June 26, 2018
Oregon CCOs continue to advance health system transformation by focusing on better care and better health outcomes while controlling health care costs.
“What we’ve seen over the past five years is that incentives work,” said Jeremy Vandehey, OHA’s director of health policy and analytics. “They are driving improvement in the care that Oregonians receive and helping to improve the health of our communities.”
The 2017 CCO Metrics Report details Oregon’s pay-for-performance program where OHA created a quality pool from a percentage of monthly CCO payments to reward performance. To earn their full incentive payment, CCOs have to meet benchmarks or improvement targets on at least 12 of the 16 measures and have at least 60 percent of their members enrolled in a patient-centered primary care home.
The quality pool model rewards CCOs for the quality of care provided to Oregon Health Plan members. This model increasingly rewards CCOs for outcomes, rather than utilization of services, and is one of several key health system transformation mechanisms for achieving Oregon’s vision for better health, better care, and lower costs.
Highlights of the 2017 report include continued improvement in adolescent well-care visits, health assessments for children in DHS custody, colorectal cancer screenings, developmental screening in the first three years of life, and effective contraceptive use. Areas that stood out for improvement included postpartum care, initiation and engagement of alcohol or other drug treatment, and hospital stays due to congestive heart failure or short-term diabetes complications.
The quality pool amount was 4.25 percent of monthly payments in 2017, for a total of more than $178 million. While all CCOs showed improvement on a majority of measures, 14 out of 16 earned 100 percent of their quality pool dollars, which left $2.3 million for the challenge pool. It was distributed to CCOs that met the benchmark or improvement target on three measures: Developmental screenings in the first 36 months of life, effective contraceptive use among adult women, and depression screening and follow-up. PacificSource – Central Oregon met the highest number of measures.
For a detailed report of the CCO metrics and how much each CCO earned through the pay-for-performance program, visit the OHA Health Policy and Analytics website.
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