Children and adolescents in five Oregon counties will soon benefit from new federal funding that will help to improve health outcomes, reduce health risks and prevent unnecessary foster care placements, emergency room visits and hospital stays.
The grant is one of only eight cooperative agreements awarded by the Centers for Medicare and Medicaid Services to the Oregon Health Authority in partnership with OHSU Doernbecher Children’s Hospital.
Collectively, OHSU and OHA will receive up to $16 million over seven years to integrate community-based behavioral and physical health services, as well as other family support services, to positively impact children and youth covered by Medicaid and the Children’s Health Insurance Program, or CHIP.
The project, which began planning processes in January 2020, is led by OHA and the Oregon Pediatric Improvement Partnership, or OPIP — an evidence-based quality improvement program at OHSU Doernbecher — and will work with local communities across Marion, Polk, Crook, Deschutes and Jefferson counties.
OPIP will lead local efforts to implement a regional and population-based improvement effort conducted in partnership with local child care services, providers and region-specific Coordinated Care Organizations, or CCOs. This will expand on existing efforts to promote coordinated and integrated care, patient-centered primary care homes and investments in Health Information and Community Information Exchange.
Novel alternative payment models will be designed and Oregon will leverage and enhance the existing health complexity methodology to target children with the greatest health complexity.
"This exciting opportunity perfectly aligns with OPIP’s mission to support long-term collaborations invested in child health care quality, with the common purpose of improving health outcomes of youth. We are excited to support these local communities in implementing family-centered strategies that leverage novel child health complexity data," said Colleen Reuland, M.S., director of OPIP. "We will be able to pilot transformative complex health management models aimed at improving health outcomes and reducing unnecessary health care costs by integrated and coordinating services across sectors. It meets the triple aim: Better health, better care, lower costs."
A part of CMS’ Integrated Care for Kids Model, or InCK, the project will focus on supporting children and youth ages 0 to 21 through effective child- and family-centered care in order to reduce hospital stays and out-of-home placements for children and youth such as foster care and residential behavioral health.
Research shows that many of the factors that determine health outcomes are related to social determinants of health and health equity. This funding aims to help health care providers align with other public programs such as child welfare, education, housing, nutrition, and maternal and child health to expand access to care for children and youth.
The model will also help advance Gov. Brown’s policy priorities for the Oregon Health Plan by addressing social determinants of health and health equity, improving family behavioral health support, developing value-based payments for children’s health care, and reducing costs.
OPIP will build off learnings gathered from their extensive experience implementing patient-centered community-and population-based improvement efforts. The Oregon InCK Model also incorporates transformative work OPIP has been leading, with OHA, to operationalize and use the Child Health Complexity data, and provides an opportunity to pilot methods to use the data to guide and inform alternative payment models that support complex health management.
Additional information about InCK can be found on the CMS website.
This project is supported by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services (Grant 2B2CMS331759-01-01) as part of an award totaling $2,927,111 in 2020 with 0 percentage financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS, HHS or the U.S. Government.