Skip to main content

Oregon State Flag An official website of the State of Oregon » Homepage


Community Health Assessments (CHAs) and Community Health Improvement Plans (CHIPs)

Coordinated Care Organizations (CCOs), local public health authorities (LPHAs), non-profit hospitals, and tribal health departments are important partners in health improvement at the local level.  CCOs, LPHAs and non-profit hospitals are required to develop and implement CHAs and CHIPs. CCOs must also invite tribal health departments to this process if they have a CHA or are in the process of developing a CHA.. CHIPs serve a similar purpose as the SHIP, but at a county or regional level.

Many CHIPS are in alignment with the priorities and strategies of the SHIP.  CCOs are required to incorporate at least two of the SHIP health priorities and strategies.  To illustrate this alignment with the SHIP and alignment across CHA/CHIP partners by county, the OHSU Office of Rural Health, in partnership with OHA, developed this matrix of community health priorities by agency and region.

Additional information about community health improvement plans, community benefit investment and reporting requirements is detailed below.

​CCOs are required, per Oregon Revised Statue, Oregon Administrative Rule and CCO contract, to complete a CHIP, based on a CHA, at least every five years. CCOs are now required to have a shared CHA/CHIP with local public health authorities, hospitals and other CCOs, and also invite tribes that share service areas to be equal shared partners. CCO Guidance: Community Health Assessments and Community Health Improvement Plans provides guidance to CCOs regarding how OHA defines a "shared" CHA/CHIP and when the next CHA/CHIP deliverable is due.  

CCOs are also required to submit annual CHIP progress reports, as well as a new CHA and CHIP at least every five years, to OHA. 

Community investment 
CCOs are able to invest in the social determinants of health and equity (SDOH-E) through Health-Related Services (HRS) Community Benefit Initiatives (CBIs). Additionally, CCOs are required to invest a portion of their net income or reserves in SDOH-E through the Supporting Health for All through Reinvestment (SHARE) Initiative. For CCO spending on HRS CBIs and SHARE Initiative, there must be alignment with their CHIP health priorities.

Health Related Services   
HRS are offered are non-covered services that are offered as a supplement to covered benefits under Oregon’s Medicaid State Plan. The purpose of HRS are to improve care delivery and overall member and community health and well-being. Health-related services include:  
  • Flexible services are cost effective services offered to an individual member to supplement covered benefits.   
  • Community benefit initiatives are community-level interventions focused on improving population health and health care quality. These initiatives include members, but are not necessarily limited to members.  
More information about HRS, including eligible expenses and reports about how CCOs are using HRS can be found here.  

SHARE Initiative 
The SHARE Initiative comes from a legislative requirement for coordinated care organizations (CCOs) to invest some of their profits back into their communities. After meeting minimum financial standards, CCOs must spend a portion of their net income or reserves on services to address health inequities and the SDOH-E. SHARE investments are made within four areas: 
  • ​Economic stability 
  • ​Neighborhood and built environment 
  • Education 
  • Social and community health. 
More information about the SHARE initiative can be found here 

Nonprofit hospitals are required, by requirements of the Internal Revenue Service (IRS), to develop and implement a Community Health Needs Assessment and Implementation Strategy as part of their non-profit tax status. The CHNA must be completed at least every three years. Hospitals are also required to support community benefit investment and report this information annually. Hospital community benefits are initiatives and activities undertaken by nonprofit hospitals to improve health in the communities they serve.  

While not required, most LPHAs develop and implement CHAs and CHIPs as a requirement of Public Health Accreditation. CHAs and CHIPs completed to meet accreditation standards must be completed at least every 5 years. Links to CHIPS produced by LPHAs can be found here 

Here are a few of our favorite CHA, CHIP and health equity related resources and tools.