November 10, 2011—Dr. Bruce Goldberg is in active discussions with the Centers for Medicare and Medicaid Services (CMS) to see if federal funds are available to jump start the coordinated care organizations (CCOs) which will provide physical, mental health and dental services to more than 630,000 people on the Oregon Health Plan next July.
“It is showing some promise in being able to do that,” Goldberg, director of the Oregon Health Authority, told the Oregon Health Policy Board on Tuesday. “Nothing is certain at this point. We’re putting a lot of effort into this.”
That money would help the Oregon Health Authority “meet what are some really aggressive timelines” in getting CCOs “some of the financial support [they need] to move forward pretty rapidly,” Goldberg said.
The funds would come from any savings the federal government achieves as a result of the CCOs providing more effective and less costly care.
The state projects reducing healthcare costs by $239 million during the 2012 fiscal year as a result of the transformation reforms to the Oregon Health Plan. With the federal government providing 60 percent of Medicaid expenditures, it would realize $143 million in savings. According to the Oregon Health Authority, the federal government could save as much as $400 million on top of savings to the state's general fund, totaling nearly $640 million dollars.
After the Health Policy Board meeting, Goldberg didn’t indicate the amount of money he’d request and was uncertain how much money CMS might provide, but did say that federal savings returned to Oregon would go toward “providing incentives and support for communities that form coordinated care organizations.”
The state has already received $1 million from CMS under the “State Demonstrations to Integrate Care for Dual Eligibles” initiative, a joint project between CMS’s Innovation Center and the Medicare-Medicaid Coordination Office.
Those funds, awarded in December 2010, have provided technical assistance as the state moves forward with designing CCOs, including the costs associated with the four workgroups that are focusing on developing the criteria, global budget and outcome measurements for the CCOs and the integration of people who are dually eligible for Medicaid and Medicare.
The state also submitted a letter to CMS on October 1, asking for a waiver allowing the Oregon Health Authority to blend its federal Medicaid and Medicare funds for this dually eligible population into the CCOs.
