Shellie Holk, B.S.N., R.N.
SHINE: Shifting Healthcare through Integrated Networks and Engagement
Health Share of Oregon
Shellie Holk is a registered nurse of 26 years and is the quality assurance operations manager at CareOregon.
Prior to this role, she was manager of nursing and clinic operations at Albertina Kerr, a nonprofit organization that supports people with developmental disabilities and mental health challenges to realize their full potential. Shellie was responsible for overseeing clinical operations for Albertina Kerr’s Community Based Mental Health Services, Children’s Developmental Health Services and the nursing program at the Inpatient Crisis Psychiatric Care facility for children and adolescents in crisis.
Through her career she has had various opportunities to contribute toward health reform through clinic projects, including creating a medical home model, patient engagement strategies and alternative care delivery models to improve care and outcomes at a reduced cost. She is passionate about health equality and the social impacts on health.
Children with development and behavioral disabilities often require multiple providers for their care. When this care is not coordinated and goals are not shared, it leads to fragmented care and confused patients. This was a pilot between a health plan and medical clinic to assess the impact of coordinated trans-disciplinary care financed in an alternative payment model. It allows for the right amount of care to be delivered at the right time, while reducing overall costs driving toward the triple aim.
This model was designed to allow for children to receive needed services often not covered by health plans. It also was developed in a manner to not limit the child to a prescribed number of visits; rather it allows the team to provide the care at the time the care is needed for how long it is needed.
Results to date
Forty-nine children were served but only 20 were able to maximize their care under this model due to program constraints. The pilot ended six months into the one-year cycle.
It is important to look broadly at the work being performed and ensure the right parties are part of the process of creating the model.
Alternative payment models are very much on the forefront of health care. Health plans such as CareOregon have a continued interest in improved models of care and reimbursement. The framework and goals of this project could be extrapolated and applied to other medical specialty services.
I am going to be meeting with a group from OHSU who currently work with children with disabilities. They are hoping I can provide them with some mentoring and guidance as they look at ways to reduce fragmentation and confusion for families, while improving care, outcomes and reducing cost.
I will continue to look for opportunities within the organization I work and the state to offer my involvement.