Paying for Value in Health Care
Paying for value is a primary strategy for achieving the Oregon Health Authority’s triple aim of better health, better care and lower costs for all Oregonians. Meeting this goal will require shifting health care reimbursement strategies away from a system that pays for volume of services to one that rewards quality and outcomes.
The Health Authority is engaged in significant value-based payment (VBP) work across the agency. The Transformation Center serves as a focal point for value-based payment strategies and works closely with Oregon’s coordinated care organizations.
Value-based Payment Roadmap
Oregon’s recent 1115 Medicaid Demonstration Waiver renewal requires OHA to advance CCOs’ use of VBP by ensuring “through its CCO contracts that VBP arrangements, structured to improve quality and manage cost growth, are used by CCOs with their network providers. The state will develop a VBP Roadmap that describes how the state, CCOs and their contracted providers will achieve a set target of VBP payments by the end of the demonstration period.”
As part of the VBP roadmap public input process, the Transformation Center convened a CCO VBP work group.
Value-based payment provider survey results
The Oregon Health Authority surveyed health care providers to fulfill a current 1115 waiver requirement and inform the CCO 2.0 VBP policy development process. The goal of the survey was to assess provider readiness and experience with VBP models in Oregon. See survey results.
The Transformation Center also engaged stakeholders through the public meetings and surveys below.
Value-based payment stakeholder engagement
General CCO 2.0 stakeholder engagement
Primary Care Payment Reform Collaborative
As initiated through Senate Bill 231, the Transformation Center coordinates a Primary Care Payment Reform Collaborative. This collaborative convenes payers to share best practices on primary care value-based payment methods and aligning initiatives.
Comprehensive Primary Care Plus (CPC+)
Following Oregon’s selection as a CPC+ region, the center began supporting the Medicaid fee-for-service CPC+ implementation. CPC+ is a regionally based, multi-payer advanced medical home model offering an innovative payment structure to improve health care quality and delivery. It is a five-year federal program that began in January 2017 and will bring significant Medicare dollars to Oregon.