Clatsop Pacific Coordinated Care Organization (CCO) Clatsop County Data Summary

Transcription

1 Clatsop Pacific Coordinated Care Organization (CCO) Clatsop County Data Summary

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3 Changes in Oregon Health Plan Healthcare Coordination & Integration Coordinated Care Organizations Community Advisory Councils

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5 OHP Client Physical Health Mental Health Addictions TX Oral Health Assessment Diagnosis Treatment Plan (EBP) Pre-set rate per service Monitor / Update Assessment Diagnosis Treatment Plan (EBP) Pre-set rate per service Monitor / Update Assessment Diagnosis Treatment Plan (EBP) Pre-set rate per service Monitor / Update Assessment Diagnosis Treatment Plan (EBP) Pre-set rate per service Monitor / Update

6 Local Control (different CCO models) Coordination Integrate Physical health, mental health, dental health single point of accountability Metrics / Performance Measures Operate under contracted performance standards with clinical, financial and operational metrics Global Budget And Shared Saving More flexibility to manage dollars Coordinated Care Organizations Primary Care Health Homes Center of patients coordinated care. Includes a team that works on keeping patients at their healthiest. Community Advisory Council Each CCO convenes a CAC to ensure that the health care needs of consumers are being addressed

7 CCO created a culture which allowed providers to bring these local activities into the next generation of integration Why This Why Now?

8 Better Health Care System Better Health Outcomes Cost Savings

9 Improve Health System, Improve Health Outcomes, Lower Costs All OHP Clients At High Risk - Chronic Disease Chronic Disease Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management Reduce likelihood become chronic Coordinated case management Reduce high end costs

10 All OHP Clients At High Risk - Chronic Disease Chronic Disease Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management reduce likelihood become chronic Coordinated case management Reduce high end costs

11 All OHP Clients At High Risk - Chronic Disease Chronic Disease Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management reduce likelihood become chronic Coordinated case management Reduce high end costs

12 All OHP Clients At High Risk - Chronic Disease Chronic Disease Early Assessment & Identification of High Risk For Chronic Disease Coordinated case management reduce likelihood become chronic Savings = reinvestment into system incentive, etc. Coordinated case management Reduce high end costs

13 Cost Impact Sample Using Diabetes for A Single Oregon County: Number of Persons: Number of Deaths: Costs: 9, $42.6M If you can prevent 4.67% of people from getting Diabetes: If you can prevent 20% of people from getting Diabetes: Number Prevented: 437 Lives Saved: 32 Financial Cost Savings: $2 M 1, $8.52 M

14 Cost Impact Sample Using Diabetes for Douglas County: The risk of Type 2 Diabetes can be reduced by 50-70% by control of obesity And by 30-50% by increasing physical activity $8.52 Million Question: What is the likelihood of preventing 5%, 10%, 20% of population from getting Diabetes? If you can prevent 4.67% of people from getting Diabetes: Number Prevented: 437 Lives Saved: 32 Financial Cost Savings: $2 M If you can prevent 20% of people from getting Diabetes: 1, $8.52 M

15 Personal impact cannot be quantified Can apply model to other chronic diseases Each has risk factors which increase the likelihood of illness: Heart Disease and Stroke Prevention: No tobacco Physically active Healthy weight Healthy food choices Preventing / controlling high blood pressure point reduction in average systolic blood pressure over 4 years reduces heart disease risk by 21%, stroke risk by 37% Cancer Prevention: No tobacco Limiting alcohol Limited exposure to ultraviolet rays Diet rich in fruits and vegetables Maintaining a health weight Being physically active Seeking regular medical care

16 PCP Oral Health Addictions Mental Health

17 Health Integration System Family Behavioral Health Spiritual Community Patients Mental Health Providers Dental Health Peers Physical Health Neighborhood Health

18 15 CCO management areas Community Advisory Councils Ensure health care needs of consumers are being met. Community / consumer focus within CCO s work to accomplish vision Improve Health Care System, Improve Health Outcomes, Lower Costs Current Goal Identify 3 priority areas to improve health then identify strategies to reach that goal 18

19 National / State Studies: Higher death rates related to: Heart disease Stroke Unintentional injuries Summary of Findings Community Responses (Not in specific Order) Higher death rate from drug induced causes Slightly higher death rates related to alcohol induced diseases Higher rates of: DUII rates Heavy drinking female Youth who use marijuana Limited access to health foods Higher rates of preventable hospital stays Higher percentage of reporting of depression/anxiety and high blood pressure (CP CCO Medicaid data) Conditions create a healthy community: Jobs Clean environment / Access to healthy foods Affordable housing / Education Schools Health problems in community: Alcohol / drug addiction Obesity Cancer 3 things to improve community health: Health education Expand OHP More doctors

20 Poor Or Fair Health 14% 14% 12% 13% 10% 10% 8% 6% 4% 2% 0% Clatsop Co Oregon National Benchmark

21 Premature Death 7,000 6,000 6,585 6,076 5,000 5,317 4,000 3,000 2,000 1,000 - Clatsop Oregon National Benchmark

22 Poor Physical Health Days Clatsop Oregon National Benchmark

23 Chronic Condition Diagnoses Medicaid-eligible Population (CPCCO Service Area Chronic Health Conditions Percent told they have it by a physician (N= 1,486) Of those percent currently taking RX for it Diabetes High cholesterol High blood pressure Depression / anxiety Asthma Emphysema / COPD Heart attack / Angina Congestive heart failure 2 69 Kidney problem Cancer

24 Poor Mental Health Days Clatsop Oregon National Benchmark

25 Low Birthweight 6.1% 6.1% 6.1% 6.0% 6.0% 6.0% 5.9% 5.9% 5.9% 5.8% Clatsop Oregon National Benchmark

26 Leading Cause of Death - Rate Per 100,000 (5 year average) Cause Clatsop County Oregon Heart Disease Stroke Unintentional Injuries Suicide

27 Health Behaviors

28 Adult Smoking 25.0% 20.0% 21.0% 15.0% 10.0% 17.0% 13.0% 5.0% 0.0% Clatsop Oregon National Benchmark

29 Excessive Drinking 16.0% 14.0% 12.0% 10.0% 15.0% 16.0% 8.0% 6.0% 7.0% 4.0% 2.0% 0.0% Clatsop Oregon National Benchmark

30 Binge Drinking 20.0% 18.0% 18.7% 16.0% 14.0% 16.3% 12.0% 10.8% 10.0% 8.0% 9.8% 6.0% 4.0% 2.0% 0.0% Male Clatsop Co. Male Statewide Female Clatsop Co. Female Statewide

31 Heavy Drinking 10.0% 9.0% 9.7% 8.0% 7.0% 6.1% 6.0% 5.0% 4.0% 4.8% 5.4% 3.0% 2.0% 1.0% 0.0% Male Clatsop Co. Male Statewide Female Clatsop Co. Female Statewide

32 DUI Rates Per 100, Clatsop Oregon

33 Percent Motor Vehicle Fatalities Involving Alcohol Oregon Clatsop 00 - ' '05 02-'06 03-'07 04-'08 05-'09 06-'10

34 Death Rate from Alcohol-Induced - Diseases per 100, Clatsop C ' '05 02-'06 03-'07 04-'08 05-'09 06-'10 07-'11

35 Percent of Youth Who Had Drank Alcohol Past 30 Days (11 th Grade)

36 Percent of Youth Who Binge Drink in the Past 30 Days (11 th Grade) Clatsop

37 Percent of Youth Who Drove When Drinking Alcohol (11 th Grade) Clatsop

38 Death Rate from Drug-Induced Causes per 100, Clatsop ' '05 02-'06 03-'07 04-'08 05-'09 06-'10 07-'11

39 Percent Who Used Illicit Drug(s) Other Than Marijuana in Past 30 Days Clatsop to 17 yrs yrs 26 or older

40 Percent of Youth Who Used Marijuana In Past 30 Days (11 th Grade) Clatsop

41 Death Rate from Suicide per 100, Clatsop ' '05 02-'06 03-'07 04-'08 05-'09 06-'10 07-'11

42 10 Percent of Youth Who Attempted Suicide in the Past Year (11 th Grade) Clatsop

43 Percent of Youth Who Had Depressive Episode in the Past Year (11 th Grade) Clatsop

44 Obesity and Access to Recreation

45 Obesity 25.0% 25.0% 24.9% 24.8% 24.7% 24.6% 24.5% 24.5% 24.4% 24.3% 24.2% Clatsop Oregon

46 Physical Inactivity 21.0% 21.0% 20.5% 20.0% 20.0% 19.5% 19.0% 18.5% 18.0% 18.0% 17.5% 17.0% 16.5%

47 Access To Recreational Facilities Clatsop Oregon National Benchmark

48 Limited Access To Healthy Foods.0%.0% 11.0%.0%.0%.0% 5.0%.0%.0% 1.0% Clatsop Oregon National Benchmark

49 Fast Food Restaurants 45.0% 40.0% 43.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 25.0% 27.0% 0.0% Clatsop Oregon National Benchmark

50 Clinical Care

51 Uninsured 25% 20% 21% 20% 15% 10% 11% 5% 0% Clatsop Oregon National Benchmark

52 Preventable Hospital Stays Clatsop Oregon National Benchmark

53 Diabetic Screening 90.0% 90.0% 89.0% 88.0% 87.0% 87.0% 86.0% 86.0% 85.0% 84.0% Clatsop Oregon National Benchmark

54 Mammography Screening 74.0% 72.0% 73.0% 70.0% 68.0% 66.0% 66.0% 64.0% 64.0% 62.0% 60.0% 58.0%

55 Up-to-date Immunizations Among Two-year Olds 69.5% 69.4% 69.0% 68.5% 68.0% 67.5% 67.6% 67.0% 66.5% Clatsop Oregon

56 Mothers Receiving Inadequate Prenatal Care 5.5% 5.5% 5.4% 5.3% 5.2% 5.1% 5.0% 4.9% 4.9% 4.8% 4.7% 4.6% Clatsop Oregon

57 Percent Age 20+ with Diabetes 9.0% 9.0% 8.8% 8.6% 8.4% 8.2% 8.0% 7.8% 7.9% 7.6% 7.4% 7.2% Clatsop Oregon

58 Social, Economic, and Physical Environment

59 High School Graduation 68.0% 68.0% 67.5% 67.0% 66.5% 66.0% 66.0% 65.5% 65.0% Clatsop Oregon

60 Some College 70.0% 70.0% 68.0% 66.0% 64.0% 65.0% 62.0% 60.0% 58.0% 59.0% 56.0% 54.0% 52.0% Clatsop Oregon National Benchmark

61 Unemployment 9.0% 8.0% 7.0% 6.0% 8.5% 8.7% 5.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% Clatsop Oregon National Benchmark

62 Children In Poverty 30.0% 25.0% 20.0% 28.0% 23.0% 15.0% 14.0% 10.0% 5.0% 0.0% Clatsop Oregon National Benchmark

63 Inadequate Social Support 16.0% 16.0% 16.0% 15.5% 15.0% 14.5% 14.0% 14.0% 13.5% 13.0% Clatsop Oregon National Benchmark

64 Children in Single-parent households 40.0% 35.0% 37.0% 30.0% 30.0% 25.0% 20.0% 20.0% 15.0% 10.0% 5.0% 0.0% Clatsop Oregon National Benchmark

65 Teen Birth Rate Clatsop Oregon National Benchmark

66 Violent Crime Rate Clatsop Oregon National Benchmark

67 A Look At Who We Are

68 Average Age? Oregon = 38.1 Clatsop County = 42.7

69 Age % 23.4% 20.0% 19.1% 15.0% 10.0% 5.0% 0.0% Clatsop Oregon

70 Under Age % 23.0% 22.5% 22.0% 21.5% 21.0% 20.9% 20.5% 20.0% 19.5% Clatsop Oregon

71 Percent White / Caucasian 88.0% 87.8% 86.0% 84.0% 82.0% 80.0% 79.3% 78.0% 76.0% 74.0% Clatsop Oregon

72 Percent African American 1.8% 1.6% 1.7% 1.4% 1.2% 1.0% 0.8% 0.6% 0.6% 0.4% 0.2% 0.0% Clatsop Oregon

73 Percent Indian or Alaskan Native 1.0% 1.0% 0.9% 0.8% 0.7% 0.6% 0.5% 0.4% 0.3% 0.2% 0.3% 0.1% 0.0% Clatsop Oregon

74 Percent Asian or Pacific Islander 4.0% 3.9% 3.5% 3.0% 2.5% 2.0% 1.5% 1.0% 0.5% 0.0% Clatsop 0.9% Oregon

75 Percent Other Race 0.3% 0.3% 0.3% 0.2% 0.2% 0.1% 0.1% 0.1% 0.0% Clatsop Oregon

76 Percent Two or More Races 3.0% 2.5% 2.8% 2.8% 2.0% 1.5% 1.0% 0.5% 0.0% Clatsop Oregon

77 Percent Male 49.6% 49.6% 49.6% 49.6% 49.5% 49.5% 49.5% 49.5% 49.5% 49.5% 49.4% Clatsop Oregon

78 Percent Who Speak Language Other than English At Home 16.0% 14.0% 14.3% 12.0% 10.0% 8.0% 7.8% 6.0% 4.0% 2.0% 0.0% Clatsop Oregon

79 Housing Vacancy Rate 25.0% 23.7% 20.0% 15.0% 10.0% 9.2% 5.0% 0.0% Clatsop Oregon

80 Percent Households With Retirement Income 25.0% 20.0% 15.0% 21.9% 17.9% 10.0% 5.0% 0.0% Clatsop Oregon

81 Percent Households with Social Security Income 34.0% 33.0% 33.3% 32.0% 31.0% 30.0% 29.0% 28.0% 28.2% 27.0% 26.0% 25.0% Clatsop Oregon

82 Community Survey Preliminary Data: 189 Community Surveys

83 1. In the past year, have you or anyone living in your home used health services at any of the following locations? Please select all that apply: Percent Number Hospital 54% 102 Urgent care 44.4% 84 Doctor s office or other outpatient medical clinic 70.9% 134 Veterans health Administration hospital or clinic 5.3% 10 Addictions treatment center 1.1% 2 Dental services 61.4% 116 Public health department 20.1% 38 Mental health / behavioral health or other counseling 19.6% % 18

84 2. What conditions exist now in your community to help create or foster good health? Please select all that apply: We have good doctors (They care about patients, provide good health care, etc.) We have local access to specialty services (A focus on specific area of care like a heart doctor) There are good prevention services that help reduce health problems (Services that help people quit smoking or to eat healthy) Citizens make use of recreational activities (Helps with exercising and stress reduction, etc.) 68.8% % % % 90

85 3. What do you think are the three (3) most important ways to create a healthier community? Please select only 3 A clean environment 37.6% 71 Mental health treatment 21.2% 40 Access to healthy foods 37% 70 Food banks/hunger programs 17.5% 33 Affordable housing 32.8% 62 Low crime/safe neighborhoods 14.8% 28 Cultural acceptance 7.9% 15 Sports and recreation activities 18% 34 Education / Schools 31.2% 59 Tobacco prevention / treatment services Drug/alcohol 21.2% 42 Job opportunities and a healthy prevention and economy treatment Health prevention and wellness education 22.2% 42 Better access to health care services 7.9% 15 45% % 45

86 4. What do you think are the three (3) most critical health problems in your community? (those problems which have the greatest impact on overall community health) Cancer 21.7% 41 Lack of mental health treatment 3.7% 7 facilities Respiratory/lung disease 4.2% 8 High crime rates 4.2% 8 HIV/AIDS 2.6% 5 High cost of mental health services 3.7% 7 Diabetes 18% 34 Not enough doctors and clinics 9% 17 Heart disease / stroke 6.9% 13 High cost of health care / lack of 6.3% 12 health insurance High blood pressure 9% 17 Too few recreational and exercise 2.6% 5 facilities Tobacco use 15.9% 30 Poor eating habits 14.8% 28 Obesity 29.1% 55 Lack of access to healthy foods 5.8% 11 Mental Illness 15.3% 29 Domestic violence 3.7% 7 Alcohol/drug addiction 36% 68 Lack of transportation to medical 4.2% 8 facilities Dental problems 9.5% 18 Too little affordable housing 6.9% 13 Sexually transmitted 3.7% 7 Child abuse 6.3% 12 diseases Suicide 3.2% 6 Too few educational opportunities after high school (college, trade schools, et.) 6.3% 12

87 5. If you could pick just three (3) things to improve your community's access to health care, what would they be? Please pick only 3 boxes: More health education services 30.7% 58 More doctors 31.7% 60 More illness prevention services 5.3% 10 More alcohol and drug treatment 36% 68 More dentists 13.2% 25 Doctor appointments after 5 pm or on weekends 27% 51 More culturally sensitive care 4.2% 8 Transportation assistance 13.8% 26 More mental health services 26.5% 50 Alternative health care 18.5% 35 Expand the OHP (Medicaid) 37.6% 71 More tobacco cessation programs 8.5% 16

88 6. Think about the most recent time when you or a family member living in your home went without needed health care. What were the reasons why? Please check all that apply It costs too much 46.6% 88 Don t know where to go to get care 3.2% 6 Don t have insurance 30.2% 57 Afraid of what they might find wrong with me 7.4% 14 Childcare issues 2.6% 5 Do not have a regular doctor 14.3% 27 Transportation problems 9.5% 18 Couldn t get appointment quickly enough 11.6% 22 Don t like doctors 10.1% 19 On the Oregon Health Plan, but do not have a doctor Waited for the health 28% 53 Doctor s office not open not open problem to go away when needed 1.6% % 29

89 7. Age

90 8. Gender

91 Income Race / Ethnicity: Less than $5, % 30 American Indian or Alaska Native 5.3% 10 $5,000 - $15, % 37 Asian 1.1% 2 $16,000 - $25, % 26 Black or African American 1.6% 3 $26,000 - $40, % 32 Latino / Hispanic 6.3% 3 $41,000 - $70, % 26 Native Hawaiian or Other Pacific Islander 1.1% 2 $71,000 - $100, % 16 White 79.9% 151 More than $100, % 13 Other: 4.2% 8

92 National / State Studies: Higher death rates related to: Heart disease Stroke Unintentional injuries Summary of Findings Community Responses (Not in specific Order) Higher death rate from drug induced causes Slightly higher death rates related to alcohol induced diseases Higher rates of: DUII rates Heavy drinking female Youth who use marijuana Limited access to health foods Higher rates of preventable hospital stays Higher percentage of reporting of depression/anxiety and high blood pressure (CP CCO Medicaid data) Conditions create a healthy community: Jobs Clean environment / Access to healthy foods Affordable housing / Education Schools Health problems in community: Alcohol / drug addiction Obesity Cancer 3 things to improve community health: Health education Expand OHP More doctors

93 Community Health Needs Survey, - Clatsop County Clatsop Pacific Coordinated Care Organization : Community Advisory Council. Oregon. County Health Calculator, Robert Wood Johnson Foundation and the Virginia Commonwealth University Center on Human Needs. County Health Rankings and Roadmaps a Healthier Nation County by County, Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. Data Elements for CCOs Reports, Oregon Health and Science University. Office of Rural Health. Clatsop County s Epidemiological Data on Alcohol, Drugs and Mental Health to Oregon Health Authority. Office of Health Analytics and Addictions and Mental health Division. Clatsop Pacific CCO Service Area. Health & Care Profile for Newly Eligible Oregonians Under the ACA Prevention Chronic Diseases and Reducing Health Risk Factors, Centers for Disease Control and Prevention. CDC 24/7 : Saving Lives. Protecting People. Quick Facts, January Oregon Department of Human Services; Children, Adults and Families Division. Office of Business Intelligence and the Office of Forecasting, Research and Analysis.