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Health-Related Services

Overview

Health-related services are non-covered services that are offered as a supplement to covered benefits under Oregon’s Medicaid State Plan to improve care delivery and overall member and community health and well-being. Health-related services include:
  • Flexible services, which are cost-effective services offered to an individual member to supplement covered benefits, and
  • Community benefit initiatives, which are community-level interventions focused on improving population health and health care quality. These initiatives include members, but are not necessarily limited to members.
Health-related services must meet requirements for:

a) Activities that improve health care quality (45 CFR 158.150);
- or -
b) Expenditures related to health information technology and meaningful use requirements to improve health care quality (45 CFR 158.151).

Health-related services are defined by Oregon Administrative Rules (OAR 410-141-3500 and 410-141-3845), the 1115 waiver special terms and conditions, and federal regulations. See the OHA brief below for more details.

CCOs are required to report annual HRS spending to OHA through their Exhibit L Financial Reports (template available on the CCO Contract Forms webpage). OHA reviews the annual CCO Exhibit L HRS expenditures to ensure expenditures meet HRS criteria. Reporting and spending summaries are available here:

HRS office hours

CCO questions about OHA's feedback on HRS spending data
General CCO questions
July 12 and Oct. 5 (9:05–9:30 a.m.)

HRS CCO memos 

HRS information for OHP members

If you are an Oregon Health Plan member and enrolled in a CCO, learn how to request flexible services (multiple languages available).

HRS guidance

General guidance Topic-specific resources
Reporting and evaluation

HRS learning opportunities

Webinars

​Join us for an overview of a new braided funding concepts document. This document will provide example scenarios illustrating how CCOs can braid multiple funding streams, including health-related services (HRS), Supporting Health for All through REinvestment (SHARE) and in lieu of services (ILOS). Using a community-based approach, we'll show example scenarios of Oregon Health Plan members navigating their community context and services, and how a CCO can strategically address community-specific opportunities and leverage community strengths to support them. This webinar will be most beneficial for CCO staff overseeing Medicaid spending programs in their communities. 

​Join us to learn about communicating with your CCO's community partners about various Medicaid spending programs — including health-related services (HRS), Supporting Health for All through REinvestment (SHARE) and in lieu of services (ILOS). We will share a new resource for CCOs that aims to simplify the program requirements and descriptions. This webinar is sponsored by the OHA Transformation Center in partnership with Oregon Rural Practice-based Research Network (ORPRN).

  • Audience: This webinar will be most beneficial for CCO staff who oversee these spending programs and programmatic work with community partners. 
  • Slides
  • Recording​
  • Handout​ (for CCOs to edit and share with community partners)

​Join us for an overview of 2022 HRS spending, updates to frequently-asked HRS questions, and updates to examples of past-approved HRS expenditures. The content of this webinar will be most useful to CCO staff who work on implementing HRS within their communities. 

​​

Learn more about HRS in Oregon's 2022-2027 Medicaid 1115 Demonstration Waiver. This webinar will review upcoming changes to HRS based on the waiver and the impact of the waiver's health-related social needs benefits for transition populations.

​Slides are available for a three-part technical assistance series on centering equity in health-related services (HRS) flexible services programs. These hands-on work sessions were intended to help coordinated care organization (CCO) staff plan and integrate equity-centered strategies into their HRS programs. The series builds on recent webinars that showcased Health Literacy and Equity in HRS Flex. All CCO staff are welcome, but the content will be particularly relevant for HRS flex program lead staff.​

  • Pre-series webinar: ​​​Centering equity in HRS flexible services 
  • Part 1: Making HRS flex more accessible to members and providers View slides
  • Part 2: Addressing community needs through HRS flexView slides
  • Part 3: HRS flex policies and proceduresView slides​

​Cliff Coleman, MD, MPH, presents an overview of health literacy, discusses the role of health literacy in advancing health equity and provides CCOs with strategies to effectively communicate with Medicaid patients. Dr. Cliff Coleman is a practicing family medicine physician at Oregon Health & Science University and national expert in health literacy and doctor-patient communication. 

This webinar covers the basics of housing in Oregon, and health-related services (HRS) investments in housing. The webinar features panelists from Oregon Housing and Community Services, Eastern Oregon CCO, and Health Share. Topics include current statewide trends in housing, how housing is built and financed, and how CCOs can meaningfully invest in housing through community partnerships. 

Events

10/9/2024
  • October 9, 2024
  • 8:30 a.m.-3:30 p.m.
  • Salem Convention Center
  • For CCO staff working in HRS, SHARE, ILOS, SDOH-E and related spending efforts.
  • Registration will open in June.​

9/13/2023

​See the event page​.

9/20/2022

​This virtual convening is sponsored by the OHA Transformation Center in partnership with Oregon Rural Practice-based Research Network (ORPRN) in an effort to support CCOs in implementing Supporting Health for All through REinvestment (SHARE), health-related services (HRS) and in lieu of services (ILOS).​

  • ​What: Annual convening for CCOs on OHA spending initiatives, focused on housing
  • When: Tuesday, September 20–Friday, September 23 (9 a.m.–1:15 p.m. each day)
  • Who should attend: CCOs interested in sharing and learning from others about how HRS, SHARE and ILOS can support their work to address housing as a social determinant of health and equity. CCOs are strongly encouraged to invite their community partners involved in this work.
  • Register in advance (required)
  • See event page for agenda and materials​
Contact: Anne King (kinga@ohsu.edu), Nancy Goff (nancy055@gmail.com) or the Transformation Center (Transformation.Center@dhsoha.state.or.us)

Evidence base to support use of specific interventions as HRS

In addition to other resources a CCO may identify, OHA has identified the following resources as acceptable sources for published studies or evidence to support a health-related service: OHA has also identified the following resources to support CCOs in calculating return on investment (ROI) for health-related services expenditures. Note: Calculating an ROI is not required for reporting HRS expenditures to OHA, but it may support CCOs' long-term HRS expenditure planning.
  • Commonwealth Fund ROI Calculator. This calculator is designed to help health systems and their community-based organization partners plan sustainable financial arrangements to fund the delivery of social services to high-need, high cost patients. To help users of this ROI calculator, the Commonwealth Fund has provided a summary assessment of available evidence of health care impact for interventions related to addressing health-related social needs for high-need adults.
  • Center for Health Care Strategies ROI Forecasting Calculator: This web-based tool is designed to help Medicaid state agencies, health plans and other stakeholders assess and demonstrate the cost-savings potential of efforts to improve quality.

CCO HRS Policy and Procedure (P&P) Submissions

Contact

If you have questions, please email the OHA health-related services team at health.relatedservices@oha.oregon.gov

Note: The OHA staff who manage this email account do not have access to OHP member information and are not able to help request health-related services for members.