Trillium Unveils Access to Care Plan

The expansion of the Oregon Health Plan (OHP) occurred at the same time Trillium, the Coordinated Care Organization in Lane County, is working to change how providers take care of OHP patients and how they receive reimbursement for their services. The Affordable Care Act allowed Oregon to expand Medicaid eligibility which is good news for newly qualified OHP members who previously lacked health coverage. But assigning each OHP member to a primary care provider has become challenging to a system that was already experiencing primary care physician access problems.
 
Since January 1, Trillium has been assigned nearly 20,000 new OHP members to the 56,000 already covered by the plan at the end of 2013. This influx of new patients has overwhelmed current primary care provider capacity for adult patients. “We are unable to assign a primary care medical home to approximately 9,000 adults,” says Terry Coplin, Trillium CEO. “Trillium takes this very seriously. It was clear we needed an action plan to address the issue 
 
The Access to Care Plan focuses on four basic elements. 
 
1-New Member Assignment—immediate implementation
 
Administrative intake cost to primary care offices for new members is greater than the cost of providing care to established patients. Payments to PCPs will be increased based on the number of additional members assigned to their practice.
 
2-New Community Health Center (CHC)—second quarter 2014 
 
Trillium will provide grant funding to Lane County to develop another community health clinic which they predict can be operational by July - August 2014, providing care to approximately 6,000 additional OHP members.
 
3- Transformation Funding RFP—third quarter 2014 
 
Trillium will issue an RFP seeking proposals to utilize a $500,000 grant to create a practice structure designed to achieve specified quality measures and increase capacity with their provider resources. Providers will be incentivized to structure or redesign their practice to accept additional OHP members into a primary care medical home.
 
4-Transformation Consultation Services RFP– third quarter 2014
 
Trillium will provide professional consultation services to assist medical practice redesign that will achieve targeted quality outcomes and help them transform into highly functioning patient centered medical homes. Funding will be provided by Trillium but will require significant work by primary care providers to address the growing unmet need in our community. “Providing people access to care is the critical underpinning to our efforts  to transform health care,” says Karen Gaffney, Assistant Department Director for Lane County Health and Human Services. “Lane County’s partnership with Trillium on a new Community Health Center demonstrates a public private collaboration at its best.”
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