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The Oregon Health Policy Board (OHPB) this week approved "CCO 2.0," kicking off the next phase of health transformation in Oregon.
CCO 2.0 is a comprehensive set of policies that will improve the health of Oregon Health Plan (OHP) members, address health disparities, control program costs, and continue to transform health care delivery in Oregon.
"We’ve taken this opportunity to really look at what’s working with CCOs and where we need to push the system to advance health transformation in Oregon," said Zeke Smith, OHPB chair. "Together, these policies have the potential to significantly change how our members experience care and how the state pays for that care."
The policies were honed in public meetings and forums held across the state in more than a dozen locations, as well as through surveys and online outreach tools that gathered perspectives from a diverse cross-section of Oregonians.
OHA expects to request applications for coordinated care contracts for 2020-2025 in January, and the contracts are expected to be awarded in summer 2019.
The CCO 2.0 policies that will inform the new CCO contracts cover four priority areas identified by Governor Kate Brown:
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Improve the behavioral health system and address barriers to access to and integration of care
CCOs will be accountable for developing a person-centered mental health and substance use disorder (behavioral health) system that OHP members can count on, no matter who they are or where they live. CCOs will remove barriers between behavioral, physical and dental health.
2. Increase value and pay for performance
Over the next five years, CCOs will make a significant move away from fee-for-service payments toward paying providers based on value. OHA will incentivize providers and health systems for delivering patient-centered and high-quality care. CCOs will develop value-based payments (VBPs) to improve health outcomes specifically in the areas of hospital care, maternity care, behavioral health, oral health, and children’s health care.
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Focus on social determinants of health and health equity
Over the next five years CCOs will increase their investments in strategies to address social determinants of health and health equity. CCOs will align goals at the state and local level to improve health outcomes and advance health equity. OHA will develop measurement and evaluation strategies to increase understanding of spending in this area and track outcomes.
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Maintain sustainable cost growth
To support sustainability of OHP, CCO 2.0 policies address the major cost drivers currently in the system. OHA will also identify areas where CCOs can increase efficiency, improve value and decrease administrative costs.
For more information and to download OHPB's final report, visit the CCO 2.0 webpage.
OHA will hold a public meeting to gather comment on how to define coordinated care organization service areas under CCO 2.0.
A service area is the geographic area from which a CCO will accept members.
The meeting will be held Monday, Oct. 22, 3-5 p.m., at the University of Oregon's White Stag Block at 70 NW Couch St., Portland. The meeting will be live-streamed and the public also can join through a telephone conference line at 888-363-4735, participant code 1593726.
Public comments about the service area approaches can be submitted before the meeting by email at CCO2.0@dhsoha.state.or.us, and comments will be accepted by telephone during the meeting. If you'd like to submit comments remotely during the meeting, please send your name (and organization if applicable) to CCO2.0@dhsoha.state.or.us.
OHA has proposed regional service areas for new applicants for the 2020-2025 CCO contracts, and also is considering an alternative proposal that would require all participants to define service areas by county.
OHA’s main priorities and values guiding the service area approach include:
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Behavioral health: Align with local mental health services and systems.
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Social determinants of health: Avoid the possibility of redlining and carve-out of underserved and culturally diverse populations.
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Value-based payments and cost containment: Ensure that CCOs can maintain financial viability, implement value-based agreements with providers, and create administrative efficiencies to reduce costly duplication.
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Community engagement and governance: Decision-making should reflect local priorities and be accountable to members of the community.
For more information about the service area approaches, go to the CCO 2.0 page on the OHA website. You can also download a document about the proposed service area approaches.
For more information about the meeting or to request accommodation, contact Janet Zeyen-Hall at 503-945-6938, 711 TTY, janet.l.zeyen-hall@dhsoha.state.or.us.
 OHA Director Patrick Allen today announced that Margie Stanton, interim Health Systems Division director, has accepted the position of HSD director.
Stanton has served in the interim role since January.
"In that short period of time, she has provided stable leadership that helped us focus on the work we should be doing to transform health and health care for Oregonians," director Allen said in a message to OHA staff. "Margie was also a key leader in realigning our organizational structure to better focus on Medicaid and behavioral health. I’m excited about the ongoing work she continues to do to build relationships and implement systems that will help us deliver on our mission."
Stanton has 20 years of executive management experience in the insurance industry, most recently as vice president of Healthcare Management Administrators, Inc. in Bellevue, Wash. Margie has a Master of Business Administration from the Kellogg School of Management at Northwestern University and a Bachelor of Science in Merchandising and Marketing from Texas Southern University.
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