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August 11 2022
Media Contact: Liz Gharst, elizabeth.a.gharst@state.or.us, 971-666-2476
The Oregon Health Authority (OHA) released the 2021 Coordinated Care Organization (CCO) Metrics Report, showing the results of Oregon’s Quality Incentive Program. The program rewards CCOs for improving the quality of care provided to Oregon Health Plan members. This program is one of several key health system transformation mechanisms for achieving Oregon’s health equity goal and vision for better health, better care and lower costs.
Although the COVID-19 public health emergency continued and the Delta variant drove surges in hospitalizations and deaths, performance on CCO incentive metrics began to rebound in 2021 after sharp declines in 2020.
The report shows an encouraging return to a focus on increasing quality, consistent with the Metrics and Scoring Committee’s decisions about 2021 benchmarks. Normally, the committee sets incentive metric benchmarks that are aspirational goals to encourage ongoing improvement. To balance ongoing quality improvement needs with concerns about the pandemic’s pressures on the health care system, however, the committee set significantly lower benchmarks for 2021, after suspending benchmarks entirely for 2020 due to the public health emergency.
CCOs earned substantial bonuses for performance on the metrics. The 2021 Quality Pool for CCO incentive metrics was almost $235 million, representing 3.75% of the total amount all CCOs were paid in 2021. The share of these bonus funds that each CCO earned depends on the number of members it serves and its performance on the 14 incentive metrics.
“After the initial shock of 2020, this report shows CCOs regaining ground in 2021,” said OHA’s Interim State Medicaid Director Dana Hittle. “Despite ongoing challenges, we saw CCOs improve over 2020 performance on most of these key measures of care for Oregon Health Plan members. This is very positive progress.”
Report highlights
In sharp contrast to 2020, statewide performance in 2021 showed improvement on most of the 14 incentive measures. The exceptions were two immunizations measures, which worsened for both children and adolescents, and the measure of drug and alcohol screening and referrals, which improved for the screening rate but worsened for the referrals rate. This report contains both encouraging trends and areas for improvement.
- Oral health measures regained substantial ground in 2021. Preventive dental services improved by 25.9% over 2020 in ages 1 to 5 and 17.1% in ages 6 to 14. Oral evaluations for adults with diabetes improved by 21.7%.
- The rate of CCO members who receive postpartum care after giving birth continued to improve in 2021, up 5.6% from 2020. The postpartum period is an important time for physical recovery; addressing pregnancy spacing and family planning needs; managing chronic conditions that may have been exacerbated during pregnancy; providing breastfeeding support; and ensuring mental health.
- Improvements are needed in rates of youth immunizations, which are down 7.7% for adolescents and 8.3% for immunizations received by the child’s second birthday. Because these measures include a “look back” for immunizations received in previous years, they continue to be affected by disruptions in preventive care that occurred earlier in the pandemic.
In 2021, the Health Equity measure: Meaningful access to health care services for persons with limited English proficiency was incentivized for the first time, following extensive development work by a public workgroup and other partners. The measure’s goal is to achieve meaningful access to health care services for all CCO members through quality communication and language access services, as well as the delivery of culturally responsive care. Additional metrics to incentivize upstream, systems-level changes are included in the 2022 and 2023 CCO incentive metrics sets and will be reported in future years.
For highlights of statewide performance, snapshots of CCO performance, and details on how much each CCO earned through the Quality Incentive Program, visit the OHA Health Policy and Analytics website. A dashboard coming this fall will include additional measures, with options to explore breakouts of statewide and CCO performance by race, ethnicity and language.
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