Past Policy Recommendations

Policy Details

PolicyDetails
Samaritan-MultiCare Form A Recommendation (2026) See full recommendation here. Recomendación del Formulario A sobre Samaritan-Multicare.
MAC endorsement of Ombuds 2024 Report recommendations The MAC asks for OHA to elevate three of the five 2024 Ombud's Report recommendations: 1) Formalize OHP member and client advocate forum for DME improvements, 2) Collaborate with community members to review data from Medicaid member complaints and grievances, 3) Assess Medicaid policies and rules to identify opportunities to advance OHA's health equity and anti-racism goals. See full recommendations here.
SCAN Group-CareOregon, Inc. Recommendation (2023) See full recommendation here.
Oral Health Access Framework (2016) 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.
Policy considerations for 12-Month Continuous Eligibility for Adults in the Oregon Health Plan (2015) 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.
Exploring Premium Assistance in the Children's Health Insurance Program (2015) In 2014, the Oregon Legislature passed Senate Bill 1526, charging the Oregon Health Authority (OHA) with examining the feasibility of using Children’s Health Insurance Program (CHIP) federal matching funds to subsidize commercial insurance for children in families with incomes between 200-300% of the federal poverty level (FPL), commonly referred to as premium assistance. The MAC was asked by OHA to examine this issue and review the structure of Oregon’s existing CHIP program, federal and state regulations pertaining to CHIP and premium assistance, and potential impact to individual CHIP members and their families in terms of access and continuity of care, benefits, affordability and whole family coverage. Based on the committee’s work, it advised the OHA that a premium assistance program for Oregon’s CHIP population is not feasible at this time and that the state reassess opportunities to improve Oregon’s CHIP program in the future. In January 2015, the committee submitted its recommendation in a memo to OHA. The committee’s memo was included in OHA's report submitted to the Oregon Legislature in February 2015.
Options to Mitigate the Impact of Churn between Medicaid and Qualified Health Plans in the Exchange (2014) The Affordable Care Act (ACA) is increasing the number of insured Oregonians through two primary strategies - expanding Medicaid and providing insurance through state-based insurance exchanges. As an individual's household income exceeds the maximum for Medicaid eligibility, he or she will be eligible for subsidies to buy coverage through an exchange, up to a household income of 400 percent of the federal poverty level (FPL). This switch in eligibility also works in reverse. If an individual's household income reduces below 138% FPL, he or she will become eligible for Medicaid. A key design challenge for those tasked with implementing the reform law is how to manage this "churning" phenomenon - when individuals cycle in and out of public programs as their income fluctuates - so that care is not interrupted. To address this issue, the Medicaid Advisory Committee examined the issue and considered policy options intended to promote continuity of coverage for individuals and families enrolled in the Oregon Health Plan (OHP) and qualified health plans in the Exchange. In August 2014, the committee submitted a comprehensive report and set of recommendations to the Health Policy Board for options to reduce, avoid, and mitigate future churn between these two programs.
Person-and Family-Centered Care in Oregon (2013) The committee developed and put forth a set of strategies and actions to enhance person-and family-centered Care in Oregon for individuals enrolled in the Oregon Health Plan (OHP). The guiding principle for the Committee's work is to improve person-and family-centeredness across the continuum of care for current and future OHP members. Each strategy is accompanied by a set of actions that will lead to more person-and family-centered models of care, contribute to a high-value health care system and work to support Oregon's three-part aim for individuals served by the OHP. The MAC submitted its recommendations to the Oregon Health Policy Board on July 2nd, 2013.