CCO Performance from the Consumers' Perspective

Housed within the Oregon Public Health Institute, the Consumer Confidence Project takes a look.

The Oregon Health Authority uses performance metrics and quality measures to evaluate the performance of Coordinated Care Organizations – and determine whether they are, in fact, improving care, improving health and lowering costs.

But what about the consumer’s perspective? In other words, how do CCOs measure up when it comes to their members and their communities? That’s what the Consumer Confident Project hopes to find out.

Formed by healthcare advocates and housed within the Oregon Public Health Institute, the project is evaluating the consumer-oriented aspects of Oregon’s healthcare transformation.

“There were a number of people who felt the consumer perspective was not represented using the metrics created by the state and the Centers for Medicaid and Medicare Services,” said spokesman Bob Brown. “We thought there was something missing. There’s nothing wrong with the metrics, it just doesn’t include the consumers’ view. How do we know the CCOs are meeting the needs of the CCO clients from their perspective?”

When the legislature created CCOs, it gave them substantial leeway, Brown said, and some CCOs may do a better job than others from a consumer’s point of view.

This project is focused on four different aspects of CCOs – access to information, responsiveness to members and the community, transparency of governance and person-centered services.

For example, are CCOs providing access to information about their services? Are they responsive to their members? What does health system transformation look like to their members? And how transparent is the CCO about encouraging member engagement and involvement?

To help gather this information, volunteers reviewed the websites of CCOs, their welcome packets and member handbooks, using a checklist of about 75 indicators.

“Our scoring methodology right now is binary,” Brown said. “Do they provide the information or not.”

The final report, to be released in February, will compare CCOs side-by-side in several categories so that their members and their communities can see how they perform.

“We are looking across all CCOs,” Brown explained. “We want to communicate the information broadly to CCOs and the state. All we are saying (right now) is if we know where we are at, we can make improvements.”

To avoid conflicts of interest, an operational staff with no financial ties to healthcare organization was hired to analyze the data. Because of limited resources, volunteers were unable to conduct formal surveys or hold focus groups.

That doesn’t mean Brown and his team of volunteers aren’t interested in hearing directly from consumers. “There are things we didn’t do that we’d definitely like to do,” he said.

FOR MORE INFORMATION:

http://www.oregon.gov/oha/OHPB/docs/cco-metrics.pdf

http://www.oregon.gov/oha/Pages/CCO-Baseline-Data.aspx

http://www.oregon.gov/oha/Metrics/Pages/ccos.aspx

http://www.oregonclho.org/uploads/8/6/1/7/8617117/side_by_side_measures_3_14_14.pdf

 

Joanne can be reached at [email protected].

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