OHA Releases Quarterly Legislative Report on Oregon’s Health System Transformation

Additional report released on CCO 2016 mid-year metrics

SALEM—Oregon’s health system transformation continues to pay dividends for Oregonians. Even as uncertainty about health care continues at the federal level, Oregon is seeing improved health outcomes, increased health coverage and lower costs to the state.

That's the message of the quarterly legislative report released today by the Oregon Health Authority (OHA). The report provides the Legislature with results and data on the progress of Oregon’s health transformation and the vital health care coverage for children and families struggling to make ends meet, including low-income working families. 

“Oregon has a long history of bipartisan health care reform that has improved access to affordable, high-quality health care,” said OHA Director Lynne Saxton. “We don’t yet know the impact on the state of the national health care debate, but from this report we know that the progress we are making here in Oregon is real and measurable.” 

The Oregon Health Plan (OHP) provides needed health coverage to approximately 1 million people, or more than one in four Oregonians and more than one in three residents in many rural counties. It is the largest health plan in the state and the engine for the health system transformation that has improved health outcomes and saved the federal and state governments $1.4 billion since 2012.  

One in three Medicaid recipients has coverage through the Affordable Care Act

The quarterly report released today highlights that in September 2016, more than 378,000 Oregonians and one in three Medicaid recipients were receiving health care coverage through new income eligibility criteria allowed by the Affordable Care Act (ACA). The report also reveals that statewide, nearly 40 percent of working-age OHP members enrolled in a coordinated care organization (CCO) are employed and 8 percent are working more than full time.

CCOs maintain financial health as operating margins begin to stabilize

The increased membership resulting from the ACA expansion generally led to an increase in both the net assets and restricted reserves for Oregon’s CCOs. On a statewide basis, CCO operating and total margins have been trending downward from their peak in 2014. This stabilization is to be expected and the report includes financial data for Oregon’s 16 CCOs for 2014, 2015 and the first two quarters of 2016. 

The quarterly legislative report also highlights financial pressures facing the Medicaid program and CCOs, including the impact on the OHP budget of increasing pharmacy costs. In 2015, pharmacy expenditures reached $674 million compared to $533 million in 2014. Hepatitis C drug expenditures continue to significantly increase, with $38 million spent on hepatitis C drugs in 2015 compared to $16.6 million in 2014. 

The 2016 mid-year CCO metrics report also was released today. It lays out the progress of Oregon’s CCOs on quality measures as of June 2016. Measuring quality and access to care are key to moving health system transformation forward, to ensure high-quality care for Oregon Health Plan members. 

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