Coordinated
Care Organizations
March 2012 fact sheet – Oregon Health
Authority
A more
person-centered and affordable health system for Oregon
Coordinated
Care Organization definition
A Coordinated Care
Organization (CCO) is a network of all types of health care providers who have
agreed to work together in their local communities for people who receive
health care coverage under the Oregon Health Plan (Medicaid).
What will
stay the same and what will be different with Coordinated Care Organizations
Under CCOs, the Oregon
Health Plan’s medical benefits will not change. But today the system separates
physical, behavioral and other types of care. That makes things more difficult
for patients and providers and more expensive for the state. CCOs will have the
flexibility to support new models of care that are patient-centered and team-focused,
and reduce health disparities. CCOs will be able to better coordinate services and
also focus on prevention, chronic illness management and person-centered care.
They will
have flexibility within
their budget to provide services alongside today’s OHP medical benefits with
the goal of meeting the Triple Aim of better health, better care and lower
costs for the population they serve.
How
Coordinated Care Organizations will work
CCOs will be local. They
will have one budget that grows at a fixed rate for mental, physical and
ultimately dental care. CCOs will be accountable for health outcomes of the
population they serve. They will be governed by a partnership among health care
providers, community members, and stakeholders in the health systems that have
financial responsibility and risk.
Status of
Coordinated Care Organizations
Across the state, care
providers, hospitals and health care plans are coming together to apply to
become Coordinated Care Organizations. The first CCOs should be launched by
August 1, 2012. There will be four open application periods for CCOs in 2012.
Key
milestones
April 2, 2012 Non-binding
letters of intent due to OHA from all potential 2012 CCO
applicants (no matter when
they intend to apply through the year)
April 30, 2012 Technical
applications due to OHA from potential CCOs for first period
May 14, 2012 Financial
applications due to OHA from potential CCOs for first period
May 28, 2012 First CCOs
certified and enter CMS approval process
Aug. 1, 2012 First CCOs
launched
Seewww.health.oregon.gov
for timelines for subsequent application periods.
How CCOs
will be chosen
The request for
applications (RFA) lays out detailed criteria for potential CCOs. The RFA can be
found atwww.health.oregon.gov. The Oregon Health Authority is
responsible for selecting local CCOs. Potential CCOs will be measured on their
ability to:
·Develop
and implement alternative payment methodologies that are based on the Triple Aim
of improving health, health care and lowering costs;
·Coordinate
the delivery of physical health care, mental health and chemical dependency services,
and oral health care;
·Engage
community members and health care providers in improving the health of the
community and addressing
regional, cultural, socioeconomic and racial disparities in
health care that exist
among the OHP clients/CCO members and in the CCO’s
community;
·Progress
from the baseline requirements for CCOs to the full requirements expected at maturity;
·Manage
financial risk, establish financial reserves and meet minimum financial
requirements; and
·Operate
within a fixed global budget.
Public
process in creating CCOs
The request for
applications requires each CCO applicant to hold a public information session in
its local community. Additionally, all non-binding letters of intent and
technical applications from potential CCOs will be posted online atwww.health.oregon.gov.
Information
for Oregon Health Plan clients
OHP clients will be
notified at least 30 days in advance of any change in health plans, but the Oregon
Health Authority will be going above and beyond standard notices. Special
outreach and communications will be created for Oregon Health Plan clients
about CCOs, what to expect with the coming change and how to use CCOs for
better health and care.
Background
on how CCOs were created
CCOs were created in
response to escalating health care costs, due in large part to an
inefficient health care
system. Over two legislative sessions, in 2011 and 2012, Governor Kitzhaber and
bi-partisan lawmakers passed landmark legislation. More than 1,200 Oregonians
provided input through eight community meetings that were held around the
state, and another nearly 200 people met in work groups to help create the
framework for CCOs.
Reducing
costs while improving care
A third-party analysis
found that by implementing CCOs, Oregon could save a significant portion of
projected Medicaid costs in the short and long terms. Savings in state and
federal dollars would be more than $1 billion within three years and more than
$3.1 billion over the next five years.
cilman Greg Taylor was arrested Wednesday and accused of sexually abusing a 4 year old boy.
