Policy Board Voices Little Concern About CCO Letters of Intent

April 12, 2012—A presentation about the number of organizations intending to become coordinated care organizations (CCOs) by August drew little discussion from the Oregon Health Policy Board on Tuesday.

The authority received 47 letters of intent from every county and area of the state. “We look at that as being an enthusiastic response,” Judy Mohr Peterson, the authority’s director of medical assistance programs, told the board. “We have a lot of interest.”

A map developed by the authority shows there is geographic overlap of these potential CCOs, which will coordinate and integrate the physical and mental healthcare of 650,000 Oregon Health Plan patients beginning in August. In southern Oregon, four to seven organizations could compete, while 10-12 CCOs could emerge in the Portland metropolitan area.

However, not all the letters of intent will necessarily translate into actual applications, Peterson said. The authority has the final say in which applications receive the go-ahead, and it is expected to certify CCOs by June.

Dr. Bruce Goldberg, the authority’s director, said some organizations sent in a “placeholder” letter of intent in case a collaborative doesn’t “come to fruition” such as in the Portland tri-county area.

“The timelines are aggressive, and a lot of organizations aren’t sure that they’re going to be able to hammer out all the details,” Goldberg said.

An odd duck that stood out was a letter of intent from the Department of Corrections, even though its prisoners do not qualify for the Oregon Health Plan.

Dr. Carla McKelvey, a pediatrician at North Bend Medical Center, and Carlos Crespo, a Portland State University professor of community health, both wondered why the department would submit a letter of intent.

“We certainly aren’t making any judgments or assumptions,” Goldberg replied. “Every application gets treated in exactly the same way.”

Eric Parsons, chair of the policy board, noted that many of the organizations proposing to become part of a CCO are managed care organizations (MCOs) or other organizations that already provide care to Oregon Health Plan patients.

Much of the motivation to create CCOs—which will integrate and coordinate the mental and physical healthcare of Oregon Health Plan patients, and rely less on specialty and emergency room care—was growing dissatisfaction with how well the fee-for-service model of providing care worked.

Parsons wondered how different the delivery system would be if the same organizations would be involved. “I’m just wondering about the extent to which we think these organizations are thinking about transformation, and the extent to which we have the ability to sense they’re thinking seriously about transformation,” he said.

“This is about a reformed delivery system, and changing how care is delivered,” Goldberg said. “The criteria in the [request for applications] really spelled that out.”

Organizations intending to become CCOs must submit their formal applications by April 30.


Image for this story appears courtesy of The Oregonian.

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Yes, that is a good question, Eric Parsons asked. How much will they help transform the system? Will prevention be given more than lip service?