This report summarizes the work to date and identifies future opportunities for Oregon’s Coordinated Care Organizations (CCOs) to advance health equity as part of their health system transformation activities.
CCOs are obligated to identify and pursue opportunities to advance health equity in several ways. Three of the eight transformation plan areas in their Oregon Health Authority (OHA) contracts require CCOs to meet their diverse members’ cultural and linguistic needs and to reduce racial and ethnic disparities. These obligations include:
- Assuring that communications, outreach and member engagement are tailored to cultural, health literacy and linguistic needs.
- Assuring that the culturally diverse needs of members are met, including cultural competence training, provider composition that reflects member diversity, and certified traditional health workers and traditional health workers composition reflecting member diversity.
- Developing a quality improvement plan focused on eliminating racial, ethnic and linguistic disparities in access, quality of care, care experience and outcomes.
In addition, CCOs have been measuring and reporting their performance on more than 30 health care quality measures. OHA has reported statewide CCO performance on those quality measures, stratified by race and ethnicity (and, more recently, by disability and mental health diagnosis), as part of its accountability to CMS and to the public. These stratified data highlight the continuing racial and ethnic disparities in health care access and outcomes among Oregon’s diverse CCO members.
Finally, there are robust requirements for CCOs to engage the diverse communities that they serve by conducting community needs assessments and by developing and implementing community health improvement plans (CHPs) responsive to the identified community needs. Many of these community needs go beyond health care and highlight the social determinants of health fundamental to advancing health equity. CCOs have invested significant efforts and financial resources in the communities they serve through these CHPs, including addressing social determinants of health that support health equity.
The OHA Transformation Center supported tailored technical assistance to all 16 of the CCOs on health equity from March through November 2016. These health equity consultations identified and documented many activities and innovative ideas to advance health equity that Oregon’s 16 CCOs are implementing. Among the lessons learned from the CCOs about how to advance health equity are the following:
- Create a CCO-wide plan to advance health equity
- Use each CCO’s own data to identify and prioritize disparities
- Partner with diverse members and communities served
- Engage clinics and providers
- Build and sustain a diverse workforce
- Integrate equity into health system transformation
- Be accountable for advancing health equity.
This work was highlighted at a session at an Innovation Cafe in May 2017: