Oregon Health Authority Health eNews | Updates from the Oregon Health Policy Board

APRIL 5, 2012

In this month's edition of Health News from OHA and OHPB:
Coordinated Care Organizations: Non-binding letters of intent filed April 3
Next steps for potential Coordinated Care Organizations
Call for potential administrative rules advisory committee members
CCOs are topic at Portland City Club Friday, April 6
Public Health Week
Coordinated Care in Oregon: St. Clair Davis from 40 ER visits to zero in one year
In the news

Coordinated Care Organizations: Non-binding letters of intent filed April 3

On Tuesday, April 3, the Oregon Health Authority received more than 50 letters of intent from organizations interested in applying to become Coordinated Care Organizations (CCOs). The letters show broad support for a new and better model of care within the state. The letters are required for any entity to be eligible to become a CCO in 2012.

"I am pleased to see this unprecedented level of collaboration among community partners to build a more coordinated care system for the members of the Oregon Health Plan," said Governor John Kitzhaber. "This is an important milestone as we work toward better health, better care and lower costs."

You can read the full news release or go to cco.health.oregon.gov to view all the letters of intent that were submitted.

Next steps for potential Coordinated Care Organizations

Interested applicants must submit the technical part of their application by April 30 and the financial part by May 14. As part of their application, CCOs must demonstrate how they will work to meet the Triple Aim of better health, better care and lower costs, including:

  • Coordination of the delivery of physical health care, mental health and chemical dependency services, and oral health care;
  • Establishing alternate ways of paying providers to encourage them to focus on prevention and other activities that improve health in a community;
  • Engaging community members and health care providers in improving the health of the community and addressing regional, cultural, socioeconomic and racial disparities in health care that exist among the OHP clients/CCO members and in the CCO's community;
  • Progressing from the baseline requirements for CCOs to the full requirements expected at maturity;
  • Managing financial risk, establishing financial reserves and meeting minimum financial requirements; and
  • Operating within a fixed global budget.

A full list of criteria and timelines can be found at cco.health.oregon.gov. The first CCOs will be approved by the end of June and operating by August.

Call for potential administrative rules advisory committee members

The Oregon Health Authority is seeking people to be part of the administrative rules advisory committee. These administrative rules will govern coordinated care organizations (CCOs). For more than a year, health systems transformation has been in the planning stages. The Oregon Health Authority is now in the implementation stage, and part of that implementation is adopting administrative rules that establish requirements for CCOs.

The rules advisory committee likely will meet three times in mid- to late-April, with each meeting lasting two hours. In addition to that time commitment, members will need to read and be prepared to offer advice on about 43 rules.

If you are interested in becoming a member, please submit your name and the association you represent, if applicable, to Rosa Jensen at rosa.d.jensen@state.or.us by April 12, 2012. Because of the committee's limited membership, members will be chosen with an eye toward a broad spectrum of participation.

CCOs are topic at Portland City Club Friday, April 6

Friday, April 6, Bruce Goldberg, M.D., director of the Oregon Health Authority, and Mike Bonetto, health policy advisor to Governor Kitzhaber, will speak at the Portland City Club about Oregon's direction on health system transformation and Coordinated Care Organizations.

The City Club convenes Friday from 12:15 to 1:15 p.m. If you are unable to attend, you can hear it on OPB radio at 7 p.m. Friday or on KBPS (1450 am in Portland) at 9 a.m. Saturday. Or catch it on a variety of TV stations.

Public Health Week

National Public Health Week was April 2-8. On Wednesday, April 4, more than 250 people packed into the Portland State Office Building or joined by webinar to hear a panel discussion on the role that Coordinated Care Organizations can play in improving the public's health. Mel Kohn, director of OHA's Public Health Division, moderated a panel that included State Representative Mitch Greenlick, Michael Bonetto, Governor Kitzhaber's senior health policy advisor, Bruce Goldberg, director of the Oregon Health Authority, Tricia Tillman, director of OHA's Office of Equity and Inclusion, and Muriel DeLaVergne-Brown, administrator of Crook County Public Health Department.

The group held a lively conversation about the important role that CCOs will play in improving public health. Through an emphasis on prevention, coordinated care, and community based health, CCOs will be able to create innovative ways to improve the health of a population at the community level. Public Health and CCOs will be able to work hand-in-hand across the state to ensure that communities are able to offer the right care at the right time, in a healthy environment.

Visit OHA's Public Health Division for more information, and don't forget that public health week caps off Friday with National Walk to Work Day.

Coordinated Care in Oregon: St. Clair Davis from 40 ER visits to zero in one year

While entities across Oregon are applying to become Coordinated Care Organizations, some patients are already seeing the benefits of coordinated care. St. Clair Davis, who is in his late 20s, had several health problems including asthma. Due to frightening asthma attacks, Davis showed up at hospital emergency rooms nearly every week in 2009 – 40 times in all – at a cost of $97,800. The next year he began getting coordinated care from a team at Central City Concern, where he gets help managing his prescriptions and gets to use a nebulizer tube for 15 minutes each morning, in order to help open his lung passages for the upcoming day.

His coordinated care has paid huge dividends, both in his life and for his insurance: Davis made a grand total of zero hospital visits last year, and the total cost of his primary care at Central City Concern was just $11,897 – nearly a 90 percent drop from just two years ago.

To read the rest of Davis's story and others like it, or to send us your story about coordinated care, visit the Oregon Health Authority newsroom.

OHPB's next meeting

Tuesday, April 10, 1:00 p.m. to 2:30 p.m. Via webinar and conference call

Thursday, May 24, 8 a.m. to 5 p.m. Location TBD

In the news

Robert Wood Johnson Foundation
Medicaid's Pivotal Role in Leading Oregon's Health Care Transformation

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