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As the Oregon Health Authority works to develop contracts for the next five years of the Oregon Health Plan (OHP) and coordinated care, the agency is seeking public comment on member enrollment, the risk adjustment process, and rate setting methodology.
The potential for shifts in the number and service areas of coordinated care organizations (CCOs) means OHA must develop an approach for member enrollment and rate development that takes multiple scenarios into consideration. OHA will discuss why an enrollment policy is needed for CCO 2.0 and the factors affecting member enrollment and will seek public comment on the approach currently under consideration to address multiple procurement scenarios.
OHA also will seek public comment on how to set capitation rates used to build global budgets for the new contracts that meet actuarial requirements and achieve the goal of a sustainable rate of growth. OHA will share draft rate methodology adjustments to the current rate development process and how it aims to apply health-based risk adjustment to the CCO capitation rates in a fair manner when shifts in membership occur.
When: Monday, November 19: 8-9 a.m., member enrollment; 9-11 a.m., rates and risk adjustment.
Where: Department of Consumer and Business Services meeting room 260, Labor and Industries Building, 350 Winter St NE, Salem.
The public can also join remotely through a telephone conference line at 888-251-2909, participant code 2450162; or by joining a live-stream of the meeting. Those unable to attend the meeting can submit public comment to OHA at CCO2.0@dhsoha.state.or.us until November 28.
Additional information and meeting materials have been posted on the CCO 2.0 webpage on the OHA website.
The Oregon Environmental Quality Commission voted 5-0 Thursday to approve Cleaner Air Oregon proposed rules. The rules establish statewide health-based emissions limits for specific pollutants emitted by facilities. The rules also close gaps in the state's existing air quality rules that can create health risks for families and communities.
Governor Kate Brown launched the Cleaner Air Oregon initiative in April 2016 in response to community concerns about exposure to potentially harmful air toxics not regulated under federal or state law.
In addition to closing gaps in existing air quality rules, Cleaner Air Oregon rules will provide the public with greater access to air toxics emissions data and create more certainty for regulated facilities.
State air quality regulators and OHA health experts will now begin moving forward to implement the rules. In coming months, agency staff expect to identify the 25 highest-priority industrial facilities across the state (based on estimated risk levels and other factors) to review under the new rules.
At last month’s State of Reform conference in Portland, OHA Director Patrick Allen shared his vision for health transformation in Oregon and CCO 2.0 – the next round of contracts with coordinated care organizations. CCOs serve nearly 1 million Oregonians on the Oregon Health Plan. In his keynote, he said:
“As the name CCO 2.0 implies, we’re not interested incremental changes. We’re not trimming around the margins. We’re not responding to Oregon’s biggest health challenges with technical tweaks pre-shrunk to fit our estimation of the modifications we think the system will most comfortably tolerate. Instead, we see CCO 2.0 as an opportunity to reboot the entire CCO system and reinvigorate health transformation in our state.”
You can view Director Allen’s complete speech at the State of Reform website.
 
Across Oregon, communities have struggled to meet the needs of people with behavioral health illnesses who find themselves in the criminal justice system. In response, state officials have kick-started a new collaborative, data-driven effort to treat people in the criminal justice system with behavioral health problems.
The effort involves legislators, health and behavioral health experts, judges, sheriffs, district attorneys, community corrections officials and others. The Council of State Governments (CSG) Justice Center, a national nonprofit organization, will assist Oregon in this effort with funding from the U.S. Department of Justice’s Bureau of Justice Assistance and The Pew Charitable Trusts.
The project will focus on developing a statewide policy framework to support local governments in improving recidivism and health outcomes for people who repeatedly cycle through both the public safety and health systems.
For example, Clackamas County has a population of just over 400,000 residents. In 2017, 6 percent of people booked into the county jail accounted for almost 20 percent of all booking events. The analysis showed that this group of 569 people, who cycled in and out of the jail throughout the year as many as four to 15 times, accounted for 2,848 separate admissions. Earlier and more effective interventions can produce better outcomes and save costs for state and local taxpayers.
This is the first statewide justice reinvestment effort in the nation to focus on the issues of behavioral health and the correctional system. The project is scheduled to produce recommendations for the Legislature during the upcoming 2019 session.
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