Here’s the latest bulletin from the Oregon Health Authority and the Oregon Health Policy Board. To get email updates from the OHA, please sign up at their website.
News this Month
- First HB 3650 work groups meet (summaries of each group’s first meeting in August)
- September legislative days
- Oregon Health Insurance Exchange Board announced
- AIM 2011: Innovating for Healthy Oregonians
HB 3650 Work Groups hold first round of meetings
Governor Kitzhaber has selected 133 people to serve on four work groups chartered to inform the development of the Coordinated Care Organization (CCO) proposal. The four work groups are:
- CCO Criteria
- Global Budget Methodology
- Outcomes, Quality and Efficiency Metrics
- Medicare-Medicaid Integration of Care and Services
More information about CCOs and materials from HB 3650 work group meetings can be found online at health.oregon.gov.
In August, all four work groups met for the first time. Below is a short summary of each.
CCO Criteria work group:
The CCO Criteria work group will provide input into the qualification criteria and standards for proposed CCOs.
Next Meeting: Sept. 21, 6 – 9 p.m. at the Cherry Avenue Training Center in Keizer.
During the first meeting, members addressed the process for selecting and contracting with CCOs, and the topics for the group to focus on in order to provide clear input on CCO criteria within the time allowed. Under the charter for this group, there are 17 potential topics that could be considered to qualify organizations as CCOs. The group is limiting their scope of discussion to the most complex and substantive issues: CCO governance; alternative dispute resolution; CCO financial solvency, risk and business plan; patient rights; and health equity.
Visit the Health System Transformation website for more details on the CCO Criteria work group meeting.
Global Budget Methodology work group:
The Global Budget Methodology work group will provide input into the global budget methodology for CCOs, including consideration of criteria for determining what funds flow into the global, budget, shared savings arrangements, stop-loss, risk corridors and risk sharing arrangements.
Next Meeting: Sept. 20, 6 – 9 p.m. at the Cherry Avenue Training Center in Keizer.
The group was asked to identify the priority topics for the next few months and the priority considerations for determining which programs should be included in the initial CCO budgets. Future topics will include criteria for including or excluding programs; how CCOs can manage risk and ensure good health outcomes; assuring the sustainability of CCOs; and integration with Medicare. Group members also suggested that other potentially worthwhile discussions include answering the question of whether the methodology will work as other payers are folded into the CCO construct; developing a process for revising the global budget methodology over time; and changes within OHA’s organizational structure to better align with CCOs.
Visit the Health System Transformation website for more details on the Global Budget Methodology work group meeting.
Outcomes, Quality and Efficiency Metrics work group:
The Outcomes, Quality and Efficiency Metrics work group will provide input into performance standards and benchmarks to ensure that within CCOs care is being improved while costs are being reduced. Performance standards will include clinical, financial and operational metrics.
Next Meeting Date: Sept. 26, 9 a.m. to noon at the Clackamas Community College Campus in Wilsonville.
The focus of the first meeting was to provide feedback on what criteria would be appropriate to use when selecting, changing, or prioritizing CCO performance measures. Examples of criteria include a metric’s relevance to transformation goals, the feasibility of data collection, and consistency with other measurement initiatives. Members suggested a few additional criteria, including how well a metric could be communicated with consumers, and emphasized the importance of certain topic areas, including access to care and services.
Visit the Health System Transformation website for more details on the Outcomes, Quality and Efficiency Metrics work group meeting.
Medicare-Medicaid Integration of Care and Services Work Group:
The Medicare-Medicaid Integration of Care and Services Work Group will help identify strategies for improving integration of acute care—such as emergency room visits—and long-term care and services for individuals enrolled in both the Medicare and Medicaid programs within the framework of health system transformation.
Next Meeting: Sept. 22, 6 – 9 p.m. at the Cherry Avenue Training Center in Keizer.
This work group discussed the population who is dually eligible for Medicare and Medicaid and the key opportunities and challenges presented by better aligning and coordinating Medicare and Medicaid services. The focus included current successes and failures in the delivery of care and services to individuals who are dually eligible; structural changes needed to integrate the Medicare and Medicaid systems; and current disconnects between the health care and long term care delivery systems.
Visit the Health System Transformation website for more details on the Medicare-Medicaid Integration of Care and Services work group meeting.
Upcoming September Legislative Days
The Oregon Legislature’s interim committees will be meeting between Sept. 21 and 23. The Senate and House Health Care committees will be holding a joint committee hearing on Sept. 22 from 8 to 11 a.m. Senate confirmation hearings will also be held that week for the Governor’s appointees to the Health Insurance Exchange Board of Directors. The interim committees will meet two more times before the 2012 legislative session, in November and January.
Oregon Health Insurance Exchange Board Announced
On Aug. 19, Governor Kitzhaber announced his appointees (pending Senate confirmation) to the Oregon Health Insurance Exchange Board, which will oversee the development of a Health Insurance Exchange in Oregon. The Board of Directors will submit a formal business plan for the Exchange no later than Feb. 1, 2012, for approval by the Legislature. For a complete list of appointees, see the news release from Governor Kitzhaber’s office.
AIM 2011: Innovating for Healthy Oregonians
Portland State University’s Center for Public Service and the Oregon Health Authority’s Office of Health Information Technology invite you to attend a groundbreaking conference uncovering the promise that health information exchange and electronic health records bring to the world of health care.
AIM 2011: Innovating for Healthy Oregonians
Accelerate • Innovate • Motivate
Sept. 14th, 2011
Oregon Convention Center
Portland, OR
Join us! – AIMOregon.comStay involved!
Connect with us: Use Facebook.com/OregonHealthAuthority and Twitter.com/OHAOregon to find out about OHA events, public input opportunities, transition updates, and federal and state health reform news.
Send input and comments to OHPB at ohpb.info@state.or.us
View calendar of health reform meetings
The Oregon Health Authority is the organization at the forefront of lowering and containing costs, improving quality, and increasing access to health care in order to improve the lifelong health in Oregon. The Oregon Health Authority is overseen by the nine-member citizen Oregon Health Policy Board working towards comprehensive health and health care reform in our state.
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