This 6 page annual report was produced for a local non-profit agency. They used it as part of a presentation to the board of directors.

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2. 2
Our Journey Towards Equity
OPCA initiated our quest to help Oregonians receive high quality, timely, and affordable care
in 1984. Since then, our expedition has broadened to encompass the transformation of how
health care is delivered, foundationally in health centers, and working with key stakeholders
across the system to improve population health. Of course, OPCA accomplishes this work in
strong partnership with our members, Oregon’s 33 Community Health Centers.
Our Annual Report for 2015 describes our progress as a hunt for buried treasure, an effort
to pursue the elusive Quadruple Aim, where access, value, quality, and equity intersect.
Ultimately, we seek the intersection of our mission, “leading the transformation of primary
care” and our vision of “achieving health equity for all.”
This report is oriented around the Quadruple Aim and the four goals of our 2015 Strategic
Plan. You will find exciting moments from OPCA’s 2015 progress on each of these goals
charted in the next four pages. Because our work is interrelated and interdependent, some
projects bridge multiple areas but you will find their highlights in only one section.
We look forward to celebrating another year of accomplishments with you in 2016.
Sincerely,
The OPCA crew
I. Access
II. Value
IV. Social Determinants of Health
III. Quality

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I. Access
Supporting Innovative Approaches to Care through APCM
OPCA supports innovative approaches to care through the Alternative Payment and Advanced
Care Model, a program that has grown to include 14 clinics. We support centers in their
transformation efforts by providing:
™™ A strong team of support, expanded this year to include APCM Navigators, our new
Innovations Director, and learning sessions on care transformation that are open to all
members.
™™ Innovative practices at APCM learning sessions, with input from national experts on new
ways to connect with patients, telehealth dental and psychiatry programs, incorporating
community health workers into care teams, and using data to stratify and define
populations.
Fostering innovation, access and quality through learning collaboratives of CHCs who strive for
excellence in foundational and advancing care practices
™™ CHCs have adopted innovative approaches to providing care, including non-traditional
hours, co-located urgent care, group visits, different community health worker models
and nurse visits. OPCA has supported CHC innovation by providing exposure for all our
members to innovative models of care at our learning sessions throughout the year.
™™ Responsive learning collaboratives that included promoting staff engagement, improving
patient experience, and integrating oral health within primary care. We also saw the
successful completion of collaboratives on SBIRT and Patient-Centered Communication.
™™ We continue to support the foundational elements of CHCs by providing robust support
for the Bureau for Primary Health Care 19 requirements including operational site visit
support, new CFO on-boarding, and CHC board facilitation and training.
Promoting access through policy
We work in the Oregon Legislature and with allies to increase affordable access to
care and coverage through the following tactics:
™™ We increased dental access for children and pregnant women and worked with OHA and
the Department of Consumer and Business Services to implement new laws through
rulemaking and workgroups.
™™ We seized opportunities for partnership to advance our progress in creating access to
insurance coverage for all Oregonians; successes include gaining $10 million in safety net
grants to cover primary care for all kids and a new study on covering the Pacific Islander
population from states in the Compact of Free Association.
™™ We worked to ensure that individuals in the marketplace have affordable and adequate
networks of providers, regardless of where in Oregon they live. The Basic Health Plan
provides an affordable option for coverage, and OPCA advanced network adequacy
standards that include access to essential community providers.
h

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II. Value
Demonstrating the value of the work we do: evolving payment and practice
OPCA has been advancing conversations on our value as a network and the value we provide
to the health system as a whole:
™™ In 2015, OPCA started a formal conversation about collaboratively using data to
demonstrate the value of CHCs and provide technical assistance on contracting.
™™ OPCA facilitated a year long conversation with the network, resulting in a shared
definition for the value of CHCs.
™™ OPCA has shared Oregon’s APCM work with 18+ states that are considering similar
payment and care model transformation through direct collaboration and in partnership
with NACHC and the National Academy for State Health Policy.
™™ We began a process to integrate specialty mental health payment within APCM, as state
resources permit.
™™ We supported the wrap-around care and clinical pharmacy work in Oregon CHCs by
developing a method with OHA that allows CHCs to continue using 340B prescriptions
for their CCO patients using both community and in-house pharmacies.
Working with partners to support our whole system
We develop and advance models that meaningfully engage community partners:
™™ We completed the three-year, It Takes a Neighborhood (ITAN) pilot. ITAN helped
OPCA create models to assess and strengthen community partnerships and create a
health instigator tool kit.
™™ We promoted partnership models to connect with communities through new care roles
for community health workers (CHWs) and integration of outreach and enrollment work
into the core of Centers. These programs help clients tap into community strengths to
respond to food insecurity, housing, lack of health care coverage, and other upstream
factors.

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III. Quality
Promoting Data Transparency and Quality Improvement
™™ OPCA continued to prioritize the importance of CHC data as a source of strength through
training, technical support and strategic work in groups like the Data Transparency
Workgroup.
™™ OPCA facilitated webinars for CHCs to share quarterly data, work flows, and best practices
related to four UDS quality metrics and worked toward more direct data sharing between
centers.
Becoming leaders in the national conversation on using data in health centers
™™ OPCA has been increasingly recognized as a respected and influential organization and
we’ve been invited to participate in conversations locally and national about the evolution
of quality, access and utilization metrics discussions.
™™ We continued to meet with the Bureau of Primary Health Care’s executive team on
the need to deemphasize the focus on billable visit productivity, particularly to advance
Oregon’s Alternative Payment and Advanced Care Model.
Pushing social determinants of health metrics forward
™™ OPCA and Oregon Food Bank (OFB) worked together to develop a metric to track food
insecurity in healthcare settings. We developed a shared plan to work directly with OHA to
develop parameters that allow a statewide CCO pilot of this measure.
™™ We have successfully brought on one member of Oregon’s CHC staff to the Metrics and
Scoring Committee to ensure that CHCs are part of the ongoing metrics conversation.

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IV. Social Determinants of Health
CHC Understanding of Patient and Population Complexity
™™ We advanced our capacity to understand the experience of the populations that CHCs
serve. In partnership with NACHC, Association of Asian Pacific Community Health
Organizations, and Institute for Alternative Futures, OPCA participated in developing
and testing the PRAPARE tool to support interviewing patients on the social risks
impacting their health.
™™ We improved our ability to document the new ways of delivering care that are available
under APCM. OPCA worked with OCHIN to simplify and refine documenting
and reporting Engagement Touches, with a focus on innovative patient engagement
approaches. This tool ensures accountability with OHA and is used for internal quality
improvement at the center level.
™™ OPCA developed a partnership with the Center for Care Innovation, paving the way for
OPCA staff and three Oregon centers to participate in learning collaborative on human-
centered design.
Proportional Contribution to Premature Death
We continued our work to more effectively
address negative health outcomes by
focusing on the non-healthcare pieces
of this pie. Social determinants of
health account contribute 60%
to Premature deaths in the
United States.
Despite social and environ-
mental factors accounting for
an estimated 20% of health
outcomes, we know that an
individual’s ability to have
healthy behaviors depends on
the context in which they live. A
person’s diet choices are impacted
by their upbringing and access to
healthy food; exercise is influenced by
many factors including the safety of a neigh-
borhood and community.
Health care
10%
Genetic
predisposition
30%
Social
circumstances
15%
Environmental
exposure
5%
Behavioral patterns
40%

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The Journey Continues
It is an exciting time to be navigating these waters with our outstanding
community health centers. Just five years ago, Oregon was working without a
transformation map, and OPCA and our members were facing both uncertainty
and opportunity in the transformations facing the state. We could have chosen
to “drop anchor” and weather the storm in a reactive mode. Instead, we became
leaders among our peers nationwide and with our partners in the state in pursuit
of the Quadruple Aim.
Today, OPCA and our members are looked to as among the most innovative in
the country – expanding access for thousands of Oregonians while leading the
transformation to new payment and care practices. We are proud to continue to
expand our work with members in innovative and advanced practices in Oregon’s
CHCs, while contributing as national leaders in sharing our model. Key areas of
emphasis for 2016 will include:
»» Next steps in understanding and responding to the Social Determinants
of Health
»» Preparing for Value-Based Payment
»» Sharing our journey and learning from national partners
»» Innovation and Human-Centered Design
»» Integration of Oral and Behavioral Health with Primary Care
We look forward to another highly productive year!
Thank You
are
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8. 310 SW 4th Ave, Suite 200
Portland OR 97204
(503) 228-8852
www.orpca.org
info@orpca.org