OHA announces applicants for 2020-2024 coordinated care contracts

Oregon Department of Human Services sent this bulletin at 04/25/2019 08:39 AM PDT
CCO Leadership Bulletin masthead

April 25, 2019

In this issue ...

dotted line for divider

OHA announces applicants for 2020-2024 coordinated care contracts

The Oregon Health Authority has received 19 applications from organizations seeking contracts to serve as coordinated care organizations (CCOs) for the Oregon Health Plan’s nearly 1 million members. The contracts start January 1, 2020, and go through December 31, 2024. Awards for the CCO contracts are expected to be announced in July.

"OHA’s goal is to transform health care for every Oregonian by reducing costs, improving access to mental health services, rewarding providers for improving health outcomes, and addressing issues outside the doctor’s office that impact health," said OHA Director Patrick Allen. "OHA will be evaluating the applicants based on their ability to deliver on these goals."

Based on the applications, Oregon Health Plan members in every county in Oregon would have at least one CCO to coordinate their health care. In many parts of the state, multiple organizations submitted applications to operate in the same counties, giving Oregon Health Plan members more than one CCO choice.

For more details, go to the OHA CCO 2.0 webpage.

dotted line for divider

5 questions with April Gillette

april gillette

April Gillette started March 4 as the Oregon Health Authority's director of governance, compliance, quality and performance improvement. Gillette previously worked in eastern Oregon as Infection Control and Quality director in a hospital setting.

Gillette’s background is in veterinary medicine. She made the switch to public health while in graduate school at Oregon State University. Gillette will have an important role in CCO 2.0, as she prepares OHA to support CCOs through the next phase of health system transformation.

1) What is your role with OHA? As the Governance, Compliance, Quality and Performance Improvement director, I work to ensure that the Health Systems Division maintains appropriate oversight over itself as well as the Medicaid program as a whole. We also work to apply process improvement principles to increase transparency and efficiency throughout HSD and all of OHA.

2) What can CCOs expect from you in the next year? I’m looking forward to my team becoming a resource for transparent guidance as we move into and through the 2.0 contract. We also want to be able to address barriers in a systematic manner that encourages better care for our OHP members.

3) What will your role be during the implementation of CCO 2.0? We will work closely with the Medicaid office to manage deliverable expectations and address issues as they arise. I am a strong proponent of collaboration and look forward to teaming up with the CCOs to address issues.

4) What are your short-term and long-term goals at OHA? In the short term, I’m looking to build a team of critical thinkers who are efficient in their daily work and strive to break down barriers in the silos around them. In the long term, I want to standardize work flows so that the same high-quality care is given no matter what personnel changes may occur within OHA.

5) How do you like to spend your time outside of work? I enjoy spending time with my husband, two young daughters, and our new puppy outdoors if at all possible. I also enjoy horseback riding (hunters/jumpers) and am looking forward to getting back in the saddle.
dotted line for divider

Funding available for community partnerships to address chronic disease

The Oregon Health Authority is seeking proposals for the Sustainable Relationships for Community Health (SRCH) grant. The request for grant proposals will be released in early May and applications will be due in early June. SRCH is an innovative model to advance health system improvements that support chronic disease prevention and management. Creating sustainable and effective relationships between community partners improves preventive and chronic care services as well as health outcomes, reduces health care costs, and promotes equity.

SRCH brings together teams comprised of partners from local public health authorities (LPHAs) or organizations administering prevention education programs for tobacco, alcohol and other drugs (TPEP and ADPEP), Oregon federally recognized tribes or Urban Indian Health programs that administer an ADPEP or TPEP programs, and coordinated care organizations to implement evidence-based interventions and services for sustainable health system change.

These teams are encouraged to invite and fund other key partners involved in health system transformation (regional health equity coalitions or RHECs, clinics, community-based organizational partners delivering self-management programs) to create sustainable, effective relationships between community partners to improve preventive and chronic care services, improve health outcomes, reduce health care costs, and promote equity.

OHA anticipates awarding at least three grants for up to $120,000 each for the period of July 1, 2019 through June 30, 2020.

Questions? Please contact Shira Pope at 971-673-1052 or shira.r.pope@state.or.us.

dotted line for divider

OHA leaders discuss Medicaid sustainability at Capitol

On Monday, April 15, three Oregon Health Authority leaders returned to the Ways & Means Subcommittee on Human Services to discuss CCO 2.0. Patrick Allen, OHA Director, Jeremy Vandehey, Health Policy and Analytics director, and David Baden, chief financial officer, described the lessons learned from the first round of CCO contracts, the goals of the upcoming second round, and the process for getting the new CCO contracts started by January 2020.

They emphasized the importance of containing health care costs below national trends, rewarding CCOs for quality care instead of just for providing more services, addressing the social determinants of health, and ensuring CCO accountability. They also outlined the process for transitioning members to the new CCOs, with members first offered the opportunity to choose their plan, and if they do not choose, with priority on maintaining members’ existing relationships with their providers.

The bills addressing Medicaid sustainability this session include:

  • HB 2269 (Employer Health Care Responsibility Act) – Heard by house revenue committee Monday, April 22.
  • HB 2270 (tobacco tax) – Heard by house revenue committee Thursday, April 11.
  • HB 2010 (extends hospital, insurance assessments) – signed by Governor Brown March 27.

More information is available on the OHA budget and legislative information webpage.

dotted line for divider

Transformation Center updates

Register now for Transformation Center 2019 Innovation Café

Registration is now open for the 2019 Innovation Café: Strategies for Addressing the Social Determinants of Health, which will take place June 5 at the Oregon Convention Center in Portland. This one-day event will engage health system leaders and key partners in peer-to-peer learning and networking to spread innovation, with the aim of addressing key social determinants of health (specifically housing, trauma, early learning and early childhood education, and food insecurity). Best practices in health system innovation and collaboration with community-based partners will be discussed through cafe-style project presentations and plenary sessions.

Audience: CCO and clinic staff, community-based partners representing key topic areas, tribes, and other health system leaders.

Cost: No charge to attendees.

A draft café agenda will be posted to the Innovation Café website in May.

For additional information, please visit the Innovation Café website or contact the following OHA Transformation Center staff:

----

Be sure to sign up for the Transformation Center’s Transformation in Action newsletter! The new spring issue highlights some of the innovative ways six CCOs are improving maternal and child health. Sign up and see the all issues on the Transformation Center website.

dotted line for divider