New Coordinated Care Organizations approved for Oregon Health Plan

Today's News Release from the Oregon Health Authority outline five new Coordinated Care Organizations approved to begin service on September 1st, 2012.

July 31, 2012

Contact: Patty Wentz, 503-932-6243

New Coordinated Care Organizations approved for Oregon Health Plan

Five new Coordinated Care Organizations will begin serving Oregon Health Plan members in September, the Oregon Health Authority announced today.

In total, there are 13 approved Coordinated Care Organizations serving 33 counties in the Oregon. By Sept. 1 more than 500,000 adults and children – the majority of Oregon Health Plan members – will have access to a CCO.

“In Oregon we are showing that it is possible to build a health care system around patients and their providers for better health and reduced costs,” said Governor John Kitzhaber. “These new Coordinated Care Organizations will be leading the way for everyone in our state.”

Oregon Coordinated Care Organizations to start September 1

Columbia Pacific Coordinated Care Organization, LLC – All of Clatsop, Columbia and Tillamook counties. Parts of Coos and Douglas counties.

Eastern Oregon Community Care Organization – Baker, Malheur, Sherman, Union, Wallowa Gilliam, Grant, Harney, Lake, Morrow, Umatilla and Wheeler counties.

Jackson County Coordinated Care Organization, LLC – Jackson County.

PrimaryHealth of Josephine County, LLC – Josephine County and parts of Douglas and Jackson counties.

Tri-County Medicaid Collaborative – Clackamas, Multnomah and Washington counties.

Under Coordinated Care Organizations, benefits for Oregon Health Plan clients will not change. The vision of CCOs is to allow providers better ways to address health care problems.

To see full list of Coordinated Care Organizations, go towww.health.oregon.gov.

OHP members will receive personal notification of their new Coordinated Care Organization, and they do not need to take any action. More information for members and providers can be found at health.oregon.gov.

Through a waiver from the federal government, Oregon has flexibility to provide more preventive care and disease management than has been possible under traditional Medicaid guidelines. Research shows that 80 percent of health care costs are driven by 20 percent of patients, many with chronic conditions such as heart disease, diabetes and serious mental illness. CCOs will have the ability to hire community-based health workers to help people manage their conditions, ensure they are taking appropriate medications, and avoid unnecessary acute or emergency care. By focusing on improved health, Oregon has agreed to reduce Medicaid inflation by 2 percentage points within two years by focusing on improving the health of clients to reduce waste, inefficiency, and unnecessary expenditures.

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Senator Winters Sets Health Care Summit

State Senator Jackie Winters, Oregon Health Authority Director Bruce Goldberg, Oregon Health Insurance Exchange Directory Rocky King, and Health Reform Leaders in Marion and Polk Counties put together a health care Summit in August.


Read More From the Statesman Journal Here.

Eastern Oregon Coordinated Care Organization receives provisional certification to pursue formation for twelve rural counties

MEDIA RELEASE

Contact –

 Kevin Campbell, GOBHI CEO – 541-298-2101

Tammy Dennee, GOBHI Communications Director – 541-980-6887

Jonathan Nicholas, ODS Community Health, Inc. (ODS Health) Vice President – 503-219-3673

Eastern Oregon Coordinated Care Organization receives provisional certification to pursue formation for twelve rural counties

Pendleton, Oregon – The Oregon Health Authority has granted provisional certification to the Eastern Oregon Coordinated Care Organization (EOCCO) to form a Coordinated Care Organization encompassing twelve of Oregon’s rural counties including Wheeler, Gilliam, Sherman, Morrow, Umatilla, Lake, Harney, Grant, Union, Malheur, Wallowa and Baker. 

GOBHI and ODS Community Health, Inc. (ODS Health), the partners forming the EOCCO, are pleased to receive this provisional certification and now undergo preparations for the next phase of the process which involves a “Readiness Review.”  The Readiness Review will require the EOCCO demonstrate engagement with providers and hospitals in the twelve county service area’s healthcare communities and how that engagement has resulted in policies and procedures that will shape how care is provided to all Oregon Health Plan members in the service area.  The twelve county area spans more than 50,000 square miles and is home to approximately 36,000 Oregon Health Plan members. 

Upon final approval, the EOCCO will begin providing service on September 1, 2012. 

 “The EOCCO will provide a different way of providing care for members in the Oregon Health Plan,” said Sean Jessup, ODS Health Medicare and Medicaid Programs Manager. “By forming the EOCCO, both ODS Health and GOBHI will work within the service area to bring new models of care that are patient-centered and team-focused.” In addition, the EOCCO will be governed by a partnership among local healthcare providers and community members. “

Kevin Campbell, GOBHI CEO, stated the EOCCO is committed to delivering better care in Eastern Oregon. “Our commitment is providing better care, with better outcomes,” said Campbell. “When we achieve better care and outcomes, we also achieve savings for these Eastern Oregon communities.” Once savings are achieved, each Eastern Oregon community will be able to determine how to reinvest those savings back in their communities for continued enhancements.

GOBHI has a 15-year history as a mental health organization with a proven track record of serving the patient efficiently and effectively. Campbell stated, “Oregonians who choose to reside in rural communities deserve quality healthcare that addresses all needs of the patient starting with quality prenatal care.  Patients who receive regular care are ultimately in better health and require less healthcare in the emergency room setting. The bottom line is investing in the less expensive care results in savings for the long-term.”

ODS Health has been serving Oregonians for more than 55 years. ODS Health has been nationally recognized by the National Committee for Quality Assurance (NCQA) for the quality of their Oregon PPO plan, achieving an accreditation status of commendable.  ODS plans to bring that same focus on patient quality to the EOCCO partnership.

The EOCCO is in the process of securing members of the Community Advisory Committees.  If you are interested in participating in a Community Advisory Committee, please contact GOBHI at (541) 298-2101.  Additional information regarding the formation of Coordinated Care Organizations in Oregon is available on line at http://health.oregon.gov/oha. 

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Provider Webinar: Coordinated Care Organizations

Provider Webinar: Coordinated Care Organizations Join us for a Webinar on July 17 Space is limited. Reserve your Webinar seat now at: https://www2.gotomeeting.com/register/302979666 Please join us for a presentation on the development and status of Coordinated Care Organizations (CCOs) and how Oregon's provider community can become involved. Oregon Health Authority (OHA) Director, Bruce Goldberg, M.D. will lead the discussion about CCOs and Oregon's direction to improve health care and how providers will play a key role in Oregon's health systems transformation efforts. Additionally, Cathy Kaufmann, Administrator for the Office of Client and Community Services/Healthy Kids, will be on hand to present information on the status of CCOs, OHA's plans for member transition and what resources are available. Ample time will be given for questions. Title: Provider Webinar: Coordinated Care Organizations Date: Tuesday, July 17, 2012 Time: 11:00 AM - 12:00 PM PDT After registering you will receive a confirmation email containing information about joining the Webinar. System Requirements PC-based attendees Required: Windows® 7, Vista, XP or 2003 Server Macintosh®-based attendees Required: Mac OS® X 10.5 or newer

NEWS RELEASE

JULY 9, 2012

Media Contact:
Tim Raphael, 503-689-6117
Amy Wojcicki, 503-689-5324

Oregon’s Federal Agreement on Health System Transformation Finalized   

Brings more flexibility for prevention services and investment in health care workforce

(Salem, OR) — The federal government has signed off on Oregon's health transformation initiative, approving a waiver that grants the state more flexibility to improve its Medicaid services program. Governor Kitzhaber announced the agreement with the Centers for Medicare & Medicaid Services as a key step forward in Oregon's goals to improve the quality of care for Oregon Health Plan members while reducing costs.

“I want to thank our federal partners for their responsiveness and strong partnership,” said Governor Kitzhaber. “This waiver is the final building block to creating a better model of care, and Oregon is ready to demonstrate how local communities can lead the nation in keeping people healthier over the long term in a more effective way.” 

Oregon's 1115 Medicaid demonstration affirms federal financial investments over the next five years, which will be used to increase access to better coordinated, more patient-centered care and support a more efficient delivery system. In return, Oregon has committed to reducing the state’s growth in Medicaid spending, resulting in significant savings to the federal government through improved health care, not through reductions in eligibility or benefits covered. 

Kathleen Sebelius, Secretary of the Department of Health & Human Services, said, "These efforts to coordinate care, which mirror our efforts at the national level thanks to the Affordable Care Act, will mean better care for those on Medicaid, better health outcomes, and lower costs. This is another example of how we are collaborating successfully with States in their efforts to find innovative healthcare solutions that work for their communities."

Under the agreement, Coordinated Care Organizations responsible for providing care to Oregon Health Plan members will have more flexibility to pay for services that improve health and lower costs, but that are not traditionally covered by Medicaid. Examples include preventive services to reduce unnecessary hospitalizations and acute care, more primary care, and greater emphasis on local community health workers who can help Oregon Health Plan members manage chronic illnesses. 

To support a larger workforce necessary for this model of care, the federal agreement includes funding for a loan repayment program for primary care physicians who commit to working in rural or underserved communities in Oregon and training for 300 community health workers by 2015. 

Agreement terms also call for Coordinated Care Organizations and the state to meet high standards for care and quality. Measures of success include patient experience of care, hospital readmission rates, care received after hospitalizations due to mental illness, health disparities among races and ethnicities, and rates of obesity and tobacco use. Eight Coordinated Care Organizations have been approved by the Oregon Health Authority to begin serving patients in August, with more scheduled to begin operations later this year. 

“The new model of care we are creating will bring a better quality of life to people on the Oregon Health Plan,” said Bruce Goldberg, M.D., director of the Oregon Health Authority. “With the federal support, we will be able to invest in local, patient-centered care that works to improve health and lowers costs.”

The 1115 waiver can be viewed in its entirety at health.oregon.gov. 

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