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The Oregon Health Authority has released a draft request for applications (RFA) which lays out the requirements applicants must meet to serve Oregon Health Plan members for the next five years of coordinated care contracts, also known as "CCO 2.0.
OHA will be accepting public comment on the draft RFA until 10 a.m. January 14. The final RFA will be released January 25. Letters of intent to apply will be due to OHA on February 1.
Oregon first established coordinated care organizations (CCOs) in 2012 to transform health care delivery in the state. CCOs bring together physical, behavioral, and oral health providers to coordinate care for people on the Oregon Health Plan. They are designed to improve health and reduce costs by providing more coordinated, flexible and innovative services and are rewarded for achieving specific health outcomes and quality measures.
"CCOs are a critical component of health transformation in Oregon," said OHA Director Patrick Allen. "The standards and expectations that will guide their selection are important to many stakeholders, not only to those who may apply. This is why I want to provide an opportunity for Oregonians to let us know if we’ve hit the mark on setting expectations for CCOs that will improve care for members and transform our health care system."
The draft RFA advances the policy recommendations approved by the Oregon Health Policy Board in October, which addressed Governor Kate Brown’s four priority areas for improvement:
- Improve the behavioral health systems and address barriers to access to and integration of care.
- Increase value and pay for performance.
- Focus on social determinants of health and health equity.
- Maintain sustainable cost growth and ensure financial transparency.
It also addresses member enrollment and rate setting processes that were discussed during public input sessions in November.
Member enrollment and distribution
The draft RFA lays out a proposed process for member enrollment and distribution in the event there is a change in CCO availability. The process allows members to choose a CCO, and for those who do not make a choice, prioritizes keeping members with their current primary care and behavioral health providers.
Rate setting
OHA also has changed the rate development methodology used to set the capitation rates (amount paid to CCOs per member per month). Among these changes is the implementation of service area-specific rates that are developed with area factors supplemented with health-based risk factors. This means proposed 2020 rates will account for each of nine service areas’ unique differences in the cost of delivering services and the risk associated with the members they serve. The service areas proposed in the RFA are subject to change once CCOs are awarded, which will impact the final rates. Other changes aim to reward CCOs that are high performing and show success in achieving the sustainable rate of growth.
OHA expects to announce the awards for the CCO contracts in July.
Public comment on the draft RFA must be submitted through the CCO 2.0 email inbox at CCO2.0@state.or.us by 10 a.m. January 14.
OHA will continue to provide updated information about the CCO 2.0 RFA process and answers to frequently asked questions on the CCO 2.0 page on the OHA website.
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