Coordinated care organizations are delivering improved preventive and primary care at more sustainable costs.Patients and coordinated care organizations (CCOs) are starting to see the benefits of Oregon's new model for Medicaid, according to a report released today by the Oregon Health Authority.
The coordinated care model showed large improvements in the following areas for the state’s Medicaid enrollees:
-- Decreased emergency department visits. Emergency department visits by people served by CCOs has decreased 17 percent since baseline data were collected in 2011. The corresponding cost of providing services in emergency departments decreased by 19 percent over the same time period.
-- Developmental screening during the first 36 months of life. The percentage of children who were screened for the risk of developmental, behavioral and social delays increased from a 2011 baseline of 21 percent to 33 percent in 2013, an increase of 58 percent.
-- Increased primary care. Outpatient primary care visits for CCO members increased by 11 percent and spending for primary care and preventive services are up over 20 percent. Enrollment in patient-centered primary care homes has also increased by 52 percent since 2012, the baseline year for that program.
-- Decreased hospitalization for chronic conditions. Hospital admissions for congestive heart failure have been reduced by 27 percent, chronic obstructive pulmonary disease by 32 percent and adult asthma by 18 percent.
The report lays out how Oregon’s coordinated care organizations scored on health care service measures in 2013. This will mark the first time the state is rewarding CCOs for improving care, rather than only the number or type of services delivered. In addition, Oregon remains on track to stay within the capped rate of growth in Medicaid spending.
Based on how they did on the measurements, this week CCOs will receive all or part of the payments that had been held back until now. To earn their full payment, CCOs had to show improvement toward the goals on 17 measures. All CCOs showed improvements and 11 out of 15 met 100 percent of their improvement targets.
The CCOs were scored on measures such as reducing patient emergency department visits while increasing childhood health screenings and primary care, among other things.
The full report can be found on the OHA website at www.oregon.gov/oha/Metrics/Pages/index.aspx. It shows, in total, 33 health services measures including the 17 measures that drive this week’s incentive payments.
The report also shows areas where there has been progress but more gains need to be made, such as screening for risky drug or alcohol behavior and whether people are able to get timely appointments with health care providers. While there were gains in both areas, officials say that the state will put greater focus on them in the year to come. Access to care is particularly important with more than 340,000 new Oregon Health Plan members joining the system since January of 2014.
Additionally, this is the first report to show 2013 performance data by race and ethnicity compared to 2011 baseline data.
“The report shows where we started and where we are now,” said Suzanne Hoffman, interim director of the Oregon Health Authority. “It also shows us where we want to go in continuing to innovate and improve our health delivery system.”
