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Accountability


Cost Growth Target Program Accountability

Each year, beginning with the 2021-2022 measurement period, OHA determines whether payers and provider organizations that exceeded the cost growth target with statistical confidence have an acceptable reason for their cost growth. 

Performance Improvement Plans

Beginning with the 2022-2023 measurement period, payers and provider organizations that exceeded the cost growth target with statistical confidence and without an acceptable reason are subject to a Performance Improvement Plan (PIP).  Approved PIPs, supporting documents, redaction logs, and PIP progress reports will be posted below . 

Contact Us

Questions?

Please email: 
HealthCare.CostTarget@odhsoha.oregon.gov

Media Inquiries:

Franny White  Communications
franny.l.white@oha.oregon.gov
971-349-9539


Financial Penalties

Pursuant to Oregon Revised Statute 442.386, OHA may impose a financial penalty on a payer or provider organization when the cost growth exceeded the target with statistical confidence, and without reasonable cause, or is not indeterminate, in a market for at least three out of five calendar years. OHA must not impose financial penalties before January 1, 2026, and the cost growth from 2021 to 2022 must serve as the first year of a payer or provider organization’s first five-year period. 

The table below tracks payers and provider organizations that have exceeded the target with statistical confidence and without reasonable cause since the 2021-2022 measurement period. 

Payer
Market
2021-2022
2022-2023
Moda
Medicare Advantage
X
X
UHC Company
Medicare Advantage
X
X
PacificSource
Commercial
-
X


Provider organization
Market
2021-2022
2022-2023
Oregon Medical Group
Commercial
X
-
St. Charles Health System
Commercial
-
X
The Corvallis Clinic
Commercial
-
X