CCO

State Official Sues FamilyCare in Federal Court

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Although FamilyCare stopped operating as a coordinated care organization on Jan. 31, it is still suing the Oregon Health Authority in state court over rate-setting for Medicaid. Now the Oregon Health Authority’s director has filed a federal lawsuit challenging the nonprofit.

The Oregon Health Authority has sued FamilyCare in federal court, out of apparent concern that the former coordinated care organization’s continuing dispute with the state could jeopardize 2018 Medicaid agreements with Oregon’s 15 surviving CCOs.

Greenlick Renews Call for Transparency and Accountability for State CCOs

House Speaker Tina Kotek is confident that some of the key changes that she and Rep. Mitch Greenlick want for the state Medicaid system will pass in February, despite their defeat in 2017.

Representative Mitch Greenlick, D-Portland, and House Speaker Tina Kotek, D-Portland, are reintroducing legislation that will provide greater daylight and accountability in the state’s Medicaid system, opening up their b

FamilyCare Decries 2018 CCO Rates, Continuing Years-Long Battle with Oregon

The Portland-area nonprofit says even with a 9.8 percent rate hike, it faces a $75 million deficit and could go out of business.

Coordinated care organization reimbursement rates that were announced this week included a hike in how much FamilyCare will receive in 2018 – but not enough to appease the leaders of the Portland-area CCO, who say low reimbursements are putting their nonprofit organization at risk.

Kotek Joins Greenlick in Pushing for CCO Reform, Against Resistance

Rep. Greenlick introduced legislation calling for better controls on CCO reserves and more transparent accounting by the organizations, which use tax dollars to provide healthcare for the state’s neediest residents.

Rep. Mitch Greenlick, D-Portland, rolled out his coordinated care organization reform bill on Monday with the support of House Speaker Tina Kotek, D-Portland.

Greenlick intends to build on the success of locally driven reforms to the state Medicaid program by requiring CCOs to be more transparent and more accountable while protecting the public investment in the health of the state’s children, low-income adults and disabled people.

Quick Look: CCOs report mixed gains on performance metrics

CCOs were evaluated on adolescent well care, emergency department utilization and enrolling members in patient-centered primary care homes among other metrics.

The Oregon Health Authority reviewed how each of the state’s 16 CCOs performed on 17 incentive metrics, a report called “Oregon's Health System Transformation: CCO Metrics 2015 Mid-Year Update,” released earlier this week.

In depth: CCOs Report Mixed Gains on Performance Metrics

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None of the CCO met all benchmarks, with Medicaid expansion, changing health recommendations complicating efforts to measure performance.

Oregon’s coordinated care organizations are moving forwards, backwards and sideways in their efforts to measure improvements to the care they provide, according to a state snapshot of performance metrics released this month.

Greenlick Opens Controversial Debate on Future of CCO System

Rep. Mitch Greenlick seeks major changes that will ensure that the local Medicaid health management companies operate in the public interest, and he wants legislation passed before the new contracts come out. Sen. Bates seeks more transparency from the Oregon Health Authority to avoid another heated battle with CCOs over payment.

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CCOs Face Steep Cuts for Younger Adults After Actuarial Analysis Shows 2014 Overpayment

FamilyCare received some of the biggest cuts, moving from one of the best-paid CCOs to the least paid. A state report shows that the CCOs were paid nearly as much for younger adults as they were for older adults, and a more refined analysis ordered by the feds caused the state to adjust rates more closely to actual claims.

The Oregon Health Authority issued its final Oregon Health Plan rates for 2015, assigning the coordinated care organizations with figures that veer dramatically from their 2014 rates and create both winners and losers as the dust is settled.

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