsport90.0%

Oregon79.3%

National Benchmark


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188888888

Percent Hispanic (all races)

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0.049

0.112

Adult Smoking

11.2%

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Adult Smoking

Reedsport4.9%

Oregon11.2%

National Benchmark


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188888888

Under Age 18

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0.278

0.23

Adult Smoking

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Adult Smoking

Reedsport27.8%

Oregon23.0%

National Benchmark


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188888888

Percent Male

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0.5

0.495

Adult Smoking

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Adult Smoking

Reedsport50.0%

Oregon49.5%

National Benchmark


1

188888888206049.7%

209450.5%

4154

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0.148

0.153

0.16

0.186

Alcohol induced

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

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Oregon14.8%2.42

Rural OR15.3%4.42

Douglas Co.16.0%1.83

Reedsport18.6%2.85


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0.099

0.107

0.129

0.136

Alcohol induced

Unemployed

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Oregon9.9%2.42

Rural OR10.7%4.42


Reedsport13.6%2.85


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0.11

0.13

0.132

0.167

Alcohol induced

Population 25+ with High School Diploma

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Oregon11.0%2.42

Rural OR13.0%4.42


Reedsport16.7%2.85


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

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0

7

19

20

17

68

Column1

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Column1

0-17 yrs0

18-29 yrs72.42

30-39 yrs194.42

40-49 yrs201.83

50-59 yrs172.85

60 + yrs68


8. Gender

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49

81

Column1

Sheet1

Column1

Male492.42

Female814.42

Category 33.51.83

Category 44.52.85


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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