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CCOs Rewarded with $128 Million for Quality Measurements

The ups and down of their performance provide picture of an evolving industry
July 28, 2015

How did Oregon’s Coordinated Care Organizations perform on outcomes and quality in 2014?

The results are in and, while largely positive, the answers are mixed.

“Performance was better than I would have thought,” Lori Coyner, director of Health Analytics for the Oregon Health Authority, told the Metrics and Scoring Committee last week.

The size of the quality pool (incentives) jumped dramatically in one year, from $47 million in 2013 to $128 million in 2014.

More specifically, Health Share of Oregon walked away with the largest chunk -- $35 million this time around having met 16.3 of the quality measures, followed by FamilyCare with $17 million, and Trillium Community Health Plan and Willamette Valley Community Health, which each took home $13 million.

Of the 17 quality measurements, all the CCOs improved on Electronic Health Record (EHR) adoption, met the improvement target for 2014 and the benchmark for timeliness of prenatal care.

State performance measures have improved in the categories of all-cause readmissions, adolescent immunizations and hospital admissions for chronic conditions. Of particular note:

*Adult admissions for COPD decreased by 60 percent since 2011.

*Adult admissions for short-term complications from diabetes dropped by 26.9 percent since 2011.

Early elective delivery dropped to just 2.3 percent, well below the benchmark of 5 percent. The category is being retired due to its success.

Ten of the 16 CCOs met the benchmark of 47 percent for colorectal cancer screenings, while two others were extremely close at 46.7 percent.

Alcohol and other substance misuse screenings improved from 2 percent to 7.3 percent, but fell short of the benchmark of 13 percent.

On the downside, cervical cancer screenings are down to just 44.3 percent from 56.1 percent in 2011. The screenings are dropping further from the benchmark of 72 percent.

Well-child visits in the first 15 months of life have also dropped from 68.3 percent in 2011 to 50.2 percent in 2014, well short of the benchmark of 77.4 percent.

Kendra Hogue is a Portland-based freelance writer. She can be reached at [email protected].