Oregon Health Authority

October 2010

Announcements

Call for Applicants: Exchange Planning Grant Consumer Advisory Group

As part of this planning process for Oregon's health insurance exchange, the Oregon Health Authority (OHA) is establishing a Consumer Advisory Group. The group will provide input and feedback to staff on the development of a consumer-oriented exchange and on ways to ensure ongoing consumer engagement and interest in an exchange. We are seeking application from consumers and those who work on their behalf to be part of the group. The announcement and instructions on applying for the group has been posted online. The deadline for applying is October 29, 2010.

Public Input Sought on Committee Recommendations

The Oregon Health Policy Board (OHPB) will be seeking public input on each of its committee's and staff recommendations. The schedule for committee reports, public input periods, and each set of recommendations will be posted on the board's public input opportunities webpage.

Summary of September Community Meetings Now Available

OHA and the board held six community meetings across the state in September to gain valuable public input on the development of Oregon's health insurance exchange and the direction of health reform in the state. In addition to the community meetings, OHA obtained input through its public input site, OHA Feedback. Summary reports on the community meetings and input received through OHA Feedback are available online and will be presented to the board at its October 12th meeting.

Board and Committee Updates

Oregon Health Policy Board

The Oregon Health Policy Board will meet Tuesday, October 12 from 8:30 a.m. to 4:30 p.m. in Portland. Agenda items include a report on public forums and summary of public input on the health insurance exchange; the comprehensive plan and the Board's agenda; value based benefit package discussion; policy options for a health Insurance exchange; strategic options regarding a publicly owned health insurance plan; draft recommendations from the Incentives and Outcomes committee; and a comprehensive plan update. Opportunities for public testimony will be available. The meeting will take place at Legacy Emanuel Medical Center, Lorenzen Center, 2801 N Gantenbein Ave. in Portland, and audio will be web-streamed live.

Administrative Simplification Workgroup

Work group recommendations were adopted by OHPB at its August 10 meeting. Final recommendations can be found online. No further meetings of the work group are anticipated.

Health Care Workforce Committee

The Health care Workforce Committee agreed on three immediate priorities and some initial recommendations for each priority, including:

  • Preparing the current and future workforce for new care delivery models;
  • Increasing the size and capacity of the primary care workforce; and
  • Strengthening the health care workforce pipeline to ensure that Oregon has enough health care workers with the right training in the right places.

The next meeting not yet been determined. The committee will present its recommendations to the Oregon Health Policy Board on November 9.

Health Equity Policy Review Committee

The Health Equity Policy Review Committee will meet semi-monthly between September and February to hear key considerations, policy recommendations and other strategic issues from representatives of OHA and OHPB. Upon hearing presentations, the committee will make recommendations about how to advance health equity through the framework of the OHPB committees. The committee decided on initial goals for its work this year:

  • Identify the short term policy recommendations that need to be integrated into OHPB recommendations for the legislative session and determine the administrative decisions;
  • Identify long term opportunities, which might not necessarily be addressed in the next few months, but need to be established as strategic goals for creating a lasting equity structure in our health care system;
  • Develop training opportunities for staff and volunteers to assure a baseline understanding of health equity. Identify the tools and capacity needed to develop and embed health equity knowledge in Oregon's health care reform process.

The committee met on September 20 and October 5 to review draft recommendations from the Health Care Workforce Committee, Oregon Health Improvement Plan Committee, and the staff straw recommendations on the health insurance exchange. The committee will present a summary of priority recommendations to OHPB in November and a draft committee charter in December.

Health Incentives & Outcomes Committee

At its last meeting, the committee, discussed preliminary ideas from the payment reform and specific quality and efficiency topics that might provide focus for those reforms. A number of structural, process and outcome measures relevant to each priority topic were discussed. At the full committee meeting, a straw presentation of joint committee recommendations that linked the proposals emerging from the two subcommittees was discussed. Five major points of agreement emerged from committee discussion:

  • Standardize payment method, not price, to Medicare for hospital inpatient and outpatient, ambulatory surgical centers, physician and professional services.
  • Move forward decisively on primary care redesign: Adopt Oregon Patient Centered Primary Care Home (PCPCH) standards as the model for Oregon. Implement the standards across the board, as standards that everyone uses, recognizing that not all payers will pay for primary care homes immediately and practices will progress at varying rates through levels of performance.
  • Explore different payment incentives or methodologies; encourage pilots that have substantial participation; use consistent metrics aligned with Medicare and Oregon standards, and that are well evaluated.
  • Focus measurement and payment efforts where the potential for improvement is greatest: areas of high variation, large cost impact, and significant defects in quality of care.
  • Encourage the delivery system to become more patient and family-centered.

The committee will present recommendations to OHPB on October 12 and meet again shortly thereafter. Public input on the committee's recommendations will be accepted between October 12 and November 5. Please visit the public input opportunities page for more information.

Health Information Technology Oversight Council (HITOC)

At the September 2 meeting, council members unanimously voted approval for the charters, membership nominations, and draft work plans for three new workgroups to provide input on Health Information Exchange planning and implementation: Legal and Policy, Finance, and Technology. They also approved the charters for two advisory panels that will also provide input for health information exchange planning and implementation: the Consumer Advisory Panel and the Health Information Organizations Executive Panel. The council discussed health information technology oversight responsibilities as defined by House Bill 2009. The council will begin to review input provided by the newly formed workgroups and panels starting in October. The next meeting is November 4.

Medical Liability Task Force

The task force agreed to recommend changes designed to (1) make the medical liability system a more effective tool for improving patient safety; (2) ensure that it more effectively compensates individuals injured as a result of medical errors; and (3) reduce its collateral costs (including costs associated with insurance administration, litigation, and defensive medicine). The task force has considered policy avenues for supporting early disclosure of medical errors and offers of compensation; health courts as an alternative to the medical liability system; and evidence-based guideline safe harbors. The task force will not recommend creating an excess liability fund. Such a fund would not further the objectives for reform agreed to by the group. The task force will not recommend undertaking health court pilots because no short-term, voluntary system could truly test the value of the concept. The task force will recommend that a feasibility study be done to explore the costs, benefits, and design issues involved in replacing the medical liability system with an administrative system of compensation. It is assumed that the administrative system would compensate a larger class of patient injuries than just medical negligence in order for the system to be constitutional. An administrative system could help achieve the task force objectives to compensate victims of medical errors more effectively and to reduce defensive medicine by beginning to reduce physician fear of liability claims. More discussion is needed for recommendations to support early disclosure and offer programs. The next meeting of the task force has not been determined. The task force will present its recommendations to OHPB on November 9.

Oregon Health Improvement Plan Committee

The September 10 meeting addressed the guidance and direction that OHPB gave to the committee chairs and staff. The committee agreed to revise its goal to maintain a broader focus than educational attainment for achieving health equity; the strategy and outcome will focus on high school and college graduation rates. The committee will finalize its recommendations in October and obtain web-based public input. The committee will present its recommendation to OHPB on November 16.

Patient Centered Primary Care Home Pediatric Standards Advisory Committee

The committee was created and convened in August to review and revise the Patient Centered Primary Care Home (PCPCH) Standards Advisory Committee's work to reflect pediatric care. Small changes in language of the measures have been suggested, along with pediatric specific consideration for guidelines on implementation of the medical home. In September, two meetings were held. The committee's discussions have been around refining measures to reflect unique needs of children. Points that have come up include developmental screening, emphasizing preventive care measures, ensuring immunization status is known, and screening for health behaviors and risks within the family unit. The committee's next meeting has not been set.

Public Employers Health Purchasing Committee

The committee met September 27 and received initial recommendations from the Oregon Health Improvement Plan Committee and the Administrative Simplification Workgroup, and draft preliminary recommendations by the Incentives and Outcomes Committee .The committee will review these for potential endorsement or recommendation at the next meeting. The next meeting is 1-4 p.m. on October 25. The committee will present its recommendations to OHPB on November 16.

The Oregon Health Authority is a leader in the effort to innovate for quality and affordable health care in Oregon, by putting the care back in health care, improving the health of Oregonians, and working to lower the cost of care so it is affordable and accessible to everyone.

Find more information at: www.Oregon.gov/OHA or by e-mailing OHA.Info@state.or.us.

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