Health System Transformation Quarterly Progress Report November 2013

This week is Interim Legislative Days at the Oregon Capitol in Salem, Oregon. The House and Senate Health Care Committees met together to hear updates on several health related topics. See the update presentations from the Oregon Health Authority and Cover Oregon below. 

Health System Transformation Quarterly Progress Report 

November 2013 

Task Force on Individual Responsibility and Health Engagement 

Cover Oregon Update

	FOR IMMEDIATE RELEASE November 18, 2013 CONTACT: Katie Briedwell CCO Community Engagement Coordinator Yamhill County Care Organization kbriedwell@yamhillcco.org; 503-434-7339

Health care reform

Yamhill County Care Organization celebrates a year of progress; Designs Early Learning Hub

McMinnville, Ore. — Yamhill County Care Organization (Yamhill CCO) celebrates its first year of operations this month. While planning for more health-care improvement objectives in the months and years ahead, Yamhill CCO is marking the anniversary with a look back at the past year’s accomplishments, and anticipating a Letter of Intent from the Early Learning Council to award one of the state’s first Early Learning Hubs to Yamhill County.
Yamhill CCO manages care for the physical and mental health care needs of Oregon Health Plan (OHP) Medicaid members in Yamhill County, and by July 2014 will add transportation and dental care. It is one of 16 local Coordinated Care Organizations (CCOs) established to comply with state statutes affecting OHP clients.
Although most CCOs were formed by existing health care providers, including regional health plans and individual practice associations, Yamhill County leaders and providers chose to apply as a new non-profit organization, which gives more local control and accountability to the public. Its board members represent the spectrum of health care and community service interests within Yamhill County and serving mostly Yamhill County citizens.
“Community input and involvement is highly valued by Yamhill CCO,” says Jim Carlough, Yamhill CCO executive director. While all CCOs must have clinical advisory panels (CAPs) and community advisory councils (CACs), Yamhill CCO has broadened this shared responsibility with good results, he says. “Yamhill CCO held a joint session of its board of directors, clinical advisory panel and community advisory council; and, a member of the CAC serves on the Board of Directors.”
“Our community forum in June led to new ideas and goals for Yamhill CCO for 2014 and beyond,” Carlough says. The three bodies will meet jointly again this fall to review progress, and to project the work over the next months, including the task of implementing the expansion of Medicaid under the federal Affordable Care Act.
“It’s a major accomplishment for us to have such a productive forum where health providers, citizens and OHP members can brainstorm on how to improve and impact community health,” Carlough says.
Here are some of the current efforts:
YAMHILL CCO has funded two rounds of “Invest Forward” projects to address needs identified by the community. These projects are:

• Project ABLE, operated in coordination with the Traditional Health Care Worker Hub, will work with physicians and wellness teams to help clients who use a lot of health services to learn how to avoid unnecessary hospitalizations and emergency room visits.
• Virginia Garcia Memorial Health Center will increase access to comprehensive primary care, prevention services, mental health, and dental care for Oregon Health Plan members when the Affordable Care Act is expanded in 2014.
• Patient Activation Measure assessment tool will allow OHP care providers to evaluate and support patients in improving their own health.
• Behaviorists in Primary Care is a program supported by clinical leaders from George Fox University to place mental health clinicians (behaviorists) in practice settings at medical homes throughout the county.
• Community HUB Project will deploy North West Senior & Disability Services’ traditional health workers to ensure access and coordination of care for the most medically fragile members.
• Care Coordinator and Panel Manager staff have been deployed at Physicians Medical Center in McMinnville as key members of the patient-centered primary care home.
• Crimson Care Registry is a health information technology that will help the provider community to bridge the gap between various electronic health record systems and aggregate clinical data for the broader community coordination of care.

Another great community accomplishment over the past year is the work of the Yamhill Early Childhood Coordinating Council (ECCC), which led to a partnership with Yamhill CCO and a collective effort to apply to be a local Early Learning Hub.
“By having the Early Learning Hub under the Yamhill CCO umbrella, we create the capacity to achieve the core missions of both these entities toward better health and education outcomes for Yamhill County children and families,” Carlough says. “Children comprise 70 percent of our current membership, and health is a primary factor in their readiness to learn.”
With leadership from the two advisory groups, Yamhill CCO has also been working to improve quality of care throughout provider organizations.
“Yamhill CCO is committed to improving community health and wellness,” says Silas Halloran¬Steiner, director of Yamhill County Health and Human Services and chair of the Yamhill CCO board of directors.
“There are great opportunities for system coordination and improved care due to the high degree of community and provider involvement in Yamhill CCO,” Halloran¬Steiner says.

• For more information about Yamhill County Care Organization, contact Jim Carlough at jcarlough@yamhillcco.org.
• For information about Oregon’s Early Learning Hub initiative, see http://oregonearlylearning.com/other-priorities/community-based-coordinators-of-early-learning-services-hubs/.

Stakeholder Survey from OHA

Dear Stakeholder:

In our recent agreement with CMS regarding health system transformation, Oregon agreed to “conduct an exploratory stakeholder process that would result in a report to CMS regarding the integration of DHS Medicaid-funded LTC for the aged or people with disabilities into CCO global budgets.”

To accomplish DHS will engage a small group of approximately 20 Stakeholders from across a number of interests.  Our goal is that these stakeholders represent both the long term care and health care systems.  Additionally, we are seeking a balance between provider and consumer representatives.  We plan on beginning the detailed work in May 2013.  At this point, we anticipate monthly 4-hour work sessions over the course of six months.  The goal is finalize the report in November with CMS submission in December.  DHS is the lead agency for conducting this work but will partner strongly with OHA.

If you are interested in participating in this study, please submit an email to Susan Otter that answers the following questions: 

Name:

Title:

Organization:

Do you represent the provider or consumer perspective?

Why are you interested in participating in this exercise?

Can you commit to approximately six 4-hour work sessions from May 2013-November 2013?

Can you commit to reviewing and potentially editing materials resulting from work sessions?

Please send an email with the answers to these questions to susan.otter@state.or.us by February 19, 2013.  We will select approximately ten individuals from the health care community to participate in this exercise.

You can review the OHA announcement and informational materials about the Accountability Plan online athttp://www.oregon.gov/oha/OHPB/Pages/health-reform/cms-waiver.aspx

Sincerely

Bruce Goldberg, M.D.

Director

Oregon Health Authority

State Finalizes Federal Grant

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.

View the Agreement

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 4^th at 2:00 p.m. to go over the key elements of the Accountability Plan and allow stakeholders to ask questions. 

Register for the Webinar

	FOR IMMEDIATE RELEASE November 9, 2012 CONTACT: Katie Briedwell Executive Assistant Yamhill County Care Organization 503-434-7339 briedwellk@co.yamhill.or.us

Yamhill County Care Organization names Carlough new Executive Director

 Yamhill County Care Organization, one of Oregon’s newest Coordinated Care Organizations (CCOs) serving recipients of the Oregon Health Plan, has named James Carlough as its new Executive Director.

With more than 18 years experience working with managed care services and multiple health care delivery systems, Carlough combines business acumen with a broad knowledge of the community members served by the Oregon Health Plan, according to Silas Halloran-Steiner, the CCO’s board chairman.

“Jim’s experience in senior leadership positions with a diversity of health plans, will allow him to make an immediate contribution to Yamhill County Care Organization’s strategic planning and implementation efforts,” says Halloran-Steiner.

“Jim has lived with his wife and children in Newberg since 2005, so he is not only familiar with local concerns, but committed to our community’s well-being.”

Carlough, who says he feels deeply committed to vulnerable populations and delivery system enhancements, spent several years working with a Medicaid plan in Arizona. Most recently, Carlough served as senior manager, provider services, for CareOregon, the largest managed care organization serving OHP members.

Carlough’s task will be to manage both operations and coordinate with partner organizations, such as CareOregon and Mid-Valley Behavioral Care Network (MVBCN), which provide claims processing, provider contracting and other services for the CCO. He also will work with the board, member advisory council, and clinical advisory panel in developing a transformation plan demonstrating how Yamhill County Care Organization will work to improve health outcomes, increase member satisfaction and reduce costs. Each CCO is required to develop a transformation plan geared specifically to the needs of the local community it serves.

“I am excited about the opportunity to work with Yamhill County Care Organization,” says Carlough. “My goal is to increase access to services, help reduce costs, and benefit my local community.”
Yamhill County Care Organization has approximately 18,000 members.

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If you have further questions please contact:

• Jim Carlough, Executive Director, Yamhill County Care Organization
  carloughj@careoregon.org  or 503-416-8038
• Silas Halloran-Steiner, Director, Yamhill County Health and Human Services
  halloras@co.yamhill.or.us or (503) 434-7523
• Gil Munoz, CEO, Virginia Garcia Memorial Health Center
  gmunoz@vgmhc.org or (503) 352-8610
• Dan Ordyna, CEO, Willamette Valley Medical Center
  daniel.ordyna@capellahealth.com or (503) 435-6320
• Alan Olive, CEO, Providence Newberg Medical Center
  Alan.Olive@providence.org or (503) 537-1701
• Jim Russell, Executive Manager, Mid-Valley Behavioral Care Network
  jimr@mvbcn.org or (503) 585-4991
• Patrick Curran, Director of Business Integration, CareOregon
  curranp@careoregon.org or (503) 416-4100

 For general questions, e-mail carloughj@careoregon.org  or visit http://yamhillcco.com/

Oregon Health Policy Board to host public forum on progress of health system transformation

From the Oregon Health Policy Board "Health News"

The December Oregon Health Policy Board meeting will focus on the progress to date of Oregon’s Medicaid health system transformation and provide a format for public input in the early stages of the new Coordinated Care Organizations.

The board meeting will be a forum for consumers, advocates, and stakeholders to offer feedback on certain questions related to health system transformation and Oregon's coordinated approach to care. More information will be provided as the meeting approaches.

The meeting will be held at its usual time Tuesday, Dec. 11, from 1 p.m. – 5 p.m. but will be conducted at the Multnomah County Commissioner's office, 501 Southeast Hawthorne Blvd., Portland, OR 97214.

If you or your organization wish to give a public comment, please email the Oregon Health Policy Board staff at ohpb.info@state.or.us with the subject line: Health System Transformation Feedback. For those around the state who cannot travel to Portland, alternative means of commenting will be provided.

DCOs and Legislators Ask for OHA Rule Change

Dentistry Would Be Mandated Through DCOs Until 2017

Mike Shirtcliff of Advantage Dental and two state legislators, Senator Alan Bates and Representative Tim Freeman have filed a petition with the Oregon Health Authority to require that CCOs must contract directly with Dental Care Organizations if they are to provide dental care to their members. The change would specifically prevent CCOs from contracting with any other dentist, dental hygienist, or dental organization.

View the Petition Here.

Update from Health Share of Oregon

See below for an update from Health Share of Oregon on their current status.

The latest activities at Health Share: 

• HSO began operating as a CCO and serving OHP enrollees on September 1.  It was a very smooth transition, with only one minor glitch in the computer system at OHA over the Labor Day weekend that was fixed almost immediately.

• HSO's first priority was to do no harm to our Members.  In order to minimize any potential disruption for OHP members, HSO allowed members to stay enrolled with their current health plans, under the HSO umbrella.  This will ensure that members may continue access all of their current providers.

• In the coming months, HSO will be working with members, the provider community, and other stakeholders to migrate and consolidate CCO services, where appropriate, to maximize efficiency and coordinate across systems.

HSO's CAC has held two monthly meetings to date.  Stephen Weiss is the Chair of the CAC; Dalila Sarabia is the Vice Chair; Ronda Harrison is the Secretary; and Amy Anderson and Faith Gilstrap are members of the Executive Committee.  The complete CAC roster can be found on the HSO Fact Sheet.

• The  CAC has begun the process of discussing and thinking through their responsibility of overseeing the Community Needs Assessment process, adopting a Community Health Improvement Plan, and producing an annual report on the progress toward achieving the Community Health Improvement Plan
  
The CAC will also participate and contribute to the development of HSO's Transformation Plan.

• Beginning at the October 5th CAC meeting, there will an opportunity for the Public to come and submit oral or written comments on the CAC's or HSO's work. Please visithttp://healthshareoregon.org/about/community-advisory-council/ closer to the meeting date for more details.

Metrics and Scoring Committee begins meeting with task of identifying outcome and quality measures for CCOs

From the OHPB E-bulletin:

The newly-formed nine-member Oregon Metrics and Scoring Committee held its first meeting in August with the task of identifying the outcome and quality measures for Coordinated Care Organizations.

“This committee's work is important to ensuring better health outcomes. These are the metrics that will tell us where we’re going and will allow us to make quick course corrections as needed along the way to improve the health of Oregonians,” Tina Edlund, Oregon Health Authority chief of policy, said after the meeting.

The committee includes three at-large members, three members with expertise in health outcomes and three representatives of Coordinated Care Organizations. The committee was established by Senate Bill 1580, and members serve for two-year terms.

Metrics and quality measures will be used by the Oregon Health Authority to determine whether CCOs are effectively and adequately improving health, making quality care accessible, eliminating health disparities, and controlling costs for the populations that they serve.

For more information on the committee, including meeting materials and schedules, please visit the Metrics and Scoring Committee webpage.

New Coordinated Care Organizations in Hood River, Wasco, Yamhill Counties

Oregon Health Authority News Release

August 29, 2012

Contact: Patty Wentz, 503-932-6243

New Coordinated Care Organizations moving forward in Hood River, Wasco and Yamhill counties

Majority of Oregon Health Plan clients will have access to more coordinated, patient-focused care 

Two new coordinated care organizations have been provisionally certified to serve Oregon Health Plan clients, officials announced today.

Pending final approval later this month, the new CCOs will begin operation on November 1, 2012. PacificSource Community Solutions Coordinated Care Organization – Columbia Gorge Region will serve OHP clients in Hood River and Wasco counties. Yamhill County Care Organization will serve local clients there.

In total, 13 CCOs have received final approval to serve OHP clients and three have been provisionally certified. The majority of OHP clients in the state will be served through a local coordinated care organization.

“Oregon has truly come together with a renewed commitment to patient-centered care and lower costs,” said Governor John Kitzhaber. “I want to commend everyone who has worked so hard this year to launch coordinated care organizations. Your efforts will benefit your patients, your community and our state.”

Under the CCO model, for the first time care for OHP clients is jointly managed for physical and mental health to be better able to coordinate care and reduce unnecessary hospitalizations. The model also emphasizes using community-based health workers to help patients with chronic illnesses stay healthier and reduce costs.

OHP clients who are going to be enrolled in a new CCO in their communitywill receive personal notification with the name of the new coordinated care organization.

As the new coordinated care organizations prepare to begin serving clients, a committee of Oregonians is working to identify objective quality measures for all CCOs on outcomes such as ambulatory care, inpatient care, chemical dependency and mental health treatment, and all other health services provided by coordinated care organizations.

“The best path to lowering health care costs is through improved health,” said Bruce Goldberg, M.D., director of the Oregon Health Authority. “With the final CCOs approved this year the pieces are in place for a system that works for all of us in bringing better health, better care and lower costs.”

More information about CCOs can be found at health.oregon.gov.

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Tri-County Medicaid Collaborative Names Board of Directors

The Tri-County Medicaid Collaborative has named their board of directors.

Board members include:
Community-At-Large 
Mel Rader – Co-Executive Director, Upstream Public Health
Ramsey Weit – Executive Director, Community Housing Fund
Chair of Community Advisory Council
Stephen Weiss – Chair of the Elders in Action Commission of Multnomah County, Current Board President of Independent Living Resources, the Community Alliance of Tenants, and the Oregon State Council for Retired Citizens
Dentist 
Michael Biermann, DMD – Pediatric Dentist, Owner, Co-Chair, Oregon Head Start Dental Home Project
Mental Health Provider 
Mary Monnat – President and CEO, LifeWorks NW
Addictions Provider 
Jacqueline Mercer – CEO, Native American Rehabilitation Association of the Northwest, Inc.
RN/NP 
Jean-Claude Provost – Lead Clinician/Family Nurse Practitioner, Housecall Providers, Inc., Chair-Elect, Nurse Practitioners of Oregon
Primary Care Physician 
Jill Ginsberg, MD – Retired, Northwest Permanente, Founding Board Member, North by Northeast Community Health Center
Specialty Care Physician
Walter Hoffman – Member, Past President, Practicing OB/GYN, Women’s HealthCare Associates, LLC
In addition, the founding members include:
George J. Brown, MD, FACP, Chair, Legacy Health
Cindy Becker, Clackamas County Health , Housing & Human Services
Ed Blackburn, Central City Concern
Rod Branyan, Washington County Dept. of Health & Human Services
David E. Ford, CareOregon
Andrew R. McCulloch, Kaiser Permanente
Joseph E. Robertson, Jr., MD, OHSU
Thomas Russell, Adventist Medical Center
Lillian Shirley, Multnomah County Health Department
Dick Stenson, Tuality Healthcare
Greg Van Pelt, Providence Health & Systems


For more information on the Board of Directors, visit the Tri-County Medicaid Collaborative website.

New Coordinated Care Organizations approved for Oregon Health Plan

Contact: Patty Wentz, 503-932-6243

CORRECTED RELEASE: This release has been updated to correct the number of clients served by CCOs beginning Sept.1 and the Eastern Oregon Community Care Organization service area.

July 31, 2012

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.

The new CCOs will provide services for OHP members in 22 counties. In total, there are 13 Coordinated Care Organizations serving 33 counties in the state. By   Sept. 1 nearly 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

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

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 starting Sept. 1. (Gilliam, Grant, Harney, Lake, Morrow, Umatilla and Wheeler counties starting at a later date.) 

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.

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.

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.  

# # #

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.

# # #

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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