LTC/COO Study Group

December 2012

Many of you have been closely following the progress of the Oregon Health Authority (OHA) and the Coordinated Care Organizations (CCOs) in the work of Health Systems Transformation (HST). In December 2012, the OHA announced that an "Accountability Plan" for Health Systems Transformation was approved by the Centers for Medicaid and Medicare (CMS). The plan is extensive, laying out the methods, measurements and accountability for Oregon's Health System Transformation. A small but note-worthy piece of that Plan requires action from DHS and our partners in the long-term care system, and I wanted to reach out immediately to let you know what is expected and our next steps.

Since the beginning of Oregon's work to transform its health care delivery system, CMS has made clear its interest in the integration of the Medicaid Long-Term Care services and supports into the CCO global budgets.

Following on that interest, as one of the "terms and conditions" in Oregon's Accountability Plan, CMS is requiring that Oregon, "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. The report will identify opportunities, barriers and strategies for integrating LTC, and address issues of scope, process and timeline for integration." Oregon must submit its findings from this exploratory process to CMS no later than December 31, 2013.

I want to underscore the fact that this condition requires us to conduct a study. It requires an inclusive process, and does not pre-determine the outcome or result. DHS will be partnering with OHA to outline a proposed approach for meeting this CMS condition and will be communicating in January with all of you about next steps.

You can expect our approach to be transparent, data driven, and focused on the needs of consumers. You can review the OHA announcement and information materials about the Accountability Plan.