Health Care Community Involvement
Coordinated Care Organizations
In 2012 the Oregon Legislature officially approved the creation and implementation of Coordinated Care Organizations. A Coordinated Care Organization, or CCO, is a network of all types of health care providers (physical health care, addictions and mental health care and sometimes dental care providers) who have agreed to work together in their local communities to serve people who receive health care coverage under the Oregon Health Plan (Medicaid). CCOs are focused on prevention and helping people manage chronic conditions, like diabetes. This helps reduce unnecessary emergency room visits and gives people support to be healthy. PacificSource Community Solutions was awarded the CCO contracts in Central Oregon (Deschutes, Jefferson, Crook, and Northern Klamath counties) and the Columbia Gorge (Hood River and Wasco counties). Through joint management agreements with PacificSource, health councils were formed to provide governance and help facilitate work for the CCOs. COIPA Member Providers hold seats and represent COIPA providers on the Boards of both the Central Oregon Health Council (COHC) and the Columbia Gorge Health Council (CGHC).
Your COIPA representatives on the respective health councils are as follows:
Central Oregon Health Council (COHC): Stephen Mann, DO, COIPA Member
Columbia Gorge Health Council (CGHC): Trey Rigert, MD, COIPA Board Member and Sharon DeHart, PA-C, COIPA Board Member
The Quality Collaboration Initiative, including Primary Care, Specialty Care and Transitional Care, established quality guidelines through specific provider-led task forces for Asthma Management, Diabetes Screening/Management, Osteoporosis Screening, Transitional (Chronic Heart Failure) Care and Palliative Care/Advanced Illness Management. The Quality Collaboration Initiative led to the development of the Quality, Values & Outcomes Committee (QVOC), which includes provider-led task forces for Utilization Management, ER Utilization, Advanced Imaging, Transitional Care (Advanced Illness Management, Hospital Readmission) and Inpatient Newborn Management. QVOC’s purpose includes the development and monitoring of clinical quality/utilization review programs, overall utilization management priorities and prepare/review data reports regarding utilization.
Data / Health Information Exchange
COIPA members, administrators and medical directors have access to insurance claims data reports through a COIPA-sponsored data software platform to help improve quality and lower healthcare costs based on metrics established by their peers. In addition, efforts to advance a regional Health Information Exchange (HIE) are underway, which strategy includes building a results repository, increasing provider communication and enhancing clinical information shared in order to reduce inefficiencies and increase the quality of patient care.