Oregon announced a the finalization of a comprehensive
agreement with the Centers for Medicare and Medicaid Services (CMS) that sets
expectations for Oregon’s Coordinated Care Organizations. The agreement
fulfills the Special Terms and Conditions of last July’s 1115 Medicaid
demonstration.
Entitled “Oregon’s Accountability Plan and Expenditure Trend Review,” the plan “lays
out the methods, measurements and accountability” for Oregon’s health system
transformation including:
- How Oregon will be held accountable for reducing the state’s Medicaid expenditure growth trend while improving quality and access;
- Details on the health quality improvement metrics to be used to measure progress. These metrics include a set established by a stakeholder-led Metrics and Scoring Committee that will provide financial incentives for CCOs that show performance improvement.
- How the 2 percentage point reduction in per capita medical expenditure trend will be lowered; and,
- Quality assessments - and the penalties that would occur if health quality were to diminish among the OHP population.
Included in the agreement are 17 CCO Quality Pool Metrics
established by the stakeholder Metrics and Scoring Committee and additional
metrics that CMS will expect over the long term. All are geared towards
ensuring that transformation of the health system, improved outcomes and bending
of the cost curve will occur.
OHA will hold a webinar on January 4th at
2:00 p.m. to go over the key elements of the Accountability Plan and allow
stakeholders to ask questions.
