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Provider Financial Supports – CCO Strategies and Federal Funding Summaries

Medicaid providers and dentists: Apply for federal Provider Relief Fund payments by August 28, 2020

The federal Department of Health and Human Services expects to distribute approximately $15 billion to eligible Medicaid/CHIP providers who have not yet received a payment from the Provider Relief Fund General Distribution.

Learn more on the Provider Relief Fund website. Look for "Apply for funding from General Distribution (Phase 2): Medicaid, CHIP and Dental Providers." Also read OHA's fact sheet about the distribution.

Need to find out if you are on Oregon's list of Medicaid organizations and providers? Search the list now (use Ctrl-F to search by name).

Overview

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Health care providers, hospitals and health systems across Oregon have lost revenue due to COVID-19. ​The Oregon Department of Consumer and Business Services (DCBS), Department of Human Services (DHS), and Oregon Health Authority (OHA) are working together to identify financial supports to help sustain Oregon’s health care system through the COVID-19 emergency.​

DCBS, DHS and OHA convened an internal, cross-agency staff working group to monitor the landscape of available state and federal financial resources for Oregon’s healthcare providers, identify provider needs and providers at risk of closure, and provide information to agency leadership.

  
  
STFS-Workgroup-Summary.pdfSummary of financial supports for providers and stakeholder perspectives on needs (August 2020)
PCP-Survey-Summary.pdfImpacts of COVID-19 on Oregon’s Primary Care Providers - Survey Highlights

CCO Provider Payment Strategies

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OHA is working with coordinated care organizations (CCOs) to fund needed services through the use of Quality Incentive Program (“Quality Pool”) funds.

  • On March 31, 2020, OHA released 60 percent of 2019 Quality Pool payments ($98 million) to CCOs; the remaining 40 percent will be released at the end of June 2020.
  • Starting April 2020, OHA has suspended the CCO withhold for the 2020 Quality Pool (approximately $17 million per month), so that CCOs can use the revenue during the emergency.

OHA recognizes that these funds are typically directed towards providers; however, using quality funds now will help CCOs to immediately address critical areas of need that cannot wait for later funding.

Areas of need include, but are not limited to, hospital access (urban and rural), operation of residential facilities, expanded telehealth services, and laboratory and diagnostic testing, as well as support for local public health agencies, primary care providers, behavioral health providers, transportation services and social service agencies.

  • To learn how CCOs plan to use these funds to support providers across the state, read the following OHA summaries and the individual provider payment strategies linked below. 
  • OHA is working with CCOs to release additional information on specific allocation of resources to providers and hospitals as details become available.
  
  
QualityPool_Early_Release_Summary.pdf2019 Quality Pool - CCO Spending Plan Summary
CCO_withhold_suspension_summary.pdf2020 Withhold Suspension - CCO Spending Plan Summary
CCO-Spending-Plan-Summary.pdfSummary of CCO Provider Financial Strategies



DCO Provider Payment Strategies

OHA surveyed the five Dental Care Organizations (DCO) it directly contracts with to better understand strategies the DCOs may be deploying in response to the financial needs of their providers who have experienced a sharp decline in revenue.

DCO Financial Sustainability Survey Summary

Federal CARES Act Provider Relief Funds – Oregon Summaries

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​The federal CARES Act and Health Care Enhancement Act provided billions in relief funds to hospitals and other health care providers across the country. A federal dataset lists all providers that have attested to receiving payment from General Distribution, High Impact Targeted Allocation, Rural Targeted Allocation and Skilled Nursing Facility Targeted Allocation portions of the Provider Relief Fund.

  • OHA has summarized the federal dataset as of May 14, 2020 for Oregon hospitals and hospital systems, and as of July 23, 2020 for all listed providers.
  • Due to changes in the dataset over time, the May 14 hospital summary contains the most relevant data specific to individual hospitals.

OHA's summary relies on the federal dataset information and is only meant to help stakeholders review the information specific to Oregon providers. The provider-specific information is summarized by county, by hospital and by categories. These summaries rely on names, key words and locations in the federal datasets; the summaries do not reflect all sources of federal distributions made to Oregon providers.

  
  
Hospital-PRF-Allocations-051420.pdfOregon CARES Act General Distribution - Hospital-Level Summary (updated 5/14/2020)
PRF-Allocations-County.xlsxOregon CARES Act General Distribution - County-Level Summary (updated 7/23/2020)
PRF-Allocations-Category.xlsxOregon CARES Act General Distribution - Category-Level Summary (updated 7/23/2020)

Paycheck Protection Program - Oregon Summaries

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​The Paycheck Protection Program (PPP) is a federal loan program designed to provide a direct incentive for small businesses and non-profits to keep their workers on the payroll. Loans may be forgiven if all employee retention criteria and other eligibility conditions are met. ​

  
  
PPP-Distribution-Summary.pdfSummary of PPP loans to Oregon health care organizations
PPP-Loan-Data.xlsxAppendix - Oregon PPP Loan Data



Questions?

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​As needs related to the COVID-19 pandemic evolve, OHA will continue to evaluate the financial needs of the system considering enacted federal funding bills, in coordination with the Oregon Legislature and the Governor’s Office.

If you have any questions about CCO quality pool spending during the COVID-19 emergency, contact OHA Actuarial Services.

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