Oregon's health system transformation continued to show positive trends in health care quality and financial measures for the second year in a row. That is the overall message of the 2014 Health System Transformation report released today by the Oregon Health Authority.
The 2014 Health System Transformation report lays out the progress of Oregon’s coordinated care organizations (CCOs) on key quality and financial measures. The report includes expanded information on the new Oregon Health Plan members who have joined since Jan. 1, 2014, when more Oregonians became eligible for Medicaid as allowed under the Affordable Care Act.
This report, which covers calendar year 2014, continues to show improvements in areas such as enrollment in patient-centered primary care homes, and continued decreases in both emergency department visits and hospital admissions due to chronic diseases.
The report also says that all of Oregon’s CCOs showed improvement in a number of quality incentive measures and 13 of the 16 CCOs earned the full amount of their quality pool payments in 2014.
“We have added more than 434,000 Oregonians to the Oregon Health Plan since January 1, 2014, and the coordinated care model continues to show improvements to Oregonians’ care for the second straight year,” said Lynne Saxton, Oregon Health Authority director. “These improvements are a great example of how CCOs are implementing positive changes through better care coordination and integration of services.”
The coordinated care model continues to show improvement in the following areas for the state’s Oregon Health Plan members:
-- Decreased emergency department (ED) visits. Emergency department visits for people served by CCOs decreased 22 percent since 2011 baseline data. Many CCOs have implemented a number of best practices to reach this result, including the use of emergency department navigators. For example, one such program includes referrals to a patient-centered primary care home for patients who do not have a primary care provider, as well as intensive management for patients who visited the ED three or more times within six months.
-- Decreased hospital admissions for short-term complications from diabetes. The rate of adult patients (ages 18 and older) with diabetes who had a hospital stay due to a short-term problem from their diabetes dropped by 26.9 percent since 2011 baseline data.
-- Decreased rate of hospital admissions for chronic obstructive pulmonary disease. The rate of adult patients (ages 40 and older) who had a hospital stay due to chronic obstructive pulmonary disease or asthma decreased by 60 percent since 2011 baseline data.
-- Increase in patient-centered primary care home (PCPCH) enrollment. PCPCH enrollment has increased 56 percent since 2011. Additionally, primary care costs continue to increase, which means more health care services are happening within primary care rather than other settings such as emergency departments.
This report also shows areas of challenge. In 2014, CCOs saw a reduction in cervical cancer and chlamydia screenings for women, which may be due to changes in national guidelines, which recommend women wait three to five years between Pap tests and to wait until age 21 to have their first Pap test. In addition, members initiating alcohol and drug treatment increased; however, ongoing treatment after an initial visit or service for alcohol and drug use remained unchanged, showing room for improvement.
Finally, financial data indicate that coordinated care organizations are continuing to hold down costs. Oregon is staying within the budget that meets its commitment to the Centers for Medicare and Medicaid Services to reduce the growth in spending by 2 percentage points per member, per year.
“The CCOs are clearly hitting their marks as they work toward the triple aim of better health, better care and lower costs,” said Saxton. “These metrics offer positive proof that Oregon’s health system is continuing to improve care for the nearly 1.1 million Oregonians who need it most.”
The report is available online at www.Oregon.gov/oha/metrics.
