2017-2022 Quarterly and Annual Reports to CMS

Overview

This page lists the quarterly and annual reports about Oregon's progress meeting the goals of the 2017-2022 Oregon Health Plan 1115 Medicaid Demonstration. The Oregon Health Authority (OHA) submits these reports with their attachments to the Centers for Medicare & Medicaid Services (CMS).

Both sets of reports may include the following terms:

CCO – Coordinated care organization
DY – Demonstration Year - The number of years Oregon's 1115 demonstration has been in effect. For example, the DY 16 is the 16th year (2017-2018).
SEDS – Statistical Enrollment Data System - The system used to report enrollment data to CMS.
SFY – State Fiscal Year (July 1 – June 30; July 1, 2017 – June 30, 2018 is SFY 18).

To view older reports:

View the Oregon State Library's digital collection of quarterly and annual reports, or
View past reports and documents related to the OHP 1115 waiver on the CMS website.

Annual Report

At the end of each demonstration year, OHA produces an annual report that presents compiled quarterly data and additional evaluation information. Click the report title to view related attachments and links.

Annual Report - July 1, 2021 through June 30, 2022

Appendix A - SEDS Report

Appendix B - CCO Complaints Summary

Appendix C - Hearing Requests by Plan

Appendix D - Hearing Requests Received

Appendix E - Two-Percent Test

Annual Report July 1, 2020 - June 30, 2021

Appendix A - SEDS Reports

Appendix B - CCO Complaints Summary

Appendix C - Hearing Requests by Plan

Appendix D - Hearings Requests Received

Appendix E - Two-Percent Test

Annual Report July 1, 2019 - June 30, 2020

Attachment A - SEDS Reports

Attachment B - Annual Enrollment Report

Attachment C - Hearing Request Totals

Attachment D - Hearings by Plan

Appendix E - Two-Percent Test

Appendix F - Neutrality Reports

Annual Report July 1, 2018 - June 30, 2019

Appendix A - Enrollment Reports

Appendix B - Complaints and Grievances

Appendix C - CCO Appeals and Hearings

Appendix D - Neutrality Reports

Appendix E - Two Percent Test

Annual Report July 1, 2017 - June 30, 2018

Appendix A – Enrollment Reports

Appendix B – Complaints and Grievances

Appendix C – CCO Appeals and Hearings

Appendix D – Neutrality Reports

Appendix E – CCO Performance Improvement Projects

Appendix F – Two-Percent Test Data

Quarterly Reports

Reports are listed with the most recent report on top. Each report contains:

An overview of the current reporting period which includes updates on enrollment progress, health information technology, and metrics development;
Progress toward demonstration goals, which outlines improvement strategies to achieve the triple-aim of lower cost, better care, and better health; and
Budget analysis and action plans for addressing any policy, administrative, or budget issues identified.

Click the report title to view related attachments and links.

Quarterly Report - July 1, 2022 - September 30, 2022

Appendix A - SEDS Reports

Appendix B - CCO Complaints Summary

Appendix C - Hearing Requests by Plan

Appendix D - Hearing Requests Received

Quarterly Report - Jan. 1, 2022 - March 30, 2022
Appendix A - SEDS Reports
Appendix B - CCO Complaints Summary
Appendix C - Hearing Requests by Plan
Appendix D - Hearing Requests Received

Quarterly Report - Oct. 1, 2021 - Dec. 31, 2021
Appendix A - SEDS Reports
Appendix B - CCO Complaints Summary
Appendix C - Hearing Requests by Plan
Appendix D - Hearing Requests Received

Quarterly Report - July. 1, 2021 - Sep. 30, 2021
Appendix A - SEDS Reports
Appendix B - CCO Complaints Summary
Appendix C - Hearing Requests by Plan
Appendix D - Hearing Requests Received

Quarterly Report - Jan. 1, 2021 - March 31, 2021
Appendix A - SEDS Reports
Appendix B - CCO Complaints Summary
Appendix C - Medical Hearings by Plan
Appendix D - Neutrality Reports

Quarterly Report - Oct. 1, 2020 - Dec. 31, 2020
Appendix A - SEDS Reports
Appendix B - Complaints and Grievances
Appendix C - Medical Hearings by Issue
Appendix D - Medical Hearings by Plan
Appendix E - Neutrality Reports

Quarterly Report - July 1, 2020 - Sep. 30, 2020
Appendix A - SEDS Reports
Appendix B - Complaints and Grievances
Appendix C - Medical Hearings by Issue
Appendix D - Medical Hearings by Plan
Appendix E - Neutrality Reports

Quarterly Report - Jan. 1, 2020 - Mar. 31, 2020
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report - Oct. 1, 2019 - Dec. 31, 2019
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report - July 1, 2019 - Sep. 30, 2019
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report - Jan. 1, 2019 - Mar. 31, 2019
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report - Oct. 1, 2018 - Dec. 31, 2018
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report July 1, 2018 - Sep. 30, 2018
Appendix A – Enrollment Reports
Appendix B – Complaints and Grievances
Appendix C – CCO Appeals and Hearings
Appendix D – Neutrality Reports

Quarterly Report Jan. 1, 2018 - March 31, 2018
Appendix A – Enrollment Reports
Appendix B – Complaints and Grievances
Appendix C – CCO Appeals and Hearings
Appendix D – Neutrality Reports

Quarterly Report - Oct. 1, 2017 - Dec. 31, 2017
Appendix A - Enrollment Reports
Appendix B - Complaints and Grievances
Appendix C - CCO Appeals and Hearings
Appendix D - Neutrality Reports

Quarterly Report: July 1 , 2017 – Sep. 30, 2017
Appendix A – Enrollment Reports
Appendix B – Complaints and Grievances
Appendix C – CCO Appeals and Hearings
Appendix D – Neutrality Reports