OPIP led efforts to support communities and health systems in better serving medically complex children. One strategy to support this population involved developing standardized methods to identify children with health complexity and supporting utilization of this population-based information to engage communities in galvanizing improvement efforts and considering best match care coordination strategies. Click here to learn more about health complexity data work at OPIP.
Children with Health Complexity are those who are both:
• Medically Complex (Page 3 of report), with a priority focus on children identified with “complex chronic disease” or “non-complex chronic disease”, and
• Socially Complex (Page 4 of report), defined by The Center of Excellence on Quality of Care Measures for Children with Complex Needs (COE4CCN) as: “a set of co-occurring individual, family or community characteristics that can have a direct or indirect impact on health outcomes by affecting a child’s access to care and/or a family’s ability to engage recommended medical and mental health treatments”.
This population and data-based approach to identify children with health complexity was developed by OPIP, in collaboration with OHA, and was derived from research led by Dr. Rita Mangione-Smith. Medical complexity was calculated using the Pediatric Medical Complexity Algorithm, a form of data analysis based on claims data of service utilization and diagnoses. Social complexity indicators were operationalized using existing system-level data sources and were derived from a list of social factors identified by The Center of Excellence on Quality of Care Measures for Children with Complex Needs (COE4CCN) to be predictive of high-cost health care events or poor health outcomes. For further exploration of Oregon’s approach, click here to watch the April 2019 Webinar: Maximizing System-Level Data to Address Health & Social Complexity in Children: Spotlight on Oregon.
Oregon’s health complexity data was made publicly available from 2018-2023 and was updated annually in order to support the pursuit of best care for children and families across the state. Children’s health complexity reports that were released in 2023 were posted to the OHA Transformation Center website, where you can access the following:
- Statewide report released in 2023
- Coordinated Care Organization (CCO) level data reports
- County-level data reports
OPIP has created the following related materials:
- A slide deck summarizing the findings released in 2023.
- A policy brief on why children with health complexity NEED to be a priority in health equity efforts, the risk of the data not being continued, and actionable steps for Governor Kotek and OHA’s consideration.
OPIP Projects Engaging Health Complexity
OPIP led, and contributed to a number of efforts aimed at improving systems for children and families impacted by health complexity. These included:
- Health System Strategies to Ensure a Focus on Children with Health Complexity: Click here to view a summary brief of how health complexity data can be used to implement four option strategies to ensure a focus on children with health complexity.
- Care Coordination for Children and Youth with Special Health Needs: Initiated in 2015, this work ultimately led to statewide interest and investment in Health Complexity Data. Click here to learn more about OPIP’s involvement with Care Coordination.
- Developing Complex Care Programs for Children with Health Complexity: Beginning in 2016, this work guided health systems in identifying children with health complexity and developing novel, generalizable approaches to better support these children and their families. Click here to learn more about this work funded by Lucille Packard Foundation for Children’s Health.
- Galvanizing Action for Children with Health Complexity: Beginning in 2019, this project supported local and regional efforts to create actionable momentum in south-central Oregon communities and identify best match services to help families impacted by health complexity to thrive. Click here to learn more about this work funded by Ford Family Foundation.
- Integrated Care for Kids (InCK): This effort supported a population and system-based approach to improve service Integration for children with health complexity.
- Provided Public Comment to the Oregon Health Policy Board about the Importance of Including Children Who Experience Health Complexity In Oregon Health Authority’s Health Equity Efforts.
