Mid-year Health System Transformation report shows continued progress into 2014

First report to include data on new Oregon Health Plan members since the Affordable Care Act

Oregon’s mid-year Health System Transformation report lays out the progress of Oregon’s coordinated care organizations on key quality and financial measures. For the first time, the report includes a special section with data on the new Oregon Health Plan members who have joined since January 1, 2014, as more people became eligible for Medicaid through the Affordable Care Act.

The report, which covers July 1, 2013, through June 30, 2014, shows continuing improvements in areas such as enrollment in patient-centered primary care homes, decreased emergency department visits, and hospital admissions from chronic diseases. Additionally, financial data indicate coordinated care organizations are continuing to hold down costs. Oregon is staying within the budget that meets its commitment to the Centers for Medicare and Medicaid Services to reduce the growth in spending by two percentage points per member, per year.

The coordinated care model continues to show improvements in the following areas for the state’s Oregon Health Plan members:

-- Decreased emergency department visits. Emergency department visits by people served by CCOs have decreased 21 percent since 2011 baseline data.

-- Decreased hospital admissions for short-term complications from diabetes. The rate of adult patients (age 18 and older) with diabetes who had a hospital stay because of a short-term problem from their disease dropped by 9 percent since 2011 baseline data.

-- Decreased rate of hospital admissions for chronic obstructive pulmonary disease. The rate of adult patients (age 40 and older) who had a hospital stay because of chronic obstructive pulmonary disease or asthma decreased by 48 percent since 2011 baseline data.

-- Patient-centered Primary Care Home enrollment continues to increase. Coordinated care organizations continue toincrease the proportion of members enrolled in patient-centered primary care homes – indicating continued momentum even with the new members added since January 1, 2014. Patient-centered Primary Care Home enrollment has increased 55 percent since 2011. Additionally, primary care costs continue to increase, which means more health care services are happening within primary care rather than other settings such as emergency departments.

This is the first report to include data on some key measures for Oregonians who have newly enrolled in the Oregon Health Plan since the Affordable Care Act took effect in 2014. The proportion of Medicaid members ages 19-35 has increased more than other age groups between December 2013 and October 2014. Data show that newly enrolled Oregon Health Plan members use emergency rooms 33 percent less frequently than those currently enrolled. Newly enrolled Oregon Health Plan members also have fewer avoidable emergency room visits than other members.

“This report shows Oregon’s continued progress in transforming the health delivery system,” said Suzanne Hoffman, interim director of the Oregon Health Authority. “We will continue to measure progress, share it publicly, and learn from the successes and challenges.”

The report is available online at www.Oregon.gov/oha/metrics.

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The Oregon Health Plan is now open to more adults as allowed under the Affordable Care Act. Today, approximately 990,000 Oregonians are enrolled in the Oregon Health Plan – more than 380,000 Oregonians gained coverage in 2014. Learn more at Health.Oregon.gov.

For more information contact Alissa Robbins at 503-490-6590

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