To develop and implement innovative strategies that improve health through the active participation of the Central Oregon community.
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- Duane Pope
- 8 years ago
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2 Mission To develop and implement innovative strategies that improve health through the active participation of the Central Oregon community. Vision The vision of HealthMatters of Central Oregon is to become the premier community model by improving the health of Central Oregonians through innovative, equitable and sustainable systems.
3 Who We Are The Board of Directors includes health and human service leaders, business leaders, policy makers, community advocates and others. These unlikely allies are working together to coordinate services, improve access and effect health system change within our region.
4 Board of Directors Mike Bonetto, President Wendy Schechter, Vice President Charla DeHate, Secretary Senator Chris Telfer, Treasurer Laura Brennan Beth Ann Beamer, RN Former Senator Bev Clarno James A. Diegel Jill Freeman Ryan Gallivan, MD Gunnar Hansen Scott Johnson Mary Jeanne Kuhar, MD Marvin Lein Jim Lussier Patrick O Keefe Ken Provencher Christine Winters
5 Addressing a Need Need within Crook, Deschutes and Jefferson Counties: Central Oregon's uninsurance rate is over 20%, or more than 40,000 people the highest in the state, and 78% more than its rate in Based on 2010 Oregon County Health Rankings, Jefferson County is ranked 33 out of 33 in poor health outcomes and health factors.
6 Dedicated to improving the health of Central Oregonians through these initiatives:
7 Trails to Health Empower people with information, skills and resources for better health and health care. Help employees and their families promote health, prevent illness and make informed decisions. Support employers to manage health costs and rate increases, reduce absenteeism, and improve productivity and morale.
8 What Trails to Health Offers Online Tools Health Coaching Health Risk Assessments Plus more Trails to Health will benefit SharedCare members and local employers
9 Living Well Central Oregon Developed and tested by Stanford University, this six week workshop teaches skills for living a healthy life while living with chronic conditions. Participants learn: Practical ways to deal with pain and fatigue Better nutrition and exercise choices New treatment choices Better ways to talk with doctor and family Possible due to funding from PacificSource Charitable Foundation, DHS, partnerships with tri county health departments, federally qualified health centers, and hospital system.
10 Living Well Central Oregon Workshops are held in Bend, La Pine, Madras, Prineville and Redmond (2010 focus: Warm Springs) In 2009, 17 workshops were held with over 223 people registered. In the first quarter of 2010: 7 workshops were held with over 85 people registered For more information, to register for a workshop or view video testimonials visit website at: livingwellco.org
11 What is SharedCare? Community Health Improvement Plan Provide affordable, comprehensive health care benefits to uninsured, low wage employees in Crook, Deschutes and Jefferson counties. Made possible by Oregon Senate Bill 862 and federal funding from the Health Resources and Services Administration received through the Oregon Department of Human Services
12 SharedCare offers affordable health care by encouraging: Effective use of health services and community resources Care Coordination Health Education Member Responsibility Provides health care coverage to uninsured workers in small businesses with 1 to 50 employees
13 A Healthier Community Benefits All of Us Stakeholders Employers Hospitals & Physicians Patients* Benefits Increased worker productivity Increased revenue Decreased costs and improve health * Patients are employees and their families who chose to enroll in the program Information taken from Oregon Health Authority Return on Community Investment analysis
14 SharedCare Plan Benefits Physician Services Routine Diagnostic Testing In patient Hospital Services Out patient Hospital Services Emergency Room Services Ambulance Services Behavioral Health Physical/Occupational/Speech Therapy Prescription drugs Screening Mammograms MRI s, Colonoscopies, etc. Specialist Visit Out patient Surgery Pre natal care Urgent Care DME/Orthotics/Devices Coverage only available in Crook, Deschutes & Jefferson County
15 SharedCare Plan Exclusions Contraceptive supplies and devices Dental services Cosmetic surgery Orthopedic shoes Corrective lenses, frames, contact lenses, and refractive surgery Hearing aids Routine hearing and vision exams Experimental and investigational services Use of emergency room for nonemergency services Treatment for infertility Medical or surgical obesity treatment, weight loss programs Treatment or surgery for sexual dysfunction Air ambulance Health care services provided outside of Crook, Deschutes and Jefferson counties Alternative care services Private rooms and personal comfort items
16 SharedCare Plan Eligibility Employer Eligibility Requirements Business as defined by IRS For 12 months prior to enrollment (or for duration of operations if less than 12 months) has not have provided employer based health insurance coverage for which the employer contributes at least 50% of the cost of premiums Median wage of all eligible employees is $16/hour or less Employee Eligibility Requirements Employed by qualified employer Employed within Crook, Deschutes & Jefferson counties Does not have health insurance or qualify for publicly funded health care Prior to effective date must have been employed by current employer for 13 weeks and work an average of 15.4 hours per week
17 How it Works Cost of Coverage Split Between Employer 30% Employee 30% Community 40% Improve Access to Health Care Low monthly premiums and co pays Two Plans (Health Improvement Plan and Standard Plan) Health Improvement Plan ($98): $49/month for employee & employer Standard Plan ($140): $70/month for employee & employer No exclusions for pre existing conditions and no deductibles
18 Links 4 Health : Health Goals Develop pathways to coordinate care for specific high need populations Initial focus on: Children & Youth, Behavioral Health, and SharedCare members coordinated, ongoing complete care enough private and/or public insurance to pay for the services they need early and regular screening to identify potential needs assistance with decision making at all levels to make sure clients are satisfied with the services they receive services for clients organized in ways that clients can use them easily
19 How Links 4 Health Works A Community Links Specialist helps clients/families navigate services and community resources. Examples may include: Linking with a primary care provider Insurance coverage Development screenings Mental Health and County services Other necessary social services
20 Links 4 Health : Children & Youth High Risk Neonates Born less than 34 weeks At risk physically, developmentally, family dynamics, social health Children and Youth with Special Healthcare Needs Presence of two different health consequences (medical or behavioral) of medium to high risk Expected duration one year or more Three to twenty four years old
21 Links 4 Health : Children & Youth Neonate Program Since starting in January we have: Clients Enrolled: 18 (7 more pending) Pathways: 77 Current Pathways include: Medical Home Connection, Medical Home Utilization, Health Care Coverage, NICU Clinic, CaCoon Nurse, Screening Clinic, and Referral and Connections. Additional Pathways under development: Mental Health, Multidisciplinary assessment services, Parenting Education, Dental Pathway, and Head Start
22 Links 4 Health : Health Integration Program Creation of Primary Medical Homes Target populations High Frequency Emergency Department users Severely and Persistently Mentally Ill with concurrent chronic physical health conditions Community Links Specialists Peer Specialists with additional training Work with the Primary Behavioral Health Consultant at the Primary Medical Home Target Start Date: June 1, 2010
23 For more information healthmattersco.org (541)
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthoptions.org or by calling 1-855-624-6463. Important
2016 Summary of Benefits
2016 Summary of Benefits Health Net Violet Option 3 (PPO) Douglas and Josephine counties, OR Benefits effective January 1, 2016 H5520 Health Net Life Insurance Company H5520_2016_0202 CMS Accepted 09162015
Health Insurance Matrix 01/01/16-12/31/16
Employee Contributions Family Monthly : $121.20 Bi-Weekly : $60.60 Monthly : $290.53 Bi-Weekly : $145.26 Monthly : $431.53 Bi-Weekly : $215.76 Monthly : $743.77 Bi-Weekly : $371.88 Employee Contributions
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Personal Alliance 3000 Silver OFF
Personal Alliance 3000 Silver OFF Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016-12/31/2016 Coverage for: Individual / Family Plan Type: HMO This is
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.maineoptions.org or by calling 1-855-624-6463. Important