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Get the latest information about CCO 2.0 and the organizations who will be serving Oregon Health Plan members starting in January 2020. During the webinar OHA will share its communication plan for members with changes to their CCO choices, the next steps in the CCO awards process, and what stakeholders and providers can do to support members during this transition.
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On Monday the Trump administration announced a new rule that makes it harder for immigrants who rely on certain government benefit programs to obtain lawful permanent residency if they are found to be a "public charge." The new public charge rule expands the list of benefits that the federal government could consider.
The Oregon Health Authority is the state agency responsible for protecting the health of all 4 million people living in Oregon. As part of our role, we want to inform state residents about the impact of the rule on programs that provide health coverage and health-related benefits in Oregon. Read about how the rule change will affect the people of Oregon in our public statement shared with the media Tuesday.
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Oregon's coordinated care organizations (CCOs) continue to advance health system transformation by focusing on better care and better health outcomes while controlling health care costs. Children's health and behavioral health outcomes are among the top improvements.
The 2018 CCO Metrics Report details Oregon’s pay-for-performance program for CCOs.
Highlights of the 2018 report:
- The percentage of children in foster care who received mental, physical, and dental health assessments has improved by more than 200 percent since becoming an incentive metric in 2015.
- Dental sealants for children ages 6 to 14 has improved by 34 percent from 2015 to 2018.
- While emergency department use decreased for all members between 2017 and 2018, the decline was greater for members with mental illness. This is the first year that emergency department use among members with mental illness was a CCO metric.
- CCO performance on depression screening and follow-up has more than doubled since 2015, increasing from 27.9 percent to 64 percent in 2018.
The quality pool model rewards CCOs for the quality of care provided to Oregon Health Plan members. This model increasingly rewards CCOs for outcomes, rather than use of services.
The quality pool totaled $188 million. All CCOs showed improvement on a majority of measures, and 12 out of 15 earned 100 percent of their quality pool dollars.
That left nearly $11 million for the challenge pool, which was distributed to CCOs that met the benchmark or improvement target on four measures that impact early childhood: assessments for children in DHS custody, childhood immunization status, developmental screenings in the first 36 months of life, and timeliness of prenatal care.
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The CCO Metrics and Scoring Committee will discuss the integration of social determinants of health into its performance standards for CCOs on Aug. 16.
The committee will also discuss some of the 2020 benchmarks and challenge pool measures for CCOs at that meeting. The committee meets 9 a.m. to noon in the Transformation Training Room, Suite 775, of the Five Oak Building, 421 SW Oak St., Portland. The public also may attend by webinar and listen to the meeting via conference line at 888-204-5984, access code 1277166.
More information on the committee's website.
The Metrics and Scoring Committee in July finalized the list of health care quality measures that will be included in the 2020 CCO Quality Incentive Program.
These metrics will be the first set of pay-for performance measures included in the new CCO contracts beginning January 2020. The committee chose to reduce the number of measures included in the program from 19 to 13. This included retiring 10 of the measures currently included in the program and adding four new claims-based measures.
Two of the new measures are part of a multi-year strategy focused on the health sector’s role in preparing children for kindergarten (well-child visits for children ages 3-6 and preventive dental visits for ages 1-5). The other new measures focus on immunizations for adolescents and ensuring those newly diagnosed with substance use disorders are able to access treatment.
The committee will spend the next two months identifying targets each of the measures included in the 2020 incentive measure set. More information about the Metrics & Scoring Committee, including past meeting materials and copies of written public testimony, is available on their webpage.
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