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Oregon Health Authority

Supporting Health for All through REinvestment: the SHARE Initiative

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 social determinants of health and equity (SDOH-E). 

The SHARE Initiative is just one way that CCOs respond to SDOH-E, health inequities and the social needs of their members. CCOs may also use their global budgets to address members’ social needs and community SDOH-E through health-related services (HRS). See this SHARE, HRS and ILOS comparison for an overview of CCO spending programs to meet member and community needs. 

The SHARE Initiative is defined by the following state law and Oregon Administrative Rule:

2025 changes

See this CCO memo about 2025 SHARE changes (12/13/24). 

2025 SHARE updates webinar

CCO convening

  • October 9, 2024
  • Salem Convention Center
  • For CCO staff working in HRS, SHARE, ILOS, SDOH-E and related spending efforts.
  • Convening materials

SHARE Initiative requirements

According to requirements in OAR 410-141-3735, a CCO’s SHARE Initiative dollars must:
  • Align with community priorities in the CCO's current community health improvement plan;
  • Include any statewide priorities for SHARE spending that are identified in the contract between CCOs and OHA (currently housing-related services and supports);
  • Include a role for the CCO’s community advisory council in spending decisions;
  • Involve community partnerships, with a portion of dollars going to SDOH-E partners; and
  • Fit into one of four SHARE Initiative domains related to the social determinants of health and equity (SDOH-E): economic stability, neighborhood and built environment, education, and social and community health.

CCO reports and summaries

2025 guidance and reporting templates

OHA will be implementing changes to the SHARE program in 2025, including moving to an attestation model. The goal of these changes is to expand the flexibility of CCOs’ investments, and the changes are based on input from CCO leadership. For an overview of changes and timelines, see this 2025 SHARE Changes CCO memo (12/13/24). OHA will release a CCO contract waiver memo, attestation form and guidance in mid-summer 2025.

2024 guidance and reporting templates

Guidance Reporting templates Supplemental resources

Webinars

SHARE Initiative spending areas: examples

  • Income/poverty
  • Employment
  • Food security/insecurity 
  • Diaper security/insecurity
  • Access to quality childcare
  • Housing stability/instability (including house​lessness)
  • Access to banking/credit

  • Early childhood education and development
  • Language and literacy
  • High school graduation
  • Enrollment in higher education​​

  • Access to healthy foods
  • Access to transportation (non-medical)
  • Quality, availability and affordability of housing
  • Crime and violence (including intimate partner violence)
  • Environmental conditions, such as clean air and water
  • Access to outdoors, parks

  • Social integration
  • Civic participation/community engagement
  • Meaningful social role
  • Citizenship/immigration status
  • Corrections
  • Discrimination (for example, race, ethnicity, culture, gender, sexual orientation, disability)
  • Trauma (for example, adverse childhood experiences)

Contact

If you have questions about the SHARE Initiative, please contact Transformation.Center@odhsoha.oregon.gov.