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C​​ommunity Health Centers (CHCs) are trusted primary care providers in Oregon’s health safety net. As a result, many health care entities and partners look to CHCs as trailblazers, innovators, and collaborators. At the same time, health centers are accountable to payors to reduce the total cost of care while spearheading efforts to strengthen population health. Meeting these expectations places an immense burden on community health centers.

IntegratOR (also known as the Oregon Network of Community Health Centers) collaborates with health centers to leverage their collective power. As one voice, members can negotiate better value-based care agreements by utilizing dependable data systems and quality improvement initiatives.

In this post, OPCA highlights IntegratOR’s partnership strategy to position its Accountable Care Organization and Data Platform as ideal tools in addressing anticipated changes in health policy. Resources, tools, and upcoming learning opportunities mentioned in this blog are available in the CHC Toolbox section.

Conversation about Partnerships

Community Health Centers deliver primary care to their communities regardless of an individual’s insurance status or ability to pay. This raises the question: How do health centers fund health services and programs? The sustainability of CHCs depends on financial arrangements with payors. Payors are entities that cover or reimburse the cost of health services provided by primary care settings. As a means to ensure quality and control, payors will:

  • Set quality measures and monitor care transformation through data reporting

  • Offer incentive payments tied to patient health outcomes

  • Invest in care delivery through payment models

For health centers, an Accountable Care Organization (ACO) is a valuable resource to assess the quality, cost, and overall care of defined patient populations. In early 2024, IntegratOR formed an ACO, named EnactOR. Upon its formation, EnactOR received approval from the Centers for Medicare and Medicaid Services (CMS) to participate in the Medicare Shared Savings Program (MSSP).

ACOs participating in the MSSP commit to managing both the quality and total cost of care for a specific group of Medicare beneficiaries. When they meet quality standards and keep costs below an established benchmark, ACOs earn a portion of the savings. EnactOR, with Medicare attribution and claims data representing around 8,000 patients, along with comprehensive EHR data from 12 member clinics, earned shared savings in its first year of performance in the MSSP.

To gain a deeper understanding of existing partnerships, I had the privilege of sitting down with Carla Jones, Network Director of IntegratOR.

Carla Jones, Network Director

As Network Director, I bring over 25 years of broad healthcare experience—including leading a public entity Community Health Center; more than 15 years designing and managing value-based payment models for CCOs and Medicare Advantage; over 20 years negotiating provider contracts and reimbursement across payer types; and nearly 15 years in coding, billing, and payment operations.  

Our Senior Data Strategy Director, Simon Parker-Shames, MPH, adds 18 years of experience supporting Oregon's FQHCs through data strategy, healthcare IT, and full-scale data warehouse development, along with consulting for OHA, the Oregon Medical Board, CCOs, and FQHCs. He pairs his technical expertise with practical clinical experience as a former medical assistant. Every member of the Network's internal team brings significant professional depth and a shared commitment to strengthening community health and amplifying the collective voice of Oregon's safety net.

IntegratOR has formed some great partnerships outside of the walls of the FQHCs that support the safety net. Partnerships today include:  

  • AllCare Health (CCO in the Southern part of Oregon).  
  • CareOregon (CCO administrator and Medicare Advantage payor in the metropolitan area, the northern coast, and in the southern part of Oregon).  
  • Arcadia  
  • The Oregon Health Authority 
  • Centers for Medicare and Medicaid Services 
  • OCHIN 
  • Reliance HIE 

Partnerships are in the process of being developed with additional organizations including, but not limited to, 

  • Eastern Oregon CCO and MODA 
  • NextGen 
  • Athena 
  • EClinicalWorks 
  • Point Click Care 
  • APCM Health Centers 
  • Delegated Credentialing Service Providers 
  • Staffing Service Organizations 
  • Office of Rural Health

IntegratOR is partnering with the Oregon Health Authority to leverage VisualizOR as a statewide solution that strengthens data sharing, improves care coordination, and supports value-based care for Oregon’s safety net. Through this collaboration, we are aligning VisualizOR with OHA’s APCM program requirements, building the infrastructure to incorporate OHA’s CCO claims data, and positioning the platform as a key tool for OHA and FQHCs in the APCM program.

We’ve submitted both a project proposal and a letter to the Governor to use VisualizOR as a key solution for the Rural Health Transformation Grant to support rural and frontier communities. By combining clinical data from FQHCs with statewide claims information, VisualizOR will give health centers a more complete picture of patient care, reduce reporting burden, and unlock powerful insights that drive better outcomes. Utilizing VisualizOR as an ecosystem for health information across Oregon’s health centers and rural health facilities holds significant potential to reduce administrative costs for the state. Additionally, it offers valuable, data-driven insights into the performance and challenges faced in delivering services to the safety net and rural communities throughout Oregon.

IntegratOR is using VisualizOR to clearly demonstrate to payors the value FQHCs provide, especially as uninsured rates rise. By combining clinical and claims data, we can show how our members reduce avoidable costs, improve outcomes, and absorb growing numbers of uninsured patients. This data strengthens our case for increased investment, enhanced value-based payments, and targeted support for safety-net providers.

At the same time, we’re using VisualizOR to explore creative strategies for sustaining care for uninsured patients and to identify new opportunities with commercial payors. With a large shared patient population and robust analytics, IntegratOR is well-positioned to engage commercial plans in partnerships that recognize the impact and scale of Oregon’s FQHC network, and to think outside of the box for additional partnership opportunities to maintain access to care regardless of ones ability to pay for integrated primary care services.

IntegratOR is deeply committed to strengthening partnerships with providers to identify pain points and propose effective solutions. A complementary service to the ACO, EnactOR, is VisualizOR, which is a data platform built by and for Oregon’s community health centers. Read the post, From Insight to Impact: Strengthening Population Health, to learn how CHCs gain insight into the individual and collective performance of health centers.

Access Population Health Resources

Community Health Centers are a cornerstone of primary care in Oregon. For over 60 years, their reliability and dedication to delivering care to Oregonians in the most need have secured their position as respected primary care providers. However, the changing health policy landscape and the increasing challenges in health care delivery pose significant challenges.

Central to improving population health, IntegratOR offers a sustainable, long-term solution to enhance advanced access to care and support the financial and clinical success of CHCs. Through collective bargaining power, quality improvement initiatives, and centralized services, member clinics can navigate anticipated challenges and continue their mission of delivering care to those in need.

To be a part of this transformation and learn more about IntegratOR and its services, contact Carla Jones, Network Director, at cjones@orpca.org.

CHC Toolbox

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