Herding cats: Organizing competing Medicaid health plan CCOs for a collective Community Health Assessment and Improvement Plan

Oregon, in an effort to provide coordinated health care for the Medicaid population embarked on a first-in-the nation project in 2012.  The idea, led by the Governor, was to recreate how hospitals, medical, dental and mental health providers deliver services to those on Medicaid.  The objectives were to improve care, reduce costs and improve population health outcomes. The Coordinated Care Organization (CCO) model was launched and many long established Independent Practice Associations and insurance plans jumped to create new CCOs across Oregon.  How Medicaid funding was dispersed changed significantly while new requirements for the funding were added, such as completing a community health assessment, having community advisory councils and population health improvement planning.  Many communities in Oregon had multiple CCOs organized within the same geographic and population area.  Suddenly, community engagement and collaboration were vital for CCO success, creating conflict for organizations that were traditionally competitors and focused only on individual clinical outcomes of enrollees.  Three organizations were granted CCO status in the Southern Oregon rural counties of Jackson and Josephine.  The three CCOs have vastly different organization structures, leadership, size, scope and culture yet they joined together in January of 2013 to embark on a collective CHA and CHIP. Focus of session will be sharing lessons learned engaging competing health plans in trans-agency collaboration, working with community advisory council members of multiple CCOs in health status assessment and planning and applying principles of collective impact in a competitive for-profit environment.