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Report: Oregon Health Plan Shows Improvements

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Wednesday, June 25, 2014   

SALEM, Ore. - More than 340,000 new people have joined the Oregon Health Plan since January, and a new report says it's a system that has shown major improvement in the past year.

The state tracked what coordinated care organizations (CCOs) are doing for Oregon Health Plan or Medicaid patients. It found that the number of outpatient primary-care visits increased by 11 percent in 2013, an indication that more people are getting care sooner and not at emergency rooms.

Mimi Haley, regional executive at Columbia Pacific CCO, said that means it's likely to save the state money in the long term.

"You can drive down inappropriate emergency department utilization by making sure that people are getting connected with primary-care services," she said, "that those primary-care practices that are medical homes are doing the outreach to say, 'Hey, we haven't seen you for a while, and we really need to bring you in for your mammogram.' "

Haley said CCOs' current challenge is to keep up the higher standards while serving a lot more patients this year. Her CCO grew from 15,000 members to more than 24,000 when the Affordable Care Act made more people eligible for the Oregon Health Plan.

The state report said more babies are being screened early for health problems, and there are fewer hospitalizations for chronic conditions among Oregon Health Plan members than in previous years.

Dr. Jim Rickards, health strategy officer for Yamhill Community Care Organization, said it's partly the result of collaboration between different types of health-care providers, and because patients are part of CCO committees and workgroups.

"Before the CCOs really took off, there wasn't really a lot of dialogue between those parties, or even with the members who were receiving care. We weren't really getting their feedback," he said. "But now, with these CCOs, we have a platform for everybody to communicate, form relationships and start working together."

The Oregon Health Authority tied improvements in 17 areas to bonuses for CCOs' performance, which they will now receive and use to make further improvements. It is Medicaid money originally intended for the CCOs' budgets that was held back as an incentive for them to meet or exceed their metrics.

The report is online at oregon.gov.


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