Provider Engagement Panel PacificSource Community ...cohealthcouncil.org/apps/uploads/2016/04/PEP-Agenda-4.13.16.pdf · 4/13/2016 · February 2016 DCOs provide proposal presentation

Provider Engagement Panel PacificSource Community Solutions ndash Suite 210 (2nd Floor)

2965 NE Conners Ave Bend OR 97701

Agenda April 13 2016 from 700am-800am

Call-In Number 866-740-1260 7-Digit Access Code 3063523

1 700-705 Introductions amp UpdatesmdashAll

2 705-720 DCO Incentive Payment ProposalsmdashCentral Oregon DCO Representatives

3 720-740 Early Learning Hub OverviewmdashHillary Sacareno and Brenda Comini

4 740-750 RHIP Workgroup UpdatesmdashAll

o What is going well at each workgroup Any suggestions o What have you learned so far through these meetings

bull BH Identification amp ScreeningmdashDr Pennavariabull BH SU amp Chronic PainmdashDr Swanson Dr Pierson amp Dr Pennavariabull CVDmdashDr Sharma amp Dr Littlebull DiabetesmdashSharity Ludwigbull OralmdashSharity Ludwigbull Reproductive HealthMCHmdashMuriel DeLaVergne-Brown amp Dr Pennavariabull Social DeterminantsmdashDonna Mills

5 750-800 Quality amp Health Outcomes Committee (QHOC) Monthly Update ndash Dr Little

Consent Agenda bull Approval of the draft minutes dated March 9 2016 subject to correctionslegal review

From Heather SimmonsTo Heather SimmonsSubject PacificSourceDCO Incentive Payment Structure Proposal OpportunityDate Wednesday January 20 2016 83939 AMAttachments image001png

CGHC Contracting Principles Final Version 11pdfCOHC Alternative Payment Methodology and Contracting Principles (1)-2pdfCCO Metric Setpdfimage003png

Importance High

SENT 112315Good Afternoon Irsquom reaching out to you to talk about alternative payment methodologies and creative incentive arrangements well in advance of the next DCO contract amendment cycle I recall that during contracting activities in summer 2015 DCOs expressed a strong interest in discussing and developing new incentives and alternative payment methodologies (APMs) We also know that the health councils have developed community guidelines around APMsmdashand that some community funds exist to promote innovative models In addition we recognize that DCOs have been piloting individual efforts to utilize incentive structures Those progressive approaches may be unknown to many CCOs including PacificSource We want to leverage opportunities for our DCOs to work together with PacificSource towards increased alignment and visibility of these strategies in the DCO contracts We are hopeful that effective and promising strategies that you have piloted can be ldquospreadrdquo across the dental services system We can all benefit from your unique experience managing capitation and this population Looking ahead to the July 2016 contract amendment we would like to work with you to create the care access and utilization landscape we collectively desire for our respective members We also hope to increase parity across behavioral health medical and dental contracts To promote achieving these goals we would like each DCO in our respective regions to collaborate with each other on the research and development of 3-4 outcomes-focused incentive payment structures or metrics We are eager to take this consensus and build towards the July 2016 contract amendment We suggest that proposed structures or metrics should clearly demonstrate how they achievealign with the following (and acknowledge that you may identify additional sources of guidance to help influence proposed options)

Better population health outcomes better member care and better control of costuse of resourcesThe Central Oregon Health Councilrsquos and the Columbia Gorge Health Councilrsquos Contracting PrinciplesMinimum care expectation outcome deliverablesCCO Oregon-Dental Quality Measure Core Set and A La Carte Measures

We anticipate that proposed structures or metrics will help promote shared PacificSource and DCO aims for care and outcomes as well as promote shared success on quality incentive measures (QIMs) We are excited to see proposals that promote the following

Consistent uniform clinical quality of care and timeliness of access to services across the

P a g e 1 | 5

Columbia Gorge Health Council Contracting Principles

Version 11 Approved by Columbia Gorge Health Council September 24 2014

The Columbia Gorge Health Council (CGHC) encourages contracting models that improve the health and healthcare of our residents and maintain or enhance diverse local services while achieving the Triple Aim goals of optimizing healthcare costs improving quality and enhancing patient experience To truly effect healthcare transformation at the community level we are intentionally employing a collective impact approach in our efforts and actions This document is intended to capture the main transformation principles and associated contracting techniques that may be used in achieving those principles As part of a Shared Measurement system for collective impact there will be a comprehensive set of Performance Goals (PG) with clear measures of success Potential sources of the PGs include Transformation Plan objectives Quality Incentive Measures (QIMs) regional priorities and metrics adopted by the CGHC PacificSource and the Community Health Improvement Process (CHIP) focus areas and statewide benchmarks as defined by OHA or an equivalent authority

1 Common Agenda We aspire to improve health and healthcare of all community members and maintain or enhance diverse local services while achieving the Triple Aim goals of optimizing healthcare costs improving quality and enhancing patient experience including the poor and vulnerable Specific principles and resulting contracting techniques include

a We strive for community parity in cost quality and customer experience Like providers are reimbursed like amounts community members have equal access and equal choice quality performance is structured and rewarded in a similar fashion across disciplines

i Provider contracts shall have withholds or bonus incentivesmdashor some combination of bothmdashto incentivize the achievement of the Triple Aim goals of optimizing healthcare costs improving quality and enhancing patient experience as well as improving quality performance including performance with respect to identified Performance Goals

ii Withholds or bonuses shall be constructed based on data analysis and qualitative information that support the level of incentive necessary to change behavior workflow and provider practices

iii If no Performance Goal applies to a particular provider their provider contract shall apply other reasonable quality and coordination requirements along with appropriate incentives

iv New Performance Goals will be incorporated into contracts at renewal or through amendments Use of amendments may address timeframes for implementation

v PacificSource retains flexibility to adjust the provider network and provider or vendor contracts if performance or customer experience is not meeting Performance Goals or other objective measures

P a g e 2 | 5

vi No additional reimbursement shall be paid due to site of service differential

b Patient outcomes patient experience and access matter i We emphasize value over volume Innovative reimbursement methodologies

that emphasize value over volume shall be encouraged and tested for effectiveness and efficiency when appropriate

ii Contracts shall encourage and provide financial support to team-based care that includes a multi-disciplinary approach and yields desired outcomes

iii In some situations it may be necessary to implement a range of reimbursement methodologies to promote certain Performance Goals

c Care for the poor and vulnerable is a shared expectation i Access to quality care for all community members is paramount to a vibrant

community Provider contracts shall encouragerequire clinics to refer uninsured patients or those whose OHP insurance is about to expire to appropriate agencies to determine their eligibility for insurance or re-enrollment If ineligible for any insurance providers are encouraged to offer sliding fee scale options If the community member becomes eligible for OHP PacificSource will make all reasonable efforts to assign these patients to the provider who supported them during their uninsured status

d Maximize the successful and robust support services networks and relationships that exist and champion new ones only where there is a clear unmet need

e Use adaptive open-design practices acting in a timely manner as inaction has negative consequences Donrsquot allow the complexity of the systems to delay us in making informed improvements understanding that even with the best information and best intentions we wonrsquot get it perfect each time Consider options and approaches that can evolve as we learn

2 Shared Measurement and Objective Decision Making We value data-driven decision making and recognize that sharing of information can be challenging All parties are held to the same transparency and information sharing goals to ensure consistency and visibility in the entire eco-system The contracting themes supporting this element include

a Healthy people are what really matters We intend to leverage evolving EHR analytical predictive and service delivery measurement systems in order to constantly improve health outcomes

b Transparency of data and information as near real-time as possible to educate shape and drive continuous process improvement locally

c Where it is not feasible to encounter at least 80 of revenue it is expected that detailed and transparent accounting be presented to the CGHC or designated subcommittee no less than annually

d Participation in and support of the regionrsquos HIE with the intention of contributing data in as real-time as practical Data sharing will include information beyond traditional claims or encounter information This is based on a premise of an operational HIE that is feasible for providers to participate

P a g e 3 | 5

3 Mutually Reinforcing Activities In our small community we want to foster a healthy interdependent ecosystem The contracting themes supporting this element include

a Healthcare transformation depends on collaboration and teamwork across all disciplines and contracts need to support the spirit of rising or falling together as a healthcare ecosystem Certain contract elements should be tied together by the overall success of the community such as global budget position QIM performance or other clinical measures

b Provider contracts shall be complementary such that multiple providers affecting a workflow will be incentivized to work together to impact PGs

c CGHC acknowledges PacificSourcersquos community approach with an administrative fee cap transparent and minimal net income margins and a mechanism for gain sharing with community partners in years of strong financial performance Similar parameters should be employed by other partners in the community

d Funds shall be reserved from the CCO global budget each fiscal year in order to pay for prevention efforts or other initiatives to address upstream factors or transformational work The CGHC and CCO shall work together proactively to create a process to disburse these funds and monitor the use of the funds

e All insurers are encouraged and welcomed to embrace these principles overall and actively participate in the local community efforts

f CGHC will support efforts for cross-organizational analysis and implementation

4 Continuous and Effective Communication Consistent and open communication is needed across all participants to build trust assure mutual objectives and develop common motivation

a Outlier data elements are treated as opportunities for learning and discovery and not for punitive means but are addressed for resolution in very direct ways

b Consumer input is a vital component of what we do and the Community Advisory Council is the steward in prioritizing needs and focus areas

i Contracts shall require appropriate participation in and responding to focus areas outlined in the Community Health Improvement Process (CHIP) and garnering input for the Community Health Assessment (CHA)

c It is the expectation of CGHC that all new and renewing contracts affecting service delivery in the Columbia Gorge region be executed in consultation with these contracting principles andor additional dialogue with the CGHC board as appropriate

d Our meetings are open and the intention is for inclusion and balance in all discussions e PacificSource will communicate with the Finance Committee the progress made towards

implementing these principles in final contracts The Finance Committee shall provide a summary for the CGHC

f Once final contracts are in place PacificSource will summarize which providers are incentivized to impact which PGs and how This information will be used by the CAP CAC Finance and other sub-committees to implement strategies and complement efforts

P a g e 4 | 5

Performance Goals for 2015

Candidate list of Community Performance Goals include

Quality Incentive Measures (QIMs)

o Behavioral Health Related

Screening for clinical depression and follow-up plan

Alcohol and drug misuse (SBIRT)

Mental amp Physical health assessments for children in DHS custody

Follow-up after hospitalization for mental illness

Follow-up care for children prescribed ADHD meds

o Family Health

Prenatal care initiated in the first trimester

Reducing elective delivery before 39 weeks

Developmental screening by 36 months

Adolescent well care visits

Colorectal cancer screening

Sealants for children (Dental metrics in 2015)

Comprehensive or periodic dental exam

o Chronic Conditions

Uncontrolled diabetes (HbA1c gt 9)

Controlling hypertension (lt14090)

Controlling hyperlipidemia (LDLlt100)

o Appropriate Access

Ambulatory care ED and outpatient utilization

Rate of PCPCH enrollment

Access to care getting care quickly CAHPS survey

o Infrastructure

Patient experience of care health plan information and customer service CAHPS

survey results

Electronic Health Records adoption

Access measures (these are thought starters)

o to Urgent care 80 same day 100 within 2 days

o to Acute needs within 2 weeks days

o to wellnesspreventive exams within 6 weeks

Transformation Plan Candidates (not covered elsewhere)

o Health disparities

o Integrated Primary and Behavioral Health

Community Health Improvement Plan Candidates

o Transportation ndash NEMT connection

o Dental Access for Adults

P a g e 5 | 5

o Physical and Mental health together

o Mental Health access for Children amp Youth

o Health insurance re-enrollment

o Teamwork across the spectrum of healthcare providers (eg physical mental dental

pharmacy)

o Supporting Developmental and Healthy Growth in the Early Years

Financial measures

o Medical Loss Ratio

o Global Budget net income

Community Coordination

o Participation in or referrals to CHT

Alternative Payment Methodology and Contracting Principles Related Reporting Principles

Prepared April 2 2014 by Lindsey Hopper Updated April 29 2014 by Zach Pangares Updated May 2 2014 by Lindsey Hopper

Adopted unanimously on May 6 2014 by the COHC Finance Committee

Alternative Payment Methodology and Contracting Principles

1 Provider contracts shall have withholds or bonus incentivesmdashor some combination of bothmdashto incentivize the achievement of the Triple Aim goals of optimizing healthcare costs improving quality and enhancing patient experience as well as improving quality performance including performance with respect to identified QIMs (if any QIMs apply to a given provider)

2 Such withholds or bonuses shall be constructed based on data analysis and qualitative information that support the level of incentive necessary to change behavior workflow and provider practices Analysis shall also be conducted to determine what adverse consequences if any may arise from particular incentives

3 In the event that no QIMs apply to a particular provider their provider contract shall impose other reasonable quality and coordination requirements along with appropriate incentives

4 In the event that QIMs or regional priorities that impact a particular type of service or type of provider are not available when a contract is signed but become available at a later date during the contract period such contract shall provide for an amendment that is mutually agreed upon by both parties for the purpose of incentivizing the provider to affect the applicable QIMs or regional priorities Such amendments may address timeframes for implementation of amendments and permit providers adequate time to comply

5 Provider contracts shall be complementary such that multiple providers affecting a workflow will be incentivized to work together to affect a QIM

6 Innovative reimbursement methodologies that emphasize value over volume shall be encouraged and tested for effectiveness and efficiency

7 Pursuant to Guiding Principle 10 no additional reimbursement shall be paid due to site of service differential

8 Funds shall be reserved from the CCO global budget each fiscal year in order to pay for prevention efforts or other initiatives to address upstream factors or transformational work The COHC and CCO shall work together proactively to create a process to disburse these funds and monitor the use of the funds

9 Any funds allocated pursuant to Principle 8 above shall include a requirement that a certain portion of the funds be used to design an evaluation plan and for execution of the evaluation plan

10 Provider contracts shall include a requirement that the provider participate in the regionrsquos HIE no later than January 2016 provided that such HIE is

operational as of January 2016 and the technology and financial factors and feasibility are such that providers are able to participate

Reporting Principles

1 PSCS shall report to the Finance Committee upon request by the Finance

Committee and not less than annually on PSCSrsquos progress implementing the principles set forth above in negotiations and final contracts The Finance Committee shall provide a summary for the COHC

2 Once final contracts for each fiscal year have been negotiated and signed PSCS shall report in a chart form which providers are incentivized to impact which QIMs and how This information will be used by the CAC Ops and COHC to implement strategies and complement efforts by PSCS

3 Pursuant to Guiding Principles 1-4 PSCS shall report to the Finance Committee upon request on a periodic basis and after the end of each contracting period which providers were eligible to participate in any risk pool surplus

DRAFT CCO-DCO Quality Measure Core SetU

ndash A

DenominatorNumeratorDescription

Percentage of all enrolled adults who received at least one dental service within the reporting year

Link to additional information on measurehttpwwwadaorg~mediaADAScience20and20ResearchFilesAdult_Measures_under_considerationashx

Unduplicated number of adults who received at least one dental service

CDT codes included are D0100 ndash D9999

Measure covers both dental services and oral health services

Unduplicated number of adults who are continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days) Adults with Age Bandsmiddot 21-30 31+ ORmiddot 21-34 35-54 55-64 65-74 75-84 85+

Percentage of all enrolled children under age 21 who received at least one dental service within the reporting year

DQA measure endorsed by NQF

Link to additional information on measurehttpwwwadaorg~mediaADAScience20and20ResearchFilesNQF_Dental_DQA_Util_of_Servicesashx

Unduplicated number of children who received at least one dental service

Unduplicated number of children 0-21 who are continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days)

Children amended for age bandsmiddot 0-18 19-20 ORmiddot lt1 1-2 3-5 6-7 8-9 10-11 12-14 15-18 19-20

Percentage of children (and pregnant women) receiving at least one preventive dental service by or under the supervision of a dentist within a reporting year

Link to additional information on measurehttpwwwmedicaidgovMedicaid-CHIP-Program-InformationBy-TopicsQuality-of-CareDownloadsInitial-Core-Set-Dentalpdf

Unduplicated number of children (and pregnant women) receiving at least one preventive dental service by or under the supervision of a dentist

CDT codes included are D1000-D1999

The total unduplicated number of individuals age one through 20 who have been continuously enrolled in Medicaid or a CHIP Medicaid expansion program for at least 90 days and determined to be eligible for Early Periodic Screening Diagnostic Testing (EPSDT) services

Pregnant Women

Percentage of all enrolled children who were seen in the ER for caries-related reasons within the reporting year and visited a dentist following the ED visit

Hybrid blend of two DQA measures 1 NQF endorsed

Link to Additional measure details httpwwwadaorg~mediaADAScience20and20ResearchFilesNQF2695_DQA_FollowUpAfterEDVisit_Specificationsashxhttpwwwadaorg~mediaADAScience20and20ResearchFilesPediatric_Measures_Under_Testingashx

Unduplicated number of children who were seen in the ED for caries-related reasons in the reporting year and visited a dentist within(a) 7 days (b) 30 days(c) 60 days (added to NQF endorsed DQA measure based on another DQA ED measure)

following the ED visit

DEN 1 Unduplicated number of children who are continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days)DEN 2 Unduplicated number of children who are Continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days) seen in an ED for caries-related reasons

Rates NUM1DEN1 and NUM2DEN1 and NUM3DEN1 NUM1DEN2 and NUM2DEN2 and NUM3DEN2

Percentage of all enrolled adults who were seen in the ED for non-traumatic dental related reasons within the reporting year and visited a dentist for treatment services within 60 days following the ED visit

Link to additional measure detailshttpwwwadaorg~mediaADAScience20and20ResearchFilesAdult_Measures_under_considerationashx

Unduplicated number of adults who were seen in the ED for non-traumatic dental related reasons in the reporting year and visited a dentist for treatment services within 60 days following the ED visit

Unduplicated number of adults who are continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days) seen in an ED for non-traumatic dental related reasons

Adults with Age Bandsmiddot 21-30 31+ ORmiddot 21-34 35-54 55-64 65-74 75-84 85+

Percentage of a all enrolled identified as smokersb enrolled adults who accessed dental care (received at least one service) identified as smokers who received a comprehensive or periodic oral evaluation within the reporting year

Unduplicated number of all enrolled adults identified as smokers who received a comprehensive or periodic oral evaluation

DEN 1 Unduplicated number of adults who are continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days) identified as smokers DEN 2 Unduplicated number of adults who are Continuously enrolled in a CCO for the 12-month measurement year (with no more than one gap in continuous enrollment of up to 45 days) identified as smokers who received at least one dental service

Adults with Age Bandsmiddot Pediatric age band subject to Metrics and Scoring decision(s)middot 21-30 31+ ORmiddot 21-34 35-54 55-64 65-74 75-84 85+

Rates NUMDEN1 NUMDEN2

Patientsrsquo RatingsQ10 Using any number from 0 to 10 where 0 is the worst regular dentist possible and 10 is the best regular dentist possible what number would you use to rate your regular dentistQ18 Using any number from 0 to 10 where 0 is the worst dental care possible and 10 is the best dental care possible what number would you use to rate all of the dental care you personally received in the last 12 monthsQ25 Using any number from 0 to 10 where 0 is extremely difficult and 10 is extremely easy what number would you use to rate how easy it was for you to find a dentistQ29 Using any number from 0 to 10 where 0 is the worst dental plan possible and 10 is the best dental plan possible what number would you use to rate your dental plan

Dental Plan Costs and ServicesQ19 How often did your dental plan cover all of the services you thought were coveredQ22 How often did the 800 number written materials or website provide the information you wantedQ27 How often did your dental planrsquos customer service give you the information or help you neededQ28 How often did your dental planrsquos customer service staff treat you with courtesy and respectQ20 Did your dental plan cover what you and your family needed to get doneQ24 Did this information (from your dental plan) help you find a dentist you were happy with

Care from Dentists and StaffQ6 How often did your regular dentist explain things in a way that was easy to understandQ7 How often did your regular dentist listen carefully to youQ8 How often did your regular dentist treat you with courtesy and respectQ9 How often did your regular dentist spend enough time with youQ11 How often did the dentists or dental staff do everything they could to help you feel as comfortable as possible during your dental workQ12 How often did the dentists or dental staff explain what they were doing while treating you

Access to Dental Care Q13 How often were your dental appointments as soon as you wanted Q15 If you tried to get an appointment for yourself with a dentist who specializes in a particular type of dental care (such as root canals or gum disease) in the last 12 months how often did you get an appointment as soon as you wanted Q16 How often did you have to spend more than 15 minutes in the waiting room before you saw someone for your appointment Q17 If you had to spend more than 15 minutes in the waiting room before you saw someone for your appointment how often did someone tell you why there was a delay or how long the delay would be Q14 If you needed to see a dentist right away because of a dental emergency in the last 12 months did you get to see a dentist as soon as you wanted

Types of MeasuresThe Dental Plan Survey generates three types of measures for reporting purposesbullRating measures which are based on items that use a scale of 0 to 10 to measure respondentsrsquo assessment of their provider This measure is sometimes referred to as the ldquoglobal ratingrdquo or ldquooverall ratingrdquobullComposite measures (also known as reporting composites) which combine results for closely-related items that have been grouped together Composite measures are strongly recommended for both public and private reporting because they keep the reports comprehensive yet of reasonable length Psychometric analyses also indicate that they are reliable and valid measures of patientsrsquo experiencesbullIndividual items which are survey questions that did not fit into the composite measures These measures may be included in public reports but they are especially useful in reports for providers and other internal audiences that use the data to identify specific strengths and weaknesses

Measures Based on the Dental Plan SurveyThe Dental Plan Survey produces three Composite measures and four rating measures bullCare from dentists and staff (6 items)bullAccess to dental care (5 items) bullDental plan costs and services (6 items)bullPatientsrsquo ratings (4 items)

DRAFT CCO-DCO A La Carte MeasuresFl

DenominatorDescription Numerator(1) Fluoride (Topical) Percentage of patients assessed with moderate to high risk of developing dental caries who received at least one topical fluoride treatment

(2) Fluoride Varnish Applications (Early Childhood Caries) Percentage of children 12 to 72 months of age defined as being at higher-risk of dental disease who receive 1 or more fluoride varnish applications

(3) Topical Fluoride Intensity for Children at Elevated Caries Risk Percentage of

a all enrolled childrenb enrolled children who received at least one dental service who are at ldquoelevatedrdquo risk (ie ldquomoderaterdquo or ldquohighrdquo) who received (1 2 3 gt4) topical fluoride applications within the reporting year

(4) Percentage ofa enrolled adults b enrolled adults who accessed dental services (received at least one service) at elevated caries risk (ie ldquomoderaterdquo or ldquohighrdquo risk) receiving (12 3 ge4) topical fluoride application within the reporting year

(1) Number of patients assessed moderate to high risk of developing dental caries with at least one topical fluoride treatment during the report period

(2) Number of patients in the denominator with a topical fluoride varnish (D1206) documented (within the previous 12 months)

(3) Unduplicated number of children at ldquoelevatedrdquo risk (ie ldquomoderaterdquo or ldquohighrdquo) who received (1 2 3 gt4) topical fluoride applications as a dental service

(4) Unduplicated number of all enrolled adults at elevated caries risk who received (1 2 3 ge4) topical fluoride application

(1) Number of patients assessed moderate to high risk of developing dental caries with a documented dental visit during the report period

(2) Number of children 1-6 years of age with a documented dental visit in the last 12 months

(3) DEN 1 Unduplicated number of all enrolled children at ldquoelevatedrdquo risk (ie ldquomoderaterdquo or ldquohighrdquo) DEN 2 Unduplicated number of all enrolled children at ldquoelevatedrdquo risk (ie ldquomoderaterdquo or ldquohighrdquo) who received at least one dental service

Rates NUMDEN 1 NUMDEN 2

(4) DEN 1 Unduplicated number of all enrolled adults at elevated caries risk DEN 2 Unduplicated number of all enrolled adults at elevated caries risk who received at least one dental service

(1) Pregnant Women Who Received ProphyFluoride

(2) Percent of pregnant women with comprehensive dental exam completed while pregnant

(1) Prophyfluoride Codes - D1110 D1120 D1201 D1203 D1204 or D1205

(2) Pregnant women in the last 12 month with comprehensive exam while pregnant

(1) Pregnant women were identified as having an expected due date within year and must have been enrolled in the DCO for at least 45 days for the baseline year and for the re-measure year

(2) Pregnant women in the last 12 months

(1) The percentage of recipients 2-21 years of age who had at least one dental visit during the measurement year The eligible population has to have continuous enrollment during the measurement year with no more than one gap in enrollment of up to 45 days

(2) Use of Dental Services by Children - periodic or comprehensive examination

(3) Percentage of a all enrolled adults b enrolled adults who accessed dental care (received at least one service) who received a comprehensive or periodic oral evaluation within the reporting year

(4) Percentage of enrolled children under age 21 who received a comprehensive or periodic oral evaluation within the reporting year

(5) The percentage of enrolled members(age to be determined) who had at least one dental visit during the measurement year

(1) Had at least one dental visit during the measurement year

(2) Number of enrollees who received comprehensive or periodic exam

(3) Unduplicated number of all enrolled adults who received acomprehensive or periodic oral evaluation

(4) Unduplicated number of children who received a comprehensive or periodic oral evaluation as a dental service

(5) Medicaid members who had one or more dental visits with a dental practitioner during the measurement year

(1) Members 2ndash21 years of age as of December 31 of the measurement year Report six age stratifications and a total rate 2-3 years 4-6 years 7-10 years 11-14 years 15-18 years 19-21 years and Total

(2) Number of adult enrollees

(3) DEN 1 Unduplicated number of all enrolled adults DEN 2 Unduplicated number of all enrolled adults who received at least one dental service

(4) Unduplicated number of all enrolled children under age 21

(5) Members 2- 21 years of age as of December 31 of the measurement year Report six age stratifications and a total rate 2-3 years 4-6 years 7-10 years 11-14 years 15-18 years 19-21 years and Total

(1) Comprehensive Periodontal Oral Evaluation for those with a history of treated periodontitis Percentage of

a all enrolled adults treated for periodontitis b enrolled adults treated for periodontitis who accessed dental services (received at least one service) who received comprehensive oral evaluation OR periodic oral evaluation OR comprehensive periodontal examination at least once within the reporting year

(2) Periodontal Maintenance Services for those with history of treated periodontitis Percentage of

a all enrolled adults treated for periodontitis b enrolled adults treated for periodontitis who accessed dental services (received at least one service) who received oral prophylaxis OR periodontal maintenance at least 1 2 3 ge4 times within the reporting year

(3) People with Diabetes Oral Evaluation Percentage of a all enrolled adults identified as people with diabetes b enrolled adults identified as people with diabetes who accessed dental care (received at least one service) who received a comprehensive or periodic oral evaluation OR comprehensive periodontal examination at least once within the reporting year

(1) Ambulatory Care Sensitive ED Visits for Dental Caries in Children Number of emergency department (ED) visits for caries-related reasons per 100000 member months for all enrolled children

(2) Follow-up after ED Visit by Children for Dental Caries The percentage of caries-related ED visits among children 0 through 20 years in the reporting year for which the member visited a dentist within (a) 7 days and (b) 30 days of the ED visit

(3) Follow-up after ED Visit Percentage of all enrolled children who were seen in the ED for caries-related reasons within the reporting year and visited a dentist within 60 days following the ED visit

(4) Use of ED for caries-related reasons Percentage of all enrolled adults who were seen for non-traumatic dental reasons in an ED for 1 2 3 or more visits within the reporting year

(5) Use of ED for caries-related reasons Percentage of all enrolled children who were seen for caries-related reasons in an ED for 1 2 3 or more visits within the reporting year

(1) Number of ED visits with caries-related diagnosis code among all enrolled children

(2) Number of caries-related ED visits in the reporting year for which the member visited a dentist within (a) 7 days (NUM1) and (b) 30 days (NUM2) of the ED visit

(3) Unduplicated number of children who were seen in the ER for caries-related reasons in the reporting year and visited a dentist within 60 days following the ED visit

(4) Unduplicated number of all enrolled adults b Unduplicated number of all enrolled adults seen in an ED at least once for any Reason

(5) Unduplicated number of children who were seen in an ED for 1 2 3 or more visits for caries-related reasons

(1) All member months for enrollees 0-20 years during the reporting year

(2) Number of caries-related ED visits in the reporting year

Rates NUM1DEN NUM2DEN

(3) DEN 1 Unduplicated number of all enrolled children DEN 2 Unduplicated number of all enrolled children seen in an ED for caries-related reasons

(4) DEN 1 Unduplicated number of all enrolled adults DEN 2 Unduplicated number of all enrolled adults seen in an ED at least once for any reason

(5) DEN 1 Unduplicated number of all enrolled children DEN 2 Unduplicated number of all enrolled children seen in an ED at least once for any reason Rates NUMDEN1 NUMDEN2

(1) Unduplicated number of all enrolled adults treated for periodontitis who received comprehensive oral evaluation OR periodic oral evaluation OR comprehensive periodontal examination

(2) Unduplicated number of all enrolled adults treated for periodontitis who received oral prophylaxis OR periodontal maintenance at least 1 2 3 ge4 times

(3) Unduplicated number of all enrolled adults identified as people with diabetes who received a comprehensive or periodic oral evaluation OR comprehensive periodontal examination at least once

(1) DEN 1 Unduplicated number of all enrolled adults treated for periodontitis DEN 2 Unduplicated number of all enrolled adults treated for periodontitis who received at least one dental service ldquoTreated for periodontitisrdquo determined by prior claims history for specific perio treatment codes

(3) DEN 1 Unduplicated number of all enrolled adults identified as people with diabetes DEN 2 Unduplicated number of all enrolled adults identified as people with diabetes who received at least one dental service

CCO Metric Setvsd

Page-1

Page-2

contracted network and regardless of the DCO to which a member is assignedMembers receive new patient exams and other services to establish care (prophylaxis treatment plan development etc) within 4 weeks of the memberrsquos appointment request Proposals that seek to meet or exceed the 4 week standard from the memberrsquos enrollment date are further encouraged For example structures or metrics could be tied to of members (assigned to a DCO) that experience these outcomesMembers receive all treatment-planned services (completed treatment plan) within 6 months of treatment plan initiation Again one metric might be tied to of members (assigned to a DCO) that experience this outcomePacificSource members receive care that addresses their dental concerns (eg minor dental pain cracked or failed fillings broken teeth etc) within 2 weeks of the memberrsquos appointment request Proposed incentive structures may be tied to of members (assigned to a DCO) whom experience this outcomeMembers receive care that is coordinated integrated and adapted to individual needs Proposed incentive structures or metrics could indicate plans to achieve improvements in some or all of the following areas

Tracking monitoring and intervention to further reduce ED utilization for non-traumatic dental careTracking monitoring and increased care coordination to improve health outcomes for members with chronic conditions or other conditions that may be associated with elevated risk for declines in oral health

We hope that the aligned proposed structures and metrics will also address analytics and how each DCO will be able to track monitor and report independently on status and progress A phased approach or a system readiness discussion might promote success in this regard We look forward to working with you on this endeavor we know that each DCO has something promising to share for our discussions If you have any questions or suggestions for this process please reach out

November 2015-January 2016 DCOs collaborate on the research and development of 3-4 incentive payment structure proposals Proposals should clearly link to current APMhealth care financing best practiceevolving practice Partnership with content-area experts is encouraged

February 2016 DCOs provide proposal presentation to the designated Health Council Committees (in both regions) for feedback and further development

March 2016 DCOs prepare and submit proposals to PacificSource for consideration

April 2016-May 2016 PacificSource and DCOs participate with contract amendment negotiations

June 2016 Contract amendments are prepared and signed by all parties

3

SENT 12115 Hello- By now you and others within your organization likely have reviewed my email dated November 13 2015 regarding collaborative incentive proposals I have received a few questions and requests for clarification Please see my follow-up below Please continue to send questions and ideas We all benefit from a robust discussion Identified QuestionsHow will DCOs convene to collaborate on proposal development Is it expected that existing forums (CCO Oregon for example) be used or will PacificSource be convening a forum

PacificSource intends that DCOs convene to create proposals Please refer to the timeline included in the November 13 email to help guide the process

If DCOs meet or exceed the agreed upon metrics will an incentive payment be receivedThere are a variety of incentive structures currently being used across the nation and here in Oregon PacificSource is interested in our DCO partnerrsquos ideas and interests in this space DCO collaboration on the development of incentive proposals is an opportunity to significantly guide next steps with contracting and associated activities PacificSource cannot achieve the aims (in the proposal) without the expertise leadership and creative thinking of our contracted dental organizations as we navigate the global budget together

I look forward to hearing from you about next steps Best Regards Heather Simmons MPH | Dental Services Program Manager | PacificSource Government Programs | direct 5413304916

4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8

For a copy of the complete 2015-2017 Early Learning Hub Strategic Work Plan please go to our website at earlylearninghubcoorg

REV Date 4-1-2016 (abbreviated)

9

Early Learning Hub Goals amp Strategies

Early Learning Hub Partnerships Utilizing the Collective Impact approach the Early Learning Hub of Central Oregon is bringing together the early childhood K-12 and higher education health and human

services community and business government and philanthropic sectors to improve outcomes for young children and to align services into one efficient and effective local early learning system The Early Learning Hub builds on existing community

resources and assets and works collectively to support parents and to establish a solid foundation for childrenrsquos long term success Plan development strategies and

outcomes of the Early Learning Hub of Central Oregon are strategically aligned with existing regional plan efforts and initiatives including the prenatal to career Regional

Achievement Collaborative Better Together and the Central Oregon Regional Health Improvement Plan

Vision The vision of the Early Learning

Hub of Central Oregon is healthy stable and supported families and children who are successful in

school and life

Mission To create an efficient and effective early learning system to ensure all

children prenatal through eight receive the opportunities and

supports needed to be healthy and successful in school

Outcomes and Goals The shared outcome goals for the regionrsquos Early Learning Hub and among its network of providers and community partners are to achieve the following

Early childhood services are coordinated effective accessible and family-centered

Children receive the opportunities and supports needed to enter school ready to succeed and with health and development on track

Children are raised in healthy stable supported and supportive families

Our Priority Population The target population for the Early Learning Hub of Central Oregon is infants and

children prenatal through age eight with emphasis on vulnerable families defined as low-income from rural under-resourced communities children with cultural and

linguistic needs differently abled children children in disruptive and unstable family environments and children at risk for adverse effects of toxic stress and trauma

10

Guiding Principles of the Early Learning Hub of Central Oregon

1 Collaborative approach is preferred approach to use for planning and service delivery

2 Accessible ndash No wrong door multiple entry points

3 Timely ndash Referral and linkages to services occur in a timely fashion

4 Best Practices ndash Services investments are based on objective criteria (primarily on evidence-based

programspractices and based on prioritized strengthsneeds informed by both data and local wisdom

5 Outcome Driven amp Data Informed ndash Investments programs and projects are selected based on

demonstrated need (quantitative and qualitative) and are monitored to evaluate how well they impact the

targeted outcomes

6 Efficient ndash Services and resources are coordinated and delivered wisely without reducing quality

7 Culturally Appropriate ndash Services are delivered in a culturally specific and appropriate manner

8 Family Centered ndash Families are offered choices actively engaged in identifying prioritized needs and

solutions and respected and supported

ment

Strategic Alignment with 19 Existing Regional Plans and Initiatives

Better Together (Regional Achievement Collaborative ndash RAC) and 404020 Goals

Child Care Resource and Referral (CCRampR)

Early Childhood Learning Center (Redmond)

Early Intervention Early Childhood Special Education Plans (EI-ECSE)

Family Preservation and Support Initiative (FPSI)

Focused Child Care Network (FCCN)

Housing ldquoLIFTrdquo planning

Inclusionary Care Grant (DHS)

Kindergarten Partnership and Innovation (PreK-3RD Approach and Growth Mindset)

Literacy Grant Work and continuation efforts

Mixed Delivery Pre-School

OCF Early Childhood P-3 Grants

Oregon Parenting Education Collaborative

Partners in Practice (PiP) ECE Work Force Dev Grant

Home Visiting Service Coordination and Perinatal Continuum of Care (in development)

Pre-School Promise (in development)

Public Health Core Functions and Oregon Public Health Modernization

Regional Health Improvement Plan (RHIP in development) and Triple Aim Goals

Vroom (FRC amp Healthy Beginnings)

11

Appendix A

State-Defined Outcomes the Early Learning Strategic Plan addresses

Goal 1 Early childhood system is aligned coordinated and family-centered

1 Children arrive at Kindergarten with the social-emotional language and cognitive skills

that will support their success in school

2 Families are supported as their childrsquos first and most important teachers

3 Early care and education programs and providers are equipped to promote positive

child development

4 Children and families experience aligned instructional practices and seamless transitions

from early learning programs to kindergarten

5 Disparities in outcomes for vulnerable children and families are reduced

Goal 2 Children are supported to enter school ready to succeed





child development



5 Disparities in outcomes for vulnerable and families are reduced

Goal 3 Families are healthy stable supported and supportive

1 Families have positive physical and mental health supported by access to high-quality

health services

2 Parents and families have the confidence knowledge and skills to support healthy

attachment and the positive development of the children in their care

3 Families have adequate resources to meet their needs such as housing and

transportation and supports to strengthen their resilience to stress

4 Working families have access to safe and affordable child care that promotes positive

child development

12

Appendix B

Summary of Current Locally Defined Strategies to address State Outcomes For a copy of the complete 2015-2017 Strategic Work Plan please go to our website at earlylearninghubcoorg

Goal 1 The early childhood system is coordinated effective accessible amp family-centered

A Active leadership and participation among providers in early care and education health

education social services and businesses to ensure all young children and families with emphasis on vulnerable populations receive needed opportunities amp supports (Metric 1-1A thru 1-1D)

B Aligned planning across agencies with mutually reinforcing activities to achieve goals (Metric 1-1A to 1-1D)

C Utilize data to inform and evaluate investments to learn and adjust as needed and to continually

improve services Utilize data to identify opportunities to decrease disparities (Metric 1-1D and 1-4A)

D Provide meaningful and relevant opportunities for parents to actively participate and provide input on developing and evaluating strategies supports and services (Metric 1-2A)

E Improve coordination and connection to services for families with newborns in collaboration with the regionrsquos Healthy Families Oregon programs Public Health Departments High Desert ESD

PacificSource and other Community Based Organizations (Metric 1-3A and Metric 3-2A)

F Build upon successful existing strategies and initiatives (Metric 1-3A)

G Resource allocation to support organizations reaching and serving vulnerable children and families (Metric 1-3A)

H Identify and seek opportunities to blend and braid resources among providers to maximize use of available resources and to assure resources are invested wisely (Metric 1-5A)


A Provide a coordinated approach utilizing the PreK-3rd Framework to increase school readiness early enrollment and retention strategies that engage families early learning providers and K-3 partners (Metric 2-1A and 2-5A)

B Identify and implement strategies to effectively serve children on identified program wait lists with effective early learning programs and supports (Metric 2-2A)

C Develop a supply of 3-Star 4-Star and 5-Star quality early learning programs in coordination with

QRIS and workforce development efforts with emphasis on improving access and reducing barriers to quality early care and education opportunities for vulnerable populations (Metric 2-3A)

D Coordinate with the CCO and Community Based Organizations to align work to increase rates of developmental screenings and improve the referral information sharing systems and follow-up

processes among medical and early learning providers (Metric 2-4A)


A Strengthen provider capacity and parent supports to access affordable quality care (Metric 3-1A)

B Identify and implement strategies that connect DHS families to quality early learning and literacy experiences parenting education andor family supports (Metric 3-2A)

C Increase understanding on the importance of well child visits among parents utilize data and best practice models to develop a closed-loop referral and information sharing system among

physicians public community based and non-profit organizations (Metric 3-3A)

D Develop a seamless family-centered and culturally responsive home visiting screening and referral system and continuum of care to support pregnant women infants and young children

(Metric 1-3A amp 3-4A)

13

Appendix C

Early Learning Leadership Council (ELLC) Voting Members Alternates and Ex Officio

John Rexford ELLC Chair High Desert ESD SuperintendentWEBCO Board Member

Muriel DeLaVergne-Brown ELLC Vice Chair Crook County Health Services Director

Paul Andrews High Desert ESD Deputy Superintendent Alternate

Rebeckah Berry Central Oregon Health Council Operations amp Project Manager Alternate

Pat Carey District 10 Child Welfare Principal District Manager Alternate

Katie Condit Better Together Regional Achievement Collaborative

Caroline Cruz Warm Springs Community Health Services Liaison

Leticia Hernandez Parent and Diversity Liaison Madras

Elizabeth Holden Deschutes County Health Services Child and Family Behavioral Health Specialist

Amy Howell CO Community College Program Director Associate Prof Early Childhood Ed

Chuck Keers Central OR Family Resource Center Regional Parenting Hub Director

Elaine Knobbs Mosaic Medical Programs and Development (FQHC)

Dee Ann Lewis Family Resource Center of Central OR Director of Ed and Outreach Alternate

Shannon Lipscomb OSU Cascades Assist Professor of Human Dev and Family Science Ex Officio

Wayne Looney Prineville Kiwanis Business Liaison

Desiree Margo Redmond School District Early Learning Center Planning Principal

Linda McCoy Central Oregon Health Council (COHC) Community Advisory Committee Chair

Donna Mills Central Oregon Health Council (COHC) Executive Director Ex Officio

April Munks District 10 DHS Child Welfare Program Manager

Leslie Neugebauer PacificSource CO Community Care Organization (CCO) Alternate

Tim Rusk MountainStar Family Relief Nursery Juniper Junction Relief Nursery Director

Kim Snow NeighborImpact Associate Director of Education and Quality Alternate

Diane Tipton Early Intervention Early Childhood Special Education Director

Jerry Upham Z-21 21 Cares for Kids Director of Sales Business Liaison

Kate Wells PacificSource (CCO) Director of Community Health

Patty Wilson NeighborImpact Deputy Director of Early Learning

Wellness and Education Board of Central Oregon (WEBCO) Voting Members

Ken Fahlgren Crook County Commissioner WEBCO Chair COHC Member

Mike Ahern Jefferson County Commissioner COHC Member

Tammy Baney Deschutes County Commissioner COHC Member and Chair

John Rexford High Desert ESD Superintendent ELLC Chair

Wellness and Education Board of Central Oregon (WEBCO) Staff Supporting the EL Hub

Lionel Chad Chadwick WEBCO Executive Director

Brenda Comini WEBCO Early Learning Hub Director

Marissa Becker-Orand Jefferson County Early Learning Hub Liaison and Special Projects

Sarah Peterson Grants and Contract Management

Hillary Saraceno Deschutes County Early Learning Hub Liaison and Special Projects14

RHIP Workgroup Updates March

Behavioral Health Identification amp Awareness

  This group meets the fourth Tuesday of every month from 9-10am and currently has 19 members

  The group has decided that Aprilrsquos meeting will focus on the process of developing algorithms for PCPs around SBIRTCRAFFT and depression screening outcomes and recommended pathways that will be used to educate the provider community The group will discuss baseline OHP data for SBIRTCRAFFT and depression screenings and learn about the SBIRT QIM to understand challenges and successes implementing these screenings A side project with BendLa Pine schools is also developing around a pilot of school-based behavioral health assessments and pathways for services within the community

Behavioral Health Substance Use and Chronic Pain

  This group meets the third Wednesday of every month from 4-5pm and currently has 16 members

  During the April meeting an example of a successful referral pathway to SUD programs will be developed that will be piloted through Mosaic Medical refined and then broadened throughout the community The group will also develop a region-wide referral list for SUD programs that can be shared with providers Additionally a handout created by the Shared Futures Coalition will be updated and offered throughout the community for individuals in need of SUD services

Cardiovascular Disease

  This group meets the fourth Tuesday of every month from 4-5pm and currently has 16 members

  For year one the workgroup decided to focus on the first health indicator improving hypertension control They are looking into expanding the staff training and blood pressure equipment standardization project that Mosaic Medical is piloting with QIM dollars The group is also exploring partnering with schools Boys and Girls Clubs and similar programs throughout the region to increase physical activity and cardiovascular disease prevention and awareness

Diabetes

  This group meets the second Thursday of every month from 9-10am and currently has 18 members

  The group is developing a comprehensive list of pre-diabetes and diabetes programs throughout the region This list will help to identify gaps and focus efforts These resources will also be used to create a list of opportunities for providers and organizations to refer their clients to throughout Central Oregon

15


Oral Health

  This group meets the third Tuesday of every month from 11-12pm and currently has 15 members

  The group requested a hard copy of the Oral Health Coalition document for their April Meeting They will provide recommendations for a resource libraryrepository The group is using the Spectrum of Prevention and will align all current efforts within the framework at the April meeting A presentation of the lsquoLaunchrsquo PSA program will occur in April

Reproductive HealthMaternal Child Health

  This group meets the second Tuesday of every month from 4-5pm and currently has 16 members

  The April meeting will have a Perinatal Care Continuum Presentation They will review 1st trimester visits not captured for credit (included in global cap) Additionally the group requested an AFIX presentation for the May meeting

Social Determinants of Health

  This group meets the third Friday of every month from 10-11am and currently has 32 members

Education amp Health

bull  Identifying what gaps exist using 5 dimensions as outlined in the Early Learning Hub work

Housing

  The workgroup decided to create a subcommittee to develop housing project ideas During the April workgroup meeting members will vet and prioritize project ideas and develop an implementation timeline if time allows

16

Diabetes OrganizationMegan13 Bielemeier St13 Charles13 Medical13 GroupMary13 Deeter La13 Pine13 Community13 Health13 CenterSean13 Ferrell CAC13 Consumer13 RepresentativeUS13 Forest13 ServiceJoan13 Goodwin Volunteers13 in13 MedicineShana13 Hodgson PacificSourceKen13 House13 Mosaic13 MedicalTom13 Kuhn Deschutes13 County13 Health13 ServicesSharity13 Ludwig Advantage13 DentalTherese13 McIntyre Mosaic13 MedicalKelsey13 Meservy Redmond13 School13 DistrictEden13 Miller High13 Lakes13 Healthcare13 -shy‐13 SistersKevin13 Miller High13 Lakes13 Healthcare13 -shy‐13 SistersJules13 Moratti-shy‐Greene High13 Desert13 Food13 amp13 Farm13 AllianceAlbert13 Noyes Mosaic13 MedicalKelly13 Ornberg St13 Charles13 Health13 SystemsCourtenay13 Sherwood Redmond13 School13 DistrictKatrina13 Van13 Dis Central13 Oregon13 Intergovernmental13 CouncilSarah13 Worthington Deschutes13 County13 Health13 Services

Cardiovascular13 Disease OrganizationMary13 Deeter La13 Pine13 Community13 Health13 CenterKathy13 Drew13 Gero-shy‐Leadership13 AllianceBrenda13 Johnson Deschutes13 County13 Health13 ServicesAlison13 Little PacificSourceKylie13 Loving Crook13 County13 Health13 DepartmentMeg13 Moyer Bend-shy‐La13 Pine13 School13 DistrictLeslie13 Neugebauer PacificSourceSummer13 Phinney Bend13 Memorial13 ClinicPenny13 Pritchand Deschutes13 County13 Health13 ServicesNicole13 Rodrigues CAC13 Consumer13 RepresentativeRobert13 Ross St13 Charles13 Health13 SystemSt13 Charles13 Medical13 GroupEmily13 Salmon13 St13 Charles13 Medical13 GroupDivya13 Sharma Central13 Oregon13 IPA13 amp13 Mosaic13 MedicalKaren13 Steinbock Central13 Oregon13 IPAKris13 Williams Crook13 County13 Health13 DepartmentEmily13 Wegener Jefferson13 County13 Health13 Department

17

BH13 Screening13 and13 Awareness OrganizationDeAnn13 Carr13 Deschutes13 County13 Health13 ServicesJeremy13 Fleming PacificSourceMike13 Franz PacificSourceTamarra13 Harris Mosaic13 MedicalJessica13 Jacks Deschutes13 County13 Health13 ServicesSusan13 Keys OSU13 CascadesMalia13 Ladd CAC13 Consumer13 RepresentativeNeighborImpactNicole13 Lemmon Wellness13 amp13 Education13 Board13 of13 Central13 Oregon13 (WEBCO)Sondra13 Marshall St13 Charles13 Health13 SystemWade13 Miller Central13 Oregon13 Pediatrics13 Association13 (COPA)Leslie13 Neugebauer PacificSourceKristi13 Nix High13 Lakes13 HealthcareLaura13 Pennavaria La13 Pine13 Community13 Healthy13 CenterKristin13 Powers13 St13 Charles13 Health13 SystemSean13 Reinhart Bend13 La13 Pine13 School13 DistrictMegan13 Sergi Rimrock13 Trails13 Adolescent13 Treatment13 ServicesRick13 Treleaven BestCare13 Treatment13 ServicesJeffrey13 White CAC13 Consumer13 RepresentativeScott13 Willard Lutheran13 Community13 Services13 Northwest

BH13 Substance13 Use13 amp13 Chronic13 Pain OrganizationErica13 Fuller Rimrock13 Trails13 Adolescent13 Treatment13 ServicesNicole13 Lemmon Wellness13 amp13 Education13 Board13 of13 Central13 Oregon13 (WEBCO)Alison13 Litte PacificSourceLeslie13 Neugebauer PacificSourceMatt13 Owen Bend13 Treatment13 CenterLaura13 Pennavaria La13 Pine13 Community13 Healthy13 CenterSally13 Pfeifer Pfeifer13 amp13 AssociatesChristine13 Pierson Mosaic13 MedicalKristin13 Powers13 St13 Charles13 Health13 SystemBeth13 Quinn Cascade13 Peer13 amp13 Self-shy‐Help13 Center13 amp13 Intentional13 Peer13 SupportElizabeth13 Schmitt CAC13 Consumer13 RepresentativeRalph13 Summers PacificSourceKim13 Swanson St13 Charles13 Medical13 GroupKaren13 Tamminga Deschutes13 County13 Behavioral13 HealthRick13 Treleaven BestCare13 Treatment13 ServicesScott13 Willard Lutheran13 Community13 Services13 Northwest

Oral13 Health OrganizationMarissa13 Becker-shy‐Orand TCLCOral13 Health13 Group13 Jefferson13 13 Suzanne13 Browning Kemple13 Memorial13 Childrens13 Dental13 Clinic13 CAC13 memberKathy13 Drew13 Gero-shy‐Leadership13 AllianceDr13 Fixott Retired13 DentistWendy13 Jackson Central13 Oregon13 Pediatrics13 Association13 (COPA)

18

Elaine13 Knobbs13 Mosaic13 MedicalDyan13 Keuhn NeighborImpactDeborah13 Loy InterdentSharity13 Ludwig Advantage13 DentalMarie13 Manes La13 Pine13 Community13 Health13 CenterDr13 Martin Retired13 DentistKaren13 Nolan Moda13 HealthJill13 Rowe13 13 13 NLP13 Master13 PractitionerHeather13 Simmons PacificSourceLaura13 Spaulding WIC13 SupervisorMary13 Ann13 Wren13 Advantage13 Dental

Reproductive13 amp13 Maternal13 Child13 Health OrganizationTricia13 Clay St13 Charles13 Medical13 GroupLori13 Colvin Healthy13 FamiliesMary13 Deeter La13 Pine13 Community13 Health13 CenterMuriel13 DeLaVergne-shy‐Brown Crook13 County13 Health13 DepartmentPamela13 Ferguson Deschutes13 County13 Health13 ServicesTodd13 Gould Mosaic13 MedicalMaria13 Hatcliffe PacificSourceWendy13 Jackson Central13 Oregon13 Pediatrics13 Association13 (COPA)Heather13 Kaisner Deschutes13 County13 Health13 ServicesTom13 Machala Jefferson13 County13 Health13 DepartmentLinda13 McCoy CAC13 Community13 RepresentativeLaura13 Pennavaria La13 Pine13 Community13 Healthy13 CenterRobert13 Ross St13 Charles13 Medical13 GroupJeff13 Stewart East13 Cascades13 Womens13 GroupEmily13 Salmon13 St13 Charles13 Medical13 GroupHilary13 Saraceno Deschutes13 County13 Health13 ServicesEarly13 Learning13 HubJamie13 Weeks Weeks13 Family13 Clinic

Social13 Determinants13 of13 Health OrganizationBruce13 Abernathy Bend13 La13 Pine13 School13 DistrictPaul13 Andrews High13 Desert13 ESDScott13 Aycock Central13 Oregon13 Intergovenmental13 Council13 (COIC)Kim13 Bangerter COIPAPatty13 Bates Lutheran13 Family13 Treatment13 Services13 NWChad13 Chadwick Wellness13 Education13 Board13 of13 Central13 Oregon13 (WEBCO)Kristin13 Chatfield13 Oregon13 Health13 amp13 Science13 UniversityBrenda13 Comini Early13 Learning13 HUB13 of13 Central13 OregonScott13 Cooper Neighbor13 ImpactKatie13 Condit High13 Desert13 ESDLisa13 Dobey13 St13 Charles13 Health13 SystemKaren13 Friend Central13 Oregon13 Intergovernmental13 CouncilJazlyn13 Halberstadt High13 Desert13 ESD

19

David13 Holloway BMC13 Total13 CareChuck13 Keers Family13 Resource13 CenterElaine13 Knobbs13 Mosaic13 MedicalJulie13 Lyche Family13 Access13 NetworkKat13 Mastrangelo Volunteers13 in13 MedicineMarie13 Manes La13 Pine13 Community13 Health13 ClinicMolly13 Mardesich PacificSourceDesiree13 Margo MA13 Lynch13 Elementary13 School13 Redmond13 School13 DistrictKatie13 McClure Oregon13 Healthiest13 StateShelly13 McKittrick La13 Pine13 Community13 Health13 ClinicDebbie13 Meadows13 Department13 of13 Human13 Services13 (DHS)Ron13 Parsons Self-shy‐Sufficiency13 -shy‐13 Department13 of13 Human13 Services13 (DHS)Katie13 Plumb Crook13 County13 Health13 DepartmentHolly13 Remer High13 Desert13 ESDMichelle13 Riggs Lutheran13 Family13 Treatment13 Services13 NWTim13 Rusk Mountain13 Star13 FamilyCarlos13 Salcedo St13 Charles13 Medical13 GroupEmily13 Salmon13 St13 Charles13 Medical13 GroupHillary13 Saraceno Deschutes13 County13 Health13 ServicesMarney13 Smith Les13 Schwab13 AmphitheaterShelly13 Smith13 Kids13 CenterAndrew13 Spreadborough Central13 Oregon13 Intergovenmental13 Council13 (COIC)Dan13 Varcoe13 Newberry13 HabitatJudy13 Watts13 Central13 Oregon13 Intergovernmental13 CouncilKate13 Wells13 PacificSourceHolly13 Wenzel Crook13 County13 Health13 DepartmentKen13 Wilhelm United13 Way13 of13 Deschutes13 County

20

13 Meeting13 Packet13 httpsgallerymailchimpcomdcbb7a9f7aff441b61f49ef66filesMarch_2016_QHOC_Packetpdf13

Other13 Handouts13 available13 here13 httpwwworegongovohahealthplanPagesCCO-shy‐Quality-shy‐and-shy‐Health-shy‐Outcomes-shy‐Committeeaspx13

Topic Summary of Discussion Impacted Departments

Action Needed

Health Services Updates

bull Acumentra is affiliating with Insight out of Utah Will change their name after fully integrated

bull Youthrsquos Experience of Care Findings from Youth Listening Sessions in Jackson and Umatilla Counties Youth provided their perspective on

o Why they do and do not access preventive health services and

o Recommendations for improving health care for youth

bull LGBTQ Meaningful Care Conference March 25th

bull Training information and resources from the Northwest AIDS Education - Join their listserv

bull Competitive Funding Opportunity Sustainable Relationships for Community Health The Oregon Public Health Division Health Promotion and Chronic Disease Prevention section will be releasing a competitive funding opportunity called Sustainable Relationships for Community Purpose Supports partners to delineate organizational roles for optimizing delivery of 1) cessation support and 2) either chronic disease self-management programs or colorectal cancer screening Recipients conduct an assessment of current practices attend a series of institutes and develop agreements between consortium members to improve referral

Admin BH CQI Compliance Community Development Health Services

httpspublichealthoregongovHealthyPeopleFamiliesYouthPagesResourcesaspx Registration information is available here wwworegonlgbtqhealthorgmcc Listserv httpvisitorr20constantcontactcommanageoptinv=001jQVlpaFBJw8kZ04aZ5PlSokhddeXlR2hdvxP Ek5a2QM6_qSTTkCLifhSrp3pqNZ8zsofF2qwxNHFj67bdVF_oQfX-D_tBjq0ILC6qh-NFW03D

21

and supports HPCDP anticipates three institutes with the first one held in the summer of 2016 Funding period Spring 2016 through June 2017 Eligible applicants Consortia consisting of county local public health agencies CCOs and additional members such as clinical partners and organizations providing supportive community-based services For further information State of Oregon Procurement Information Network (ORPIN) as opportunity 4170

bull Collaboration between Health Care and Public Health The new free publication Collaboration Between Health Care and Public Health (National Academies Press) Describes national state and regional partnerships focused on payment reform specific disease initiatives (hypertension asthma) public-healthhospital collaborations and initiatives focused on building a culture of health

bull Webinar Exploring Comprehensive Diabetes Prevention amp Care in Oregon The Oregon Public Health Division and Q Corprsquos Patient-Centered Primary Care Institute will host a webinar on March 16 2016 from 8-930am on ldquoExploring Comprehensive Diabetes Prevention amp Care in Oregonrdquo

bull Immunization Resources The Oregon Immunization Program has released additional tools for CCOs and clinics in support of the childhood immunization status incentive measure at the clinic level

bull Request for Grant Proposals (RFGP) Behavioral Health Alternative Payment Models

bull Webinar Fundamentals of the National CLAS Standards March 17 2016 at 3 pm ET

bull Behavioral Health Update Applied Behavioral Health Analysis conference 31816 8-5

Collaboration Between Health Care and Public Health httpwwwnapedudownloadphprecord_id=21755 httppcpciorgresourceswebinarsexploring-shy‐comprehensive-shy‐diabetes-shy‐prevention-shy‐and-shy‐care-shy‐in-shy‐oregon13 13 Resources are available at httpspublichealthoregongovPreventionWellnessVaccinesImmunizationImmunizationProviderResourcesPagesAFIXResourceCCOaspx For more information and to apply httporpinoregongovopendllwelcome OHA-shy‐4173-shy‐1613 13 Register here httpsattendeegotowebinarcomregister1124444526228357633 13

22

Legislative Update

Short session ended10 days ago The following of relevance to CCOrsquos were passed bull HB 4107 Timing and retroactivity for amendments

to CCO contracts bull HB 4141 Authorizes OHA to change size of

geographic area served by coordinated care organization under specified conditions

bull HB 4124 PDMP modifications and naloxone prescribingdispensing

Admin bull

General Updates

bull Opioid Prescribing Workgroup ndash to develop statewide guidelines Need 2 CMOrsquos as representatives PDX meetings oncemo x 6-9 months

bull Waiver ndash see pg 29 of the Meeting Packet Information about the waiver is now available on the web site Current waiver from CMS spans 5 years and expires in 2017 Interesting facts

o OHP currently insures 25 of Oregon population

o Oregon has 5 uninsured rate o Current transformation has saved state

and federal government $17 billion o Costs are below national rate of growth o ER visits have decreased 23 since 2011 o decreased hospital admissions for

diabetes and COPD o increased enrollment in PCPCH by 61

Admin BH CQI Health Services

httpwwworegongovohahealthplanpageswaiveraspx

HERC Update bull Back Condition Prescribing Work Group ndash Lisa B will be sending survey monkey asking what CCOrsquos are currently doing Still no implementation date for the guidelines

bull Skin substitutes ndash Additional information was discovered through public comment weak recommendation made for chronic venous leg ulcers and chronic diabetic foot ulcers draft coverage has now gone to HERC for review

bull Metabolic and Bariatric Surgery ndash will expand coverage (and costs) significantly draft is now sent to HERC

CQI GampA Health Services Pharmacy

23

bull Proposed topics as part of the HERC Work Plan

Value-based Benefits sub-committee bull Pectus excavation ndash surgical treatment

considered and new Guideline would cover it No decision yet

bull Guideline Note 6 (PTOTST) ndash question of whether the current Guideline is ldquolegalrdquo for children with disabilities and Autism

bull EPSDT ndash complicated issue Various regs address it including federal mental health parity laws ACA CFR multiple CMS Guidances etc More time is needed to review and will address further in April

bull Gender Dysphoria ndash draft changes made to Guideline Notes Hormone treatment before surgery not required added laser hair removal at site of surgery clarifies coverage of previous surgery revisions add smoking cessation prior to genital surgeries

24

Hepatitis C High Cost Drugs

bull Dr Rickards CMO of OHA discussed issues related to Hep C treatment with costly anti-viral drugs CMS issued a statement to States and OHA issued a letter to CCOrsquos regarding the need to cover these medications at the same level that FFS does There are currently several hearings pending and how the ALJ decides will inform how much CCOs need to comply There was some discussion related to how to manage this expense including

o OHA rebates and cost sharing with CCOrsquos

o use of OR drug purchasing programs o carve outs o 340b pricing o Bundled payments o legislative initiatives

sect ballot initiative would tie OHP costs to VA costs

sect one state is suing based on unfair trade

Health Services Pharmacy

Click13 here13 for13 the13 presentation

April Learning Collaborative Planning MAT

APRIL bull Provide an overview of best practices for Opioid

Treatment Programs (OTP) and Medication-Assisted Treatment (MAT) Discuss innovative programs

bull Describe the role of medications in the treatment of opioid addiction

bull Discuss the management of chronic pain in substance use disorders

bull Provide a summary of OTP MAT and naloxone distribution programs in Oregon

JUNE bull How CCOs can support and encourage providers

in becoming MAT prescribers and in utilizing existing OTPs and MAT prescribers

bull CCOsrsquo responsibilities in tracking and monitoring of programs and prescribers

bull The Statersquos role in monitoring OPTs MAT and naloxone prescribers

BH CQI Health Services Pharmacy

13

25

Equity and Inclusion Coaches

BH CQI Community Development Health Services

See13 pages13 57-shy‐6713 in13 the13 Meeting13 Packet13 for13 details13

Topic

Statewide CCO Learning

Collaborative-

TRANSGENDER HEALTH

Informative presentation on bull Basics of transgender health and the clinical

environment (Look at the slides to become familiar with terminology and definitions)

bull Current research related to transgender health bull Physical and mental health needs of the

transgender individual and the corresponding benefit considerations (Reviewed hormone guidelines letter requirements for surgery etc)

bull A variety of resources are provided in the slide deck

bull Significant disparitiesmistreatment exist in provision of care

bull Revision to Guideline Note 127 o Requires abstinence from tobacco before

genital surgeries o Adds laser hair removal for chestgenital

surgeries o Clarifies when surgical revisions are

covered

ALL SEE THE SLIDE DECK IN THE MEETING PACKET

26

o adds pelvic PT for genital surgeries bull Discussion about whether mental health

assessment is required before hormone suppression therapy in children guideline note requires it presenter said they donrsquot always require it before onset of treatment

Topic

QPI Updates bull QAPI reports due 31616 bull Complaints and Grievance Workshop ndash

CCOrsquos need to provide who will attend bull Statewide13 Opioid13 PIP13 reports13 13 o March13 member13 level13 reports13 are13 available13

through13 Business13 Objects13 tomorrow13 o No13 April13 report13 will13 be13 available13 due13 to13 an13

extended13 leave13 for13 analyst13 o Monthly13 distribution13 of13 report13 will13 be13 in13

conjunction13 with13 dashboard13 timelines13 and13 through13 Business13 Objects13 beginning13 April13 and13 going13 forward13

o February13 report13 was13 not13 completed13 analyst13 was13 formatting13 to13 the13 detailed13 specifications13 (member13 level)13 that13 CCOs13 requested13 from13 JanuaryFebruary13 QHOC13

o Reminder13 If13 you13 need13 the13 crosswalks13 data13 tables13 to13 report13 the13 metric13 in13 house13 please13 let13 me13 know13 and13 I13 can13 connect13 you13 with13 the13 files13

o Rates13 summary13 of13 opioid13 data13 (gt13 12013 and13 gt13 9013 MED)13 shows13 numerator13 denominator13 and13 rates13 by13 CCO13 Transparent13 reporting13 across13 CCOs13 Clarification13 needed13 PLEASE13 RESPOND13 EACH13 CCO13 NEEDS13 TO13 RESPOND13 WITH13 VOTE13 OF13 SHARING13 THE13 RATES13 SUMMARY13 EACH13 MONTH13 ACROSS13 ALL13 CCOS13 (via13 Business13 Objects)13 Unclear13 if13 that13 was13 assumed13 and13 acceptable13 Past13

Analytics BI BH CQI GampA Health Services Pharmacy

27

statewide13 PIP13 data13 was13 quarterly13 and13 shared13 but13 did13 not13 have13 level13 of13 detail13 numeratordenominators13

bull Encounter13 Validation13 13 o This13 document13 shows13 all13 the13 due13 dates13 related13 to13

encounter13 data13 submission13 13 measure13 validation13 httpwwworegongovohaanalyticsDocuments201520Metrics20Timeline20and20Due20Datespdf13 13

bull CCO13 Dashboard13 o February13 dashboards13 were13 not13 available13 due13 to13

conversion13 to13 ICD1013 Monthly13 Dashboards13 will13 be13 available13 March13 and13 going13 forward13 13

Learning Collaborative Brainstorm

bull Learning Collaborative ideas Health Equity SBIRT UnderOver Utilization

Statewide PIP bull Acumentra Standards 1-7 report on this PIP is provided Oregon Statewide Performance Improvement Project on Opioid Safety Reducing Prescribing of High Morphine Equivalent Doses

bull Part II Summary of information from different CCOrsquos is provided

Analytics BH BI CQI Health Services Pharmacy

See report in the Meeting Packet

28

2013 QIM Performance Fund Investmentsmdashas of March 25 2016

ProviderClinic Description of ItemsServices Cost Status Mosaic Medical Staff SBIRT training $608869 Paid

Weeks Family Medicine Pt education materials and training and administration of OKQ for ECU QIM $1105797 Paid

Weeks Family Medicine Staff training and administrative efforts to get AWCVs completed by end of 2015 $120000 Paid

Mosaic Medical

Administrative costs for quality assurance chart audits and coding for potential resubmission of claims to impact SBIRT and ECU QIMs $400000

NTE $4000 awaiting invoice following completion of work

Deschutes County Health Services

Cigarette smoking cessation advertising on CET buses to encourage utilization of the Tobacco Quit Line $4400000 Paid

Crook County Public Health OKQ community provider training for ECU QIM $3720000 Paid

COPA SBIRT training for staff and local stakeholders $750000

Awaiting invoice upon completion of training

Weeks Family Medicine

Administrative costs for quality assurance chart audits and coding for potential resubmission of claims to impact ECU QIMs $400000 Paid

Total $11504666

Remaining funds $19865156

29


Proposal Name Brief Description of Proposal Entity Submitting

Entity to Receive Funds

Amount Requested Status

Access Study

Comprehensive access study of all service delivery areas analyzing qualitative and quantitative data from providers and members PacificSource Morpace $37500000

Quantitative surveying begins late March

Controlling Hypertension

Staff training for standardization in taking blood pressure measurements standardized equipment that is linked to the clinicrsquos EMR PacificSource Mosaic $16000000 Paid

Jefferson HIE

Safe secure and electronic exchange of health information among authorized providers in the health care community for more timely efficient and patient-centered care PacificSource JHIECOHIE

$200357300

Presented at February FC on hold for further vetting

Immunization Incentives

Incentivizing parents of children under two years old with a package of diapers at each well visit and a $25 grocery card at the 18 month visit

La Pine Community Health Clinic

La Pine Community Health Clinic $2500000 Paid

Assessment Feedback Incentives and eXchange (AFIX) vaccine program

Evidence based quality improvement program to assess train and strategize around childhood immunization status

DCHSCOPALa Pine Community Health Clinic DCHS $14900000

Awaiting signed LOA

SBIRT EMR Capabilities and Training

Increases workflow efficiencies for providers to administer SBIRT services


Weeks Family Medicine $400000 Paid


Purchase of two portable blood pressure monitors that interface with EMR and formal staff training



Mobile Dental Unit

Purchase of a mobile dental unit with equipment to provide on-site dental sealants and prevention services at K-8 Crook County schools

Advantage Dental

Advantage Dental $1267000

Awaiting signed LOA

Developmental Screening Training

Two day formal staff training on Developmental Screening tools



Total $275034200

Remaining funds (assuming proposals above are approved) $52082080

30

Provider Engagement PanelFeedback on the RHA and RHIP

RHARHIP Feedback

In 2015 the Operations Council of the Central Oregon HealthCouncil completed the 2015 Regional Health Assessment and 2016-2019 Regional Health Improvement Plan To do this a series ofregional and professional meetings were hosted to understandcommunity partner and stakeholder perceptions related to healthissues and forces of changes that influence Central Oregon

Percent

Strongly AgreeAgree

NeutralDisagreeStrongly Disagree

Input valued andrespected RHA

Input valued andrespected RHIP

Satisfied with extent ofinvolvement RHA

Satisfied with extent ofinvolvement RHIP

Able to provideadequate feedback

RHAAble to provide

adequate feedbackRHIP

5

6

2

5

4 3

6 2

4

2

2

2

31

Meetings AttendedNumber of community andor

professional meetings attended to hearabout issues that community members

and professionals believe are importantto the health of the region

5

2

2+Meetings

0 Meetings

Number of community andorprofessional meetings attended to

hear what was said about the RHIP

5+Meetings

1-2Meetings

3-4Meetings

4

1

Other RHA FeedbackThe RHA should identify at most 3-4 veryimportant topics for the community and

focus all their energies on those areas tosee if we can have a significant impact

Other RHIP Feedback

Dont wait until the last minuteto ask for provider input

Doctors from appropriate fieldsshould be involved in the clinical

section

11 Meeting 3

32

13

13 13 13 13 13 13

MINUTES13 OF13 A13 MEETING13 OF13 PROVIDER13 ENGAGEMENT13 PANEL13

CENTRAL13 OREGON13 HEALTH13 COUNCIL13 March13 0913 201613 from13 70013 am13 -shy‐80013 am13 ndash13 PacificSource13 Boardroom13

13 Members13 Present13 (In-shy‐Person)13 Steve13 Mann13 Chair13 (COIPA13 and13 High13 Lakes13 Healthcare)13 Muriel13 DeLaVergne-shy‐Brown13 (Crook13 County13 Public13 Health)13 Alison13 Little13 (PacificSource)13 13 Sharity13 Ludwig13 (Advantage13 Dental)13 Laura13 Pennavaria13 (La13 Pine13 Community13 Health13 Center)13 Christine13 Pierson13 MD13 (Mosaic13 Medical)13 Rob13 Ross13 (St13 Charles13 Medical13 Group)13 Kim13 Swanson13 (St13 Charles13 Medical13 Group)13 13 Members13 Present13 (Call-shy‐in)13 Divya13 Sharma13 (Mosaic13 Medical13 and13 COIPA)13 13 Guests13 Present13 Gary13 Allen13 (Advantage13 Dental)13 Mark13 Backus13 (Million13 Hearts)13 Rebeckah13 Berry13 (COHC)13 Pamela13 Ferguson13 (DCHS)13 Jeremy13 Fleming13 (PacificSource)13 Maria13 Hatcliffe13 (PacificSource)13 Donna13 Mills13 (COHC)13 Heather13 Simmons13 (PacificSource)13 Laura13 Walker13 (PacificSource) Mary13 Ann13 Wren (Advantage13 Dental) 13 Absent13 David13 Holloway13 (Bend13 Memorial13 Clinic)13 Jennifer13 Laughlin13 (St13 Charles13 Medical13 Group)13 Dana13 Perryman13 (COPA)13 13 13 13 13 13

33

13

Introductions13 amp13 Updates13 bull Dr13 Mann13 welcomed13 all13 attendees13 and13 guests13 were13 introduced13

13 Million13 Hearts13 Hypertension13 Control13 Champion13

bull Dr13 Mark13 Backus13 introduced13 himself13 and13 said13 the13 goal13 for13 blood13 pressure13 was13 debatable13 13 The13 idea13 is13 that13 providers13 that13 spend13 more13 time13 with13 their13 patients13 will13 have13 better13 blood13 pressure13 control13 13

bull Dr13 Mann13 stated13 that13 the13 clinicians13 are13 interested13 in13 costs13 and13 workflow13 with13 the13 enrollment13 of13 Million13 Hearts13 13 Dr13 Backus13 replied13 that13 minimal13 time13 and13 no13 additional13 administration13 is13 required13 and13 there13 is13 added13 prestige13 at13 a13 state13 level13 13

bull Dr13 Pennavaria13 spoke13 about13 her13 practice13 and13 focuses13 on13 blood13 pressure13 13 She13 wanted13 to13 know13 what13 Million13 Hearts13 could13 add13 by13 joining13 13 13

bull Dr13 Backus13 stated13 that13 awareness13 is13 about13 how13 well13 we13 are13 really13 doing13 13 Making13 blood13 pressure13 a13 priority13 and13 getting13 our13 patientrsquos13 blood13 pressure13 under13 control13 is13 key13 13 He13 stated13 that13 sometimes13 it13 feels13 easier13 to13 let13 the13 patient13 decide13 what13 they13 want13 to13 do13 about13 controlling13 their13 pressure13 instead13 of13 pushing13 back13 13 This13 is13 not13 ideal13

bull Dr13 Backus13 explained13 some13 of13 the13 reasons13 for13 high13 blood13 pressure13 such13 as13 sleep13 apnea13

bull Dr13 Ross13 stated13 the13 need13 for13 blood13 pressure13 measurement13 training13 and13 the13 continued13 inadequacy13 of13 measures13 currently13 being13 taken13 13 13 13

CVD13 amp13 the13 Central13 Oregon13 Regional13 Health13 Improvement13 Plan13 bull Dr13 Sharma13 shared13 an13 update13 on13 the13 CVD13 meeting13 13 The13 group13 is13 about13 to13 begin13 the13

development13 of13 their13 year13 one13 work13 plan13 13 13 QIM13 Updates13 201513 and13 201613

bull 201513 Results13 o Ms13 Laura13 Walker13 indicated13 that13 SBIRT13 is13 at13 7213 percent13 and13 needed13 to13 be13 at13

8113 percent13 We13 are13 only13 30013 SBIRTs13 off13 from13 making13 this13 measure13 for13 201513 Ms13 Walker13 said13 they13 were13 close13 enough13 to13 justify13 doing13 more13 validation13 to13 try13 to13 meet13 the13 measure13

o She13 stated13 that13 they13 needed13 paper13 claim13 submissions13 to13 help13 bring13 up13 the13 total13 for13 the13 March13 2313 deadline13 13

bull ED13 utilization13 13 o Ms13 Walker13 stated13 that13 the13 measure13 was13 in13 the13 red13 and13 we13 will13 not13 meet13 this13

measure13 this13 year13 13

bull Effective13 contraceptive13 use13 13 o Ms13 Walker13 indicated13 that13 OHA13 released13 their13 guidelines13 on13 November13 2513

201513 13

34

13

o Ms13 Walker13 said13 they13 were13 completing13 a13 chart13 review13 process13 and13 looking13 at13 claims13 resubmissions13

o Dr13 Pennavaria13 asked13 if13 this13 was13 what13 they13 were13 doing13 at13 La13 Pine13 Community13 Health13 Center13 and13 Ms13 Walker13 said13 yes13

o Ms13 Walker13 revealed13 that13 they13 were13 off13 by13 20013 claims13 and13 with13 clinic13 support13 we13 have13 the13 ability13 to13 have13 this13 in13 the13 green13 and13 meet13 the13 measure13 for13 201513 13

o An13 additional13 three13 million13 dollars13 is13 available13 if13 we13 meet13 these13 measures13 but13 we13 will13 lose13 that13 amount13 if13 we13 do13 not13 13

bull Hypertension13 13 o Ms13 Walker13 said13 that13 hypertension13 measure13 is13 currently13 in13 the13 red13 o Three13 measures13 together13 are13 Electronic13 Health13 Record13 (EHR)13 based13 o Dr13 Pennavaria13 asked13 if13 this13 was13 the13 last13 blood13 pressure13 measurement13 of13 the13

year13 the13 one13 used13 13 Ms13 Walker13 replied13 yes13 this13 is13 an13 HEDIS13 measure13 and13 there13 is13 no13 chance13 to13 change13 it13

13 bull Ms13 Walker13 shared13 the13 QIM13 measures13 that13 were13 in13 the13 green13

13 13 bull CAHPS13 13

o Ms13 Walker13 stated13 that13 last13 year13 they13 did13 not13 pass13 these13 measures13 o Ms13 Walker13 shared13 that13 chart13 reviews13 were13 in13 progress13 o Dr13 Pennavaria13 spoke13 about13 global13 billing13 and13 having13 a13 particular13 code13

assigned13 to13 assist13 with13 billing13 13 o Ms13 Walker13 said13 that13 all13 providers13 have13 to13 use13 the13 same13 code13 for13 this13 to13 be13

beneficial13 13 13

DCO13 Incentive13 Proposal13 Background13 bull Ms13 Heather13 Simmons13 provided13 an13 overview13 of13 what13 the13 DCO13 is13 and13 shared13 about13

their13 payment13 structures13 bull She13 thanked13 the13 group13 for13 being13 willing13 to13 review13 the13 proposed13 payment13 structures13

in13 the13 April13 meeting13 13

NEMT13 Stakeholder13 Provider13 Volunteer13 13 bull Dr13 Mann13 spoke13 about13 non-shy‐emergency13 medical13 transportation13 bull Dr13 Mann13 feels13 an13 individual13 with13 a13 clinical13 background13 needs13 to13 sit13 on13 this13

committee13 bull Grid13 Works13 has13 been13 hired13 to13 facilitate13 this13 work13 group13 bull ACTION13 13 Ms13 Berry13 will13 attend13 this13 meeting13 and13 offer13 feedback13 to13 this13 group13 at13 the13

next13 meeting13

35

bull Dr13 Mann13 believes13 the13 provider13 who13 volunteers13 should13 be13 from13 an13 FQHC13 or13 a13 clinicadministrator

Quality13 amp13 Health13 Outcomes13 Committee13 (QHOC)13 Monthly13 Update13 bull Ms13 Maria13 Hatcliffe13 shared13 an13 update13 on13 the13 QHOC13 and13 pointed13 out13 the13 links13 that13 are

available13 in13 the13 notes13

Consent13 Agenda13 bull Dr13 Mann13 made13 a13 motion13 to13 accept13 the13 draft13 minutes13 dated13 February13 1013 201613 and

are13 subject13 to13 correctionslegal13 review13 13 Minutes13 were13 approved13

36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

From Heather SimmonsTo Heather SimmonsSubject PacificSourceDCO Incentive Payment Structure Proposal OpportunityDate Wednesday January 20 2016 83939 AMAttachments image001png

CGHC Contracting Principles Final Version 11pdfCOHC Alternative Payment Methodology and Contracting Principles (1)-2pdfCCO Metric Setpdfimage003png

Importance High

SENT 112315Good Afternoon Irsquom reaching out to you to talk about alternative payment methodologies and creative incentive arrangements well in advance of the next DCO contract amendment cycle I recall that during contracting activities in summer 2015 DCOs expressed a strong interest in discussing and developing new incentives and alternative payment methodologies (APMs) We also know that the health councils have developed community guidelines around APMsmdashand that some community funds exist to promote innovative models In addition we recognize that DCOs have been piloting individual efforts to utilize incentive structures Those progressive approaches may be unknown to many CCOs including PacificSource We want to leverage opportunities for our DCOs to work together with PacificSource towards increased alignment and visibility of these strategies in the DCO contracts We are hopeful that effective and promising strategies that you have piloted can be ldquospreadrdquo across the dental services system We can all benefit from your unique experience managing capitation and this population Looking ahead to the July 2016 contract amendment we would like to work with you to create the care access and utilization landscape we collectively desire for our respective members We also hope to increase parity across behavioral health medical and dental contracts To promote achieving these goals we would like each DCO in our respective regions to collaborate with each other on the research and development of 3-4 outcomes-focused incentive payment structures or metrics We are eager to take this consensus and build towards the July 2016 contract amendment We suggest that proposed structures or metrics should clearly demonstrate how they achievealign with the following (and acknowledge that you may identify additional sources of guidance to help influence proposed options)

Better population health outcomes better member care and better control of costuse of resourcesThe Central Oregon Health Councilrsquos and the Columbia Gorge Health Councilrsquos Contracting PrinciplesMinimum care expectation outcome deliverablesCCO Oregon-Dental Quality Measure Core Set and A La Carte Measures

We anticipate that proposed structures or metrics will help promote shared PacificSource and DCO aims for care and outcomes as well as promote shared success on quality incentive measures (QIMs) We are excited to see proposals that promote the following

Consistent uniform clinical quality of care and timeliness of access to services across the

P a g e 1 | 5

P a g e 2 | 5

P a g e 3 | 5

P a g e 4 | 5

o Family Health

o Infrastructure

survey results

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

P a g e 1 | 5

P a g e 2 | 5

P a g e 3 | 5

P a g e 4 | 5

o Family Health

o Infrastructure

survey results

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

P a g e 2 | 5

P a g e 3 | 5

P a g e 4 | 5

o Family Health

o Infrastructure

survey results

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

P a g e 3 | 5

P a g e 4 | 5

o Family Health

o Infrastructure

survey results

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

P a g e 4 | 5

o Family Health

o Infrastructure

survey results

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

P a g e 5 | 5

pharmacy)

Financial measures

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

CCO Metric Setvsd

Page-1

Page-2









3





4















5







6


tiliz

atio

n-A

du

lts

Uti

lizat

ion

-Ch

ildre

nP

reve

nta

tive

Ser

vice

sC

AH

PS

ndash A

cces

s to

Car

e +

Pat

ien

t Ex

per

ien

ceSm

oki

ng

Ces

sati

on

Emer

gen

cy D

epar

tmen

tEm

erge

ncy

Dep

artm

ent























Pregnant Women

























7


uo

rid

e V

arn

ish

Pre

gnan

t W

om

enEx

ams

Vis

its

Dia

bet

esA

dd

itio

nal

ED





































































8



9









school and life











10









targeted outcomes





ment





















11

Appendix A







child development









child development






health services






child development

12

Appendix B




























13

Appendix C

















































Diabetes



15


Oral Health










Housing


16



17




18




19


20




Action Needed











21









22

Legislative Update





Admin bull

General Updates













23







24




















13

25




Topic


Collaborative-

TRANSGENDER HEALTH










covered


26



Topic










27












28





Mosaic Medical










Total $11504666


29





Access Study





Jefferson HIE


$200357300









Awaiting signed LOA









Mobile Dental Unit


Advantage Dental


Awaiting signed LOA





Total $275034200


30


RHARHIP Feedback


Percent

Strongly AgreeAgree







RHAAble to provide


5

6

2

5

4 3

6 2

4

2

2

2

31




5

2

2+Meetings

0 Meetings



5+Meetings

1-2Meetings

3-4Meetings

4

1



Other RHIP Feedback



section

11 Meeting 3

32

13

13 13 13 13 13 13




33

13

















201513 13

34

13











beneficial13 13 13






next13 meeting13

35






36

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

ndash A

Pregnant Women

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

school and life

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

targeted outcomes

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Appendix A

child development

health services

child development

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Appendix B

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Appendix C

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Diabetes

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Oral Health

Housing

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Action Needed

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Legislative Update

Admin bull

General Updates

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Collaborative-

TRANSGENDER HEALTH

covered

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Mosaic Medical

Total $11504666

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

Access Study

Jefferson HIE

$200357300

Awaiting signed LOA

Mobile Dental Unit

Advantage Dental

Awaiting signed LOA

Total $275034200

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

RHARHIP Feedback

Percent

Strongly AgreeAgree

RHAAble to provide

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

2+Meetings

0 Meetings

5+Meetings

1-2Meetings

3-4Meetings

Other RHIP Feedback

section

11 Meeting 3

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

13 13 13 13 13 13

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

201513 13

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

beneficial13 13 13

next13 meeting13

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2

CCO Metric Setpdf

CCO Metric Setvsd

Page-1

Page-2