TRI-COUNTY MEDICAID COLLABORATIVE. A collaborative of organizations devoted to the health of the community

Transcription

1 TRI-COUNTY MEDICAID COLLABORATIVE A collaborative of organizations devoted to the health of the community

2 Who We Are Adventist Health CareOregon Clackamas County Family Care Health Plans Kaiser Permanente Legacy Health Metro Area Community Health Centers Multnomah County Oregon Health & Science University Oregon Medical Association Oregon Nurses Association Providence Health & Services Tuality Healthcare Washington County

3 Interim Leadership Staff Chief Executive Officer Janet Meyer (Tuality Healthcare, chief operating officer) Chief Financial Officer Jeff Butcher, (Providence Health & Services Health Plan, chief financial officer) Chief Operating Officer Jon Hersen (Legacy Health, director of care transformation) Chief Medical Officer Dr. David Labby, (CareOregon, medical director) Chief Information Officer Daniel Dean Chief Health Strategy Officer Rosa Klein (Multnomah County Health Department policy advisor)

4 What is a CCO? 1. A (CCO) is a network of all types of health care providers who have agreed to work together in their local communities for people who receive health care coverage under the Oregon Health Plan (Medicaid). 2. CCOs will have one budget that grows at a fixed rate for mental, physical and ultimately dental care. CCOs will be accountable for health outcomes of the population they serve. 3. CCOs will be governed by a partnership among health care providers, community members, and stakeholders in the health systems that have financial responsibility and risk.

5 Mission Our mission is to be an integrated community delivery system that achieves better care, better health, and lower costs for the Medicaid population and the Tri-County community.

6 Goals 1. Deliver coordinated, high quality services at the right place at the right time. 2. Engage OHP members, the high-risk uninsured, providers, and community resources in meaningful partnerships. 3. Work to eliminate health disparities. 4. Focus on excellent customer service and satisfaction. 5. Achieve cost savings and create a sustainable system.

7 Stakeholders Behavioral health providers Business groups Communities of Color Consumer groups Dental providers Oregon Health Authority Educational institutions Health advocacy groups Health insurers Primary care providers Social service agencies

8 MODEL OF CARE Transforming and Integrating

9 Organizations contributing Oregon Center for Children and Youth Familias en Accion with Special Health Needs (OCCYSHN) Coalition of Communities of Color CareOregon Intel Legacy Central City Concern Kaiser Coalition of Community Clinics Multnomah County Cascadia Behavioral Health OHSU Oregon College of Emergency Portland IPA Physicians Virginia Garcia ODS Women s Health Alliance Family Care Health Plans Northwest Cardiovascular Institute Oregon Pediatric Improvement Oregon Clinic Partnership VA Alliance of Culturally Specific Marquis Behavioral Health Providers Metropolitan Pediatrics Lifeworks Northwest Children s Health Alliance Oregon Department of Public Health Providence OCHIN Washington County Pacific Medical Group Clackamas County Adventist Health Acumentra

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11 Quality Acute Care Chronic Disease Preven'on Cost Triple Aim Experience Popula:on Perspec:ve Primary Health Community Home Pa'ent Specialty Hospital / ED Low Acuity Team High Acuity Support when, where and how I need & want it Individual Perspec:ve One door opens the whole system TCMC Model of Care - January 2012, Coordina:on at every DRAFT point across the life span 11

12 Community- Clinical Partnership Charter: Community Health Assessment Community Health Improvement Plan Advocate for preventive care practices to be utilized by CCO Ensure community and consumer engagement Eliminate health disparities Community Advisory Council Board of Directors Clinical Advisory Panel Charter: Performance Metric Dev & Monitoring Clinical Initiatives Provider Capacity Bldg System Integration Eliminate Health Disparities Members & Community Orgs CAC Joint CAC / CAP CAP Plan QI Cttes Regional Health Improvement Plan

13 Questions?