Coordinated Care Organization Agreement Signed for Marion and Polk Counties

June 20, 2012 — On Tuesday, June 19, 11 organizations, plus Marion and Polk counties, signed an agreement to create Willamette Valley Community Health, LLC, seeking authorization from the state as a Coordinated Care Organization to serve Medicaid patients in Marion and Polk Counties.

Those signing the agreement are: ATRIO Health Plans, Inc.; Capitol Dental Care Inc.; Marion County; Mid-Valley Behavioral Care Network; WVP Health Authority; Northwest Human Services; Polk County; Salem Clinic; Salem Health/Salem Hospital; Santiam Memorial Hospital; Silverton Health; West Valley Hospital; and Yakima Valley Farm Workers Clinic.

Former Judge Pamela Abernethy facilitated the discussions to create the new entity. “Everyone at the table understands that collaboration by this group is the first step toward building a coordinated network of care for Oregon Health Plan clients that delivers care more effectively while reducing the cost of care for the state,” she said. “They have worked under incredible time lines to forge new relationships and build new understandings of how each provider can contribute to that effort.”

Planning for the CCO began more than a year ago, organized by the WVP Health Authority, which holds the current OHP contract for Marion and Polk Counties.

“The initial work has been focused on structure and risk and whether this made sense for the various groups in the discussion,” said Dean Andretta, chief financial officer of WVP Health Authority.

“While everyone in this group provides some form of health care, our
organizations are all set up differently,” said Cheryl Nester-Wolfe, RN, chief operating officer for Salem Health. “We spent a lot of time learning how one another’s businesses work and finding a way to mesh the requirements of not-for-profit entities with for-profit entities to come up with a new model. Working through this process we created new partnerships.”

“Patients won’t see a lot of differences initially,” said Andretta, “Over time, patients will experience more coordination between their providers and more emphasis on prevention, and making sure patients understand what prevention services are available. They will also have an expanded pool of providers available to them.”

“Today, health care is very fragmented,” said Nester-Wolfe. “The CCO offers us a way to bridge that. Our hope is that we actually be able to change the way that we care for people in this community and do it better.”

“Willamette Valley Community Health is our community’s response to the governor’s call for health-care transformation,” said Andretta. “Its about how we will care for this population and others and really work together to have a more responsive and coordinated health-care system in our community.”

“This isn’t just about structure and rules for the new entity. That will be the foundation for transformation and change. The providers are more interested in how we will transform our delivery system, not a new entity that is doing business as usual,” said Nester-Wolfe. “This whole effort ultimately about transforming the type of care we give.”

Financing is still a concern for the new organization. “The state is still in a funding crisis,” said Andretta. “We have more people on OHP and less money to provide that service. The state did give us some relief on the reserve requirements, which helped a lot.”

A Coordinated Care Organization, or CCO, is a network of all types of healthcare providers (physical, mental health and dental 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). CCOs are intended to focus on prevention and helping people manage chronic conditions, like diabetes. This helps reduce unnecessary emergency room visits and gives people support to stay healthy.

The CCOs were created to achieve the Institute for Healthcare
Improvement’s “Triple Aim” of improving the patient experience of care (including quality and satisfaction), improving the health of the populations; and reducing the per capita cost of health care.