OHA-OHPB Bulletin - November 10, 2011

In this month's edition of the OHA-OHPB e-Bulletin you'll find updates on the important health care transformation work going on all across Oregon, from policymaking to clinics making the move to coordinated care.

The final round of meetings for the House Bill 3650 transformation work groups will be held next week. The 133 members of the four groups have devoted 36 hours to collaborating on a vision for Coordinated Care Organizations, from governance structures to innovative ways of measuring outcomes, to methods for determining budgets to ways of integrating acute and long-term care. In November the groups will review draft reports for the February legislative session and put the finishing touches on their work.

Summaries of the four October meetings are posted on each work group's respective meetings page at health.oregon.gov.

CCO Criteria Work Group:
The CCO Criteria Work Group will provide input into the qualification criteria and standards for proposed CCOs.

Next meeting: Nov. 15, 6-9 p.m. at the Cherry Avenue Training Center in Keizer. 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: Nov. 14, 6-9 p.m. at the Cherry Avenue Training Center in Keizer. 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: Nov. 14, 9 a.m.-noon at the Clackamas Community College Campus in Wilsonville. 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.

Next meeting: Nov. 17, 6-9 p.m. at the Cherry Avenue Training Center in Keizer. Visit the Health System Transformation website for more details on the Medicare-Medicaid Integration of Care and Services Work Group meeting.

The Oregon Health Policy Board and the Oregon Health Authority completed three weeks of community meetings in October, covering eight cities and crossing 1,600 miles. Altogether, more than 1,000 people showed up to learn about and discuss CCOs. The meetings were a great opportunity to talk with clients, providers, advocates, tribes, home health care workers, county representatives and others across the state and to listen to their ideas and address their concerns. The interactive meetings were also an important way to ensure that CCOs work in a local and suitable way for diverse stakeholders and communities throughout Oregon.

Overall, participants were supportive of the CCO concept. Many had questions and concerns about how the new approach would be implemented locally and how it would affect providers. Oregon Consensus, a Portland State University organization, facilitated each meeting and provided an overview of common themes shared in each community. Below are the top five themes expressed across all eight meetings. These themes have been shared with the Oregon Health Policy Board, which will help them inform the plan for CCOs to be presented to the Legislature in February.

Comprehensive health care that meets the needs of the whole person is essential.
There is a strong desire for the CCO system to include alternative providers such as naturopaths and chiropractors as well as mental health, home care, and dental services. Many saw these services as potential cost saving services and important for creating better health in the community.

Mental health and addiction services should be better integrated into the health care system.
Currently, there is a strong sense that mental and addiction services are not well integrated into the health care system. All communities expressed desire for this to change with the implementation of CCOs.

Economic health and community health are linked.
Providing more efficient care that creates better health, was seen by many as an important factor in maintaining or creating long-term economic vitality.

Provide assistance and support to communities as they develop CCOs.
Many expressed the desire for state support in the development phase, including trainings to local health providers and funding to help coordinate implementation, especially in rural communities.

Provide clear direction and metrics to evaluate CCO success.
Many suggested that articulated metrics and goals would both help ensure CCO accountability to OHA and provide CCOs with clear direction when developing and managing CCOs. Suggested indicators of success include reduced emergency room visits, diminished rates of obesity, diabetes, mental illness, among others, and greater awareness in the community about the importance of health.

The last board meeting was held on Nov. 8 at the Market Square Building in downtown Portland. The Board discussed the draft business plan outline for CCOs, and reviewed the latest round of HB 3650 work group efforts. Hospitals and other health care providers gave testimony on how they are approaching the upcoming transformation work.

You can review the meeting materials by going to health.oregon.gov, or by clicking here. Or, you can watch a replay of the full meeting.

The Oregon Legislature's interim committees will meet Nov. 16-18. The Oregon Health Authority will provide updates on topics including health system transformation and the health insurance exchange IT grant. Legislative interim committees will meet once more in January, prior to the 2012 February legislative session.

Patrick Webb from The Daily Astorian talks with Bruce Goldberg, director of the Oregon Health Authority, about upcoming changes in Oregon medical programs. Listen to the podcast.

When parents call Portland's Northeast Health Center or show up with a sick child, the first person they likely speak with is Paula Williams. From then on, Williams is the personal link between that family and the pediatric team.

At Portland's Northeast Health Center, the goals are continuity of care and making sure no one goes to the high-cost emergency room for primary care they could have received at the clinic. And it's Williams who binds the staff with its diverse clientele for the best possible coordination of care.

You can read more about Williams and other local innovators in the Newsroom, a part of Oregon's Health System Transformation website, health.oregon.gov.