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Oregon Health Authority

Value-Based Payment

Oregon’s Roadmap to Value-Based Payment

Value-based payment (VBP) is one of the Oregon Health Authority’s (OHA’s) primary strategies for achieving the triple aim of better health, better care and lower costs for all Oregonians. Whereas the traditional fee-for-service payment model results in a fragmented system and unnecessary costs, transitioning to VBP increases flexibility and incentives for providers to deliver patient-centered, whole person care.

To advance VBP, OHA developed a VBP Roadmap for Coordinated Care Organizations (CCOs) to ensure at least 70% of their payments to providers are in the form of a VBP by 2024. The VBP Roadmap also includes VBP models in key care delivery areas (CDAs), infrastructure payments for Patient-Centered Primary Care Homes (PCPCHs), and strategies to promote equity in VBP design.

The VBP roadmap was informed by a significant public engagement process, including a CCO VBP Workgroup, VBP provider survey, and statewide public stakeholder meetings.

Quick links

Oregon's Toolkit for Implementing VBP across Payers and Providers

VBP Resource Library

Payment Arrangements Dashboard (2022)

CCO VBP reports

Webinar recording: Using VBP to reduce disparities

VBP roadmap progress report (December 2023)


Technical assistance

Traditional health worker (THW) billing and payment

Participants will learn about two new guidance documents on THW billing processes, including developing sustainable funding models for THW programs.
  • Webinar: THW billing guidance for CCOs
  • Webinar: THW billing guidance for community-based organizations
    • May 8, 11 a.m.-noon
    • Register here
    • Audience: THWs and community-based organizations

VBP webinars for providers

Primary care, behavioral health, and maternity care providers are invited to a five-part webinar series focused on increasing readiness for VBP and taking advantage of the additional flexibility VBPs offer for innovatively redesigning care models. 

  • Value-based payment: Is it disrupting health care for the better? (3/15/21) Slides / Recording
  • What do you need to know to negotiate VBP agreements? (4/21/21) Slides / Recording
  • Learnings from COVID-19 and how they may impact the adoption of VBPs (5/19/21) Slides / Recording
  • VBP for behavioral health providers: How do we keep from being left out? (6/1/21) Slides / Recording
  • VBP and maternity care: What have we learned so far? (6/16/21) Slides / Recording

VBP webinars for CCOs

OHA CCO VBP Workgroup recordings

VBP toolkit for coordinated care organizations

The VBP toolkit supports CCOs in achieving the expectations outlined in the VBP Roadmap.

The toolkit includes three components:
  • Technical guidance and reporting templates to clarify reporting requirements and provide guidance on eligible payment models and CDA specifications;
  • Care delivery area (CDA) resources to support CCOs in these areas; and
  • Model contract language to assist CCOs in their VBP contracting process.

CCO deliverable templates


 

VBP: Beyond Medicaid

Oregon's Health Care Payment Arrangements in 2022

Oregon is one of only a few states that collects data from health insurers about how they pay health care providers outside of fee-for-service (FFS) arrangements, including value-based payments (VBP). This report summarizes insurers' 2022 payment arrangements with health care providers such as doctors, clinics, hospitals and more.

Successful transition to paying for value will require significant multi-sector, system-wide collaboration. While the VBP Roadmap is meant for CCOs in Oregon’s Medicaid system, OHA is also working to accelerate VBP adoption across payers. Efforts include:

Contact

Questions? Please contact OHA.VBP@odhsoha.oregon.gov

Note: CCOs and partners are encouraged to submit questions they would like addressed in future FAQ resources and the annually updated VBP Technical Guide for CCOs.