Breaking news: Federal officials renew health transformation in Oregon
Today the federal government approved
Oregon’s federal Medicaid waiver application to continue the Oregon Health
Plan—Oregon’s Medicaid program—for another five years. The Oregon Health Plan
(OHP) covers over 1 million low-income Oregonians who are struggling to make
ends meet. This is the largest health plan in the state and covers one in four
Oregonians and almost 40 percent in some rural counties.
Highlights
of renewed waiver
This approval enables Oregon to continue
its innovative model of health care for OHP members and maintain the gains the
state has made in the past five years to improve the integration, coordination
and quality of care. These reforms have saved hundreds of millions of dollars
in health costs for state and federal taxpayers.
Under the agreement, Oregon will continue to:
-
Integrate care:
Provide integrated physical, behavioral and oral health care services to OHP
members through coordinated care organizations (CCOs).
-
Advance the
coordinated care model: The waiver maintains the coordinated
care model and promotes payment for value rather than volume of services. These
models will continue to allow Oregon to improve quality and outcomes and hold
down costs to a sustainable rate of growth.
-
Promote increased
investments in health-related and flexible services.
The waiver provides clarity on how non-traditional services that improve health
are accounted for in global budgets. CCOs will be encouraged to invest in
services that improve quality and outcomes, and CCOs that reduce costs through
use of these services can receive financial incentives to offset those cost
reductions.
Approval
enables Oregon to continue improvements in care and cost containment
In the past five years, Oregon has made
significant progress toward the triple aim of better health, better care and
lower cost:
-
Providing
care at the right time and place:
Avoidable emergency department use decreased by nearly 50 percent over five
years.
-
Better
outcomes and care: Hospital
readmissions have been cut by a third. Substance misuse assessments, developmental
screening and timely prenatal care have all increased.
-
Lower
costs: Federal and state governments saved $1.4
billion in Medicaid costs just since 2012 and have avoided billions more since
the inception of the Oregon Health Plan over two decades ago. Oregon’s health
reforms are projected to save a total of $10.5 billion between 2012 and 2022 by
holding down cost growth to not more than 3.4 percent per member per year.
Waiver
provides stability and continuity for Oregon’s health system
Oregon initiated early renewal talks
with federal officials last year, in anticipation of a new administration
taking office. Normal waiver approvals take a year or longer to complete and
this renewal was completed within six months. Governor Brown and her staff and
Oregon Health Authority officials have worked intensively with Centers for Medicare
& Medicaid Services (CMS) Administrator Andy Slavitt and his entire staff
to get this done.
Renewal of Oregon’s waiver provides
stability for the state’s health system. While Congress debates the repeal of
the Affordable Care Act (ACA), today’s waiver renewal is a key validation and
continuation of Oregon’s model of care.
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