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Issues and actions in Oregon health today

September 20, 2018

Oregon Health Plan members satisfied with OHP and their CCOs

Members of the Oregon Health Plan (OHP) are highly satisfied with the care they receive, trust the state’s Medicaid program for information about their health, and support proposed changes in coordinated care contracts known as CCO 2.0.

That's according to a survey by DHM Research, which conducted telephone interviews with 401 OHP members in late August. Interviewers spoke to OHP members whose primary languages were English, Spanish, Russian and Vietnamese. The survey found few significant differences of opinion among respondents based on language, region or other factors such as gender, age, race or ethnicity.

DHM presented the findings to the Oregon Health Policy Board Sept. 11. The board received draft recommendations for the CCO 2.0 contracts and will approve final changes at its meeting October 15.

Some of the results:

• Satisfaction with OHP: 90 percent of respondents were satisfied with OHP and the care they receive through the plan. (Sixty-three percent were very satisfied.)
• Satisfaction with CCOs: 78 percent who were familiar with coordinated care organizations were satisfied with CCOs. (Fifty-five percent were very satisfied.)
• Ways to improve care: When asked what they would change, one-third would not change OHP. For those who offered responses, the top changes were: expand coverage (23 percent), reduce wait times for care and customer service (12 percent) and improve access to and choice of providers (10 percent).

OHP members showed support for the major proposals to change CCO contracts:

• Improve access to behavioral health services: 76 percent supported.
• Address social factors that affect health: 83 percent supported.
• Contain costs: 50 percent supported.
• Pay providers to improve member health: 48 percent supported, 42 percent opposed.
• Transparency and representation: 63 percent agreed "having more members help make decisions about OHP would improve your health care experience."

The survey has a margin of error of plus or minus 4.9 percent.

Governor Brown releases health care agenda

Governor Kate Brown released her health care strategy, which would build on Oregon’s 94 percent rate of health coverage, sustain health transformation, and hold down health care costs. The plan outlines eight health care priorities:

1. Ensure Oregonians’ access to health insurance coverage.
2. Improve overall health outcomes through CCO 2.0.
3. Control long-term cost growth in health care spending.
4. Use reinsurance to keep rates affordable in the private market.
5. Increase investments in mental health and addiction prevention and treatment.
6. Modernize public health.
7. Increase capacity, retention, and diversity in Oregon’s health care workforce.
8. Create better health through good jobs.

You can read Governor Brown’s plan “Health Care for All” here.

Director Allen shares calendar online

The Oregon Health Authority values transparency, accountability, and the wise use of public resources. In an effort to increase transparency, OHA Director Patrick Allen will share his weekly calendar, after redacting private information. Director Allen further believes that sharing his appointments calendar will help him take a step back from his daily meetings and ensure he is meeting with and listening to a wide variety of people, partners, and stakeholders. You can view it on the OHA website.

Health Policy Board to finalize CCO 2.0 plan in October

The Oregon Health Policy Board (OHPB) will receive the final policy recommendations for CCO 2.0 at its meeting on October 15. The proposals will define the requirements OHA includes in the next contracts it issues to coordinated care organizations (CCOs), beginning in 2020. OHA will issue a request for proposals in early 2019.

The health policy board reviewed a draft CCO 2.0 policy report at its September meeting. The draft report describes how CCO 2.0 would advance health transformation and tackle Oregon’s biggest health problems through four major priorities:

1. Improve behavioral health and streamline access to care for consumers by a) improving gaps in care between doctors and behavioral health providers, b) making CCOs more accountable for behavioral health benefits and c) expanding and diversifying networks of care in underserved areas.
2. Address social factors that affect health and reduce health disparities by giving CCOs more financial incentives to target upstream problems (such as poor housing, food insecurity and lack of transportation) that contribute to poor health. Encourage CCOs to improve coordination with local public health departments and non-profit partners.
3. Increase value and pay for performance by setting statewide and CCO targets for provider payments that are based on outcomes, not volume. Increase the amount of value-based payments across state-managed public employee and educator health plans, as well as commercial plans.
4. Maintain sustainable cost growth and encourage financial transparency by rewarding efficient care delivery, high-value clinical care and cost reduction.

Process for selecting CCOs

CCOs will be selected through a request for application (RFA) process. Applications will be accepted from entities with an existing Oregon “footprint.” Current CCOs may remain in their service area or apply for the larger region in which their service area resides. Applicants may also apply for more than one region.

End of CCO 2.0 public engagement

The October OHPB meeting will conclude a two-year public engagement process that shaped the next stage in the evolution of Oregon’s innovative coordinated care system, and the terms of the next five-year CCO contracts. Throughout the process, the policy board and OHA leaders have heard from hundreds of people across Oregon, including OHP members. You can review CCO 2.0 proposals, public input and provide additional comments prior to the deadline at the CCO 2.0 web page.

Oregon uninsured rate still below national average

Since Oregon implemented the Affordable Care Act (ACA) in 2014, more than 340,000 Oregonians have gained health insurance. Today, 94 percent (3.7 million Oregonians) have coverage.

That puts Oregon's uninsurance rate at 6.8 percent, compared to the national uninsurance rate of 8.7 percent, according the U.S. Census Bureau’s latest American Community Survey (ACS).

This new report comes on the heels of the state-based Oregon Health Insurance Survey (OHIS), which pegged the uninsurance rate at 6.2 percent. The ACS and OHIS coverage rates vary slightly due to differences in methodology. OHIS includes more detailed information on demographics, access, use of services, cost of care, and health status, and better represents minority groups in the state. Oregon uses the ACS data to compare itself with other states and the national average.

More people could be covered, according to the OHIS Uninsurance Fact Sheet. In fact, more than eight in 10 children, and adults under age 65 who lacked coverage, are eligible for the Oregon Health Plan (OHP) or financial assistance to reduce commercial health insurance premium costs.

The top three reasons Oregonians cited for not being covered by OHP were: concerned about high costs of coverage (44 percent); make too much money to be eligible (36 percent); and concerned about quality of care (21 percent).

There are no premium costs or deductibles for OHP's comprehensive benefit package of medical, behavioral health and oral health care. Children and adults who qualify for coverage under the Oregon Health Plan can apply any time during the year. Oregonians can find more information about coverage available to them at OregonHealthCare.gov.

New faces and roles at OHA

The Oregon Health Authority welcomes Angie Allbee and Annaliese Dolph, the newest members of the Government Relations team in the External Relations Division. Angie Allbee will support the Public Health Division. Angie joins OHA after working as legislative liaison for the Oregon Department of Human Services (DHS) for the past four legislative sessions. Prior to DHS Angie worked for the Oregon Criminal Justice Commission, the Legislature's House Majority Office, and for an Oregon state representative. Angie received her Executive Master of Public Administration degree from Portland State University’s Mark O. Hatfield School of Government.

Annaliese Dolph will support behavioral health. Annaliese is an attorney who has more than a decade of experience in health policy. She has worked for the National Multiple Sclerosis Society, various nonprofit organizations in North Carolina, with an emphasis on behavioral health. Annaliese has a Bachelor of Science from the University of Michigan and a Juris Doctorate from the Santa Clara University School of Law. Jeanette Taylor will continue to support Medicaid policies and the Office of Equity and Inclusion. Two OHA staff are on job rotations to join ombudsperson Ellen Pinney in the expanded program to better serve Oregon Health Plan members with difficult or challenges cases.

Libbie Rascon is on rotation from her role as coordinator for the Office of Consumer Activities in Health Systems Division's Behavioral Health program. In the role of an ombudsperson, Libbie will apply her background in past government work, business management, communications and her subject matter expertise in mental health and addiction consumer voice. Libbie identifies as an ex-patient, consumer survivor and person of lived experience (PLE). Her serving as a peer support specialist (PSS) in the expanded Ombuds office will further enhance OHA’s dedication to diversity and health integration.

Diane St. Denis is on rotation from her role as a training and development specialist in HSD Provider Services. As an ombudsperson, Diana will bring her experience working with the Client Services Unit handling client calls. She will be handling individual client cases, creating and improving educational and resource materials for the recently created OHA Ombuds Program file on the I Drive, and working with the Complaint Resolution Team (CRT) in the DHS Member Services Client Services Unit to improve cross-agency ability to track client calls and responses.

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