Identifying upstream approaches for reducing health inequalities through a community health improvement plan process

Oregon has been a national leader in Health System Transformation efforts, with a particular focus on upstream approaches to reduce health disparities.  The Coordinated Care Organizations (CCO) providing Medicaid services throughout Oregon are required to complete Community Health Assessments (CHA) and Community Health Improvement Plans (CHIP).  This session will describe local CCO approaches to identifying social determinants and health disparities among their designated communities and processes for completing their CHAs and CHIPs, with a particular focus on community and consumer engagement.  Social determinants to be discussed at both a state and regional level include access to affordable care, housing, racial and ethnic disparities, prescription opioid misuse, cultural competency, transportation, and prenatal care.  CHIP work has focused on identifying community areas of interest aligned with data on corresponding Medicaid clientele to establish the most relevant action plans for the CHIP.  Community Health Improvement Plans led by CCOs have included Local Public Health organizations and multiple hospital systems to provide a well-rounded assessment of the various communities throughout Oregon.  In addition, contrasts between rural and urban CCOs and identified social determinants and health inequalities will be demonstrated and discussed during this session.