Oregon Health Policy Board discuss children’s health priorities

On Tuesday, the Oregon Health Policy Board held its monthly meeting, where they discussed the Oregon Pediatric Improvement Partnership (OPIP) Project called “System-Level Approaches to Identify Children with Health Complexity and Develop Models for Complex Care Management.”

The project, which is funded by the Lucile Packard Foundation for Children’s Health, looks to ensure quality health care for children and improve the health of Oregon’s children. They are striving for lifelong health and well-being that starts in the early stages of life.

Dana Hargunani, Chief Medical Officer for the Oregon Health Authority (OHA), and Colleen Reuland, Director of the OPIP, discussed the project’s progress at Tuesday’s meeting. Hargunani and Reuland expressed how there is a critical opportunity in Oregon with the lack of resources and payment models, and that there are new ways to get ahead of this issue on how to address and serve the needs of children and families.


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OPIP has received a grant for the next two years from the Lucile Packard Foundation for Children’s Health and will be working with OHA and other key partners: Kaiser Permanente Northwest and Coordinated Care Organizations (CCOs).

Hargunani and Reuland explained what the project has accomplished so far, and the research behind the project. The presenters explained that children with health complexity are combined into two sectors that create a global score: Medically Complex and Socially Complex.

According to the Pediatric Medical Complexity Algorithm (PMCA), Medically Complex is defined as children who are seen with complex chronic disease, children with non-complex chronic disease, or no chronic disease. PMCA was used because it is the most reliable, validated, and well-known tool.

The Center of Excellence on Quality of Care Measures for Children with Complex Needs (COE4CCN) interpreted Social Complexity as “a set of co-occurring individual, family or community characteristics that can have a direct impact on health outcomes or an indirect impact by affecting a child’s access to care and/or a family’s ability to engage in recommended medical and mental health treatments.”

COE4CCN identified 12 Social Complexity risk factors such as parent domestic violence, child abuse/neglect, and parent substance abuse. Their studies show that these six risk factors lead to the  worst outcomes:

  • Parent death
  • Parent criminal justice involvement
  • Homelessness
  • Child mental illness
  • Child substance abuse treatment need
  • Child criminal justice involvement



The PMCA found that 6.1% (4,000) kids have complex chronic disease. Of the publicly insured children in Oregon between the ages of 0 and 5, 33.4% (48,804) of children are affected by three or more of these social factors.

Evaluating Social Complexity in terms of race and ethnicity, the highest percentage of children impacted with three or more social factors are African American children, at 51.4%, while they are the lowest percentage of children who are not impacted by any social factors, at 11.5%.



Moving forward, OPIP hopes their data helps CCO 2.0 efforts in regards to social determinants, cost growth, and improving behavioral health programs. Thus far, the data has been used to identify children and family needs, create tools for better health outcomes, generate ideas on how to pay for performance, how to approach care coordination, how this data informs us about costs, how to improve health outcomes overall, and how to match this culturally for children.

For more information on the meeting, you can view the materials here.