A Journey to Buy-in for a Population Health Initiative


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The community of Albany, Oregon has a large, underserved adult Medicaid population. This population has significant health challenges including a high proportion of mental health diagnoses, uncontrolled chronic disease states, poor access to care, and poverty. These individuals are accessing the emergency room and urgent care for their acute and chronic health needs due to poor primary care access, gaps in social determinants of health, and lack of clinician-patient engagement. Samaritan Health Services (SHS) is an integrated delivery system in Oregon that currently provides primary and specialty health care to three counties, one of which is the Albany community. SHS has five hospitals, including a 79-bed hospital in Albany. Due to the above challenges and a shortage in primary care clinicians, space, and staff, it has been difficult to positively impact the health of the Medicaid population in this area. Samaritan Health Plans insures the Medicaid population in Albany through the CCO Intercommunity Health Network (IHN). It is in the best interest of the Samaritan system (health plan and medical group) to address the health needs of this community, improve primary care access, reduce cost of care, and improve outcomes. This project outlines the steps taken to gain support from executive leadership and System Board to develop a clinic that will serve the needs of the adult Albany Medicaid population utilizing population health principles. This project is shared from the viewpoint of a primary care physician leader within the organization. It will detail lessons learned along the way and propose strategies for successful buy-in with future population health initiatives.



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