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.

# # #

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.