Health Share Medical Chief and Chair of Metrics Committee Suggests Using Bonus Funding for CCOs to Double Down on Disparities

The Health Policy Board considers a vision of more upstream CCO metrics, bonus funding and using the board as a venue for debate on legislation prior to 2017 session.

“What do we mean by ‘health’? Health is broader than healthcare?” asked Dr. Carla McKelvey at the recent Health Policy Board.

A Coos Bay pediatrician, McKelvey tossed out a vision of CCO metrics such as “are kids able to go to school? Are they graduating?” rather than asking if they are using the emergency room or a primary care provider.

When it comes to metrics, Dr. Maggie Bennington-Davis, senior medical director at Health Share and chair of the metrics committee, suggests bonus funding might be best spent addressing disparities.

“We only have to achieve 12 of 18 metrics to get $168 million to infuse back into the system,” Bennington-Davis said. Maybe the “challenge pool” or “bonus round” of funding might be used for specific “select measures to double down.”

She also hopes metrics can get systems to work together better. “We know foster kids have far more health burden,” Bennington-Davis said yet some “bellyache ‘how do we even know who those kids are?’ Work with DHS (the Oregon Department of Human Services) to find out.”

As the Legislative session winds down, Zeke Smith described a mix of “big existential questions and very technical questions” which proved hard to address in a short session.

“I hope OHPB has a role in participating in those existential questions,” Smith said, suggesting that OHPB might be a good “forum for those questions to be discussed” particularly questions about keeping consumers at the core.

Total Medicaid enrollment increased 71 percent between 2013 and mid-2015, moving from serving 60 percent children and 40 percent adults to 40 percent children and 60 percent adults.

Jan can be reached at [email protected].

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