Health Share of Oregon, the state’s largest coordinated care organization (CCO), has successfully met the requisite Oregon Health Authority’s 2014 Performance Metrics and will receive an incentive award of $13,720,133, the maximum amount available. The Portland Tri-County CCO will reinvest the award earnings in provider and infrastructure support to further health care reforms.
“Health Share’s partners have worked collaboratively across the network to improve care,” said Andrew McCulloch, president of Kaiser Permanente Northwest and founding Health Share board member. “Together, we have made significant progress in critical health metrics, including increasing colorectal cancer and child development screening rates, reducing ED utilization and significantly increasing the number of members seen in a Patient-Centered Primary Care Home (PCPCH).”
Performance metrics and quality measures are being used by the Oregon Health Authority (OHA) to determine how successful CCOs have been at improving care, making quality care accessible, eliminating health disparities and curbing the rising cost of health care for the populations they serve. Incentive funds from a quality pool have been awarded to CCOs based on their performance on 17 measures.
Among Health Share’s achievements has been to develop and implement a provider performance dashboard to provide timely information about the measures to providers, so they can monitor their progress. Through this effort, Health Share is emerging as the statewide leader in the collection of clinical measures across a large network.
“We have worked to foster a community of sharing and learning across systems through identification and promotion of best practices, process enhancements and clinical expertise,” noted Janet Meyer, chief executive officer of Health Share. “From health plans and hospitals to individual providers, health clinics and social service agencies, we have embraced the concept of community-wide collaboration. Transformation will come from the collective impact of changes that occur across the system from those committed to making it better.”
In addition to continued investment in infrastructure to support quality improvement activities, Health Share will reinvest the incentive funds in payments to providers based on performance; the development of provider capacity to calculate and report specific clinical quality measures; and strategic provider-driven initiatives to improve performance on key metrics.
About the Performance Metrics
The Oregon Metrics and Scoring Committee was established in 2012 by Senate Bill 1580 to establish outcomes and quality measures for the state’s newly formed coordinated care organizations. In October 2012, the Metrics and Scoring Committee identified 17 initial outcomes and quality measures to be used in the incentive program (quality pool); the 17 CCO measures are also required by the Centers for Medicaid and Medicare Services (CMS) as part of Oregon’s 1115 waiver agreement.
To read about the incentive program, visit http://www.oregon.gov/oha/CCOData/ReferenceInstructions.pdf.
For more information on the 17 outcomes and quality measures, visit http://www.oregon.gov/oha/CCOData/CCO%20Incentive%20Measures%20Quick%20Guide%20(June%202013).pdf.
