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Improving access to oral health is critical to ensuring Oregon can meet its Triple Aim for better health, better care, and lower costs in the Oregon Health Plan. In 2016, OHA asked the MAC to develop a framework for defining and assessing oral health access in OHP. The committee formed an Oral Health Work Group made up of oral health experts and key stakeholders, to develop recommendations. The MAC and the Oral Health Work Group prepared and submitted recommendations to the OHA to adopt a standard definition of access, a framework model, and a set of recommended monitoring measures to assess access. The committee further recommends that OHA develop and share a comprehensive implementation strategy, including a communications plan and a strategy to review and update the framework and plan over time.
A continuous eligibility model serves the aims of the ACA by ensuring consistent, comprehensive coverage for low-income individuals that transition between insurance affordability programs. Recently, CMS endorsed the use of continuous eligibility for income-eligible Medicaid adults using section 1115 waivers, which Oregon already has for children. In 2015, the committee explored key policy considerations around 12-month continuous eligibility for income-eligible adults in the Oregon Health Plan (OHP). The committee prepared and submitted recommendations to the Oregon Health Authority (OHA) regarding the feasibility of this federal policy option, and outlined the potential fiscal impact on the state budget in the next biennium. The committee recommends that OHA request this policy as part of Oregon's 1115 waiver renewal with CMS in 2017. The committee also recommends that OHA adopt transparent OHP eligibility, enrollment and redetermination performance indicators; and complete annual assessments of administrative costs that result from churn and potential savings to the Medicaid program, CCOs and health providers if 12-month continuous eligibilty were adopted in the future.
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