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Digging into CCO Reimbursements

The Lund Report spoke with experts at the Oregon Health Authority to dig into recent rate increases announced for the state’s Medicaid-funded coordinated care organizations. Here’s what they had to say.

Oregon’s coordinated care organizations are getting a raise from the state – about $8 more per Medicaid member per month than they expected to receive in 2018.

Coalition for a Healthy Oregon Backs CCO Transparency Bill

A last-minute intervention by Senate President Peter Courtney made a slight amendment to the bill’s creation of public meetings for coordinated care organizations, leading to unified support from the Medicaid insurers and a 28-1 approval vote in the Senate.

The Senate has passed the coordinated care organization transparency bill with the surprise last-minute support of the Coalition for a Healthy Oregon, the group of seven CCOs that had long opposed the bill, particularly its re

Oregon State Hospital Wants Patients to Keep Medicaid Insurance

Currently, people lose their Oregon Health Plan coverage when they enter the state mental hospital and must wait to have their insurance reinstated upon discharge. A change in law could provide a boost to CCOs, since they can’t be billed for care received in the state hospital.

Oregon State Hospital officials have a new strategy for ensuring patients do not have to worry about their health insurance when they leave -- never cutting off their Medicaid coverage in the first place.

Oregon Health Authority Fights to Keep Right to Clawback CCO Money

The state agency was largely absent from discussions in the House about two new laws to protect coordinated care organizations from capricious state governance, but now the Oregon Health Authority is asking the Senate Health Committee to roll back legislation so that it may reserve the right to retroactively reset CCO budgets in 2016.

The Oregon Health Authority has been working behind the scenes to block legislative reforms in a pair of bills that the House unanimously voted to imposed on the agency.

House Clears Bill Restricting CCO Service-Area Changes, But Bates Bill is Dead

At the end of the second week of the session, the Legislature is poised to pass two narrowly tailored bills corralling the actions the Oregon Health Authority took toward CCOs, but more rigorous bills are falling by the wayside.

The House unanimously voted Friday to approve legislation backed by FamilyCare that restricts the ability of the Oregon Health Authority to upend the coverage area of the state’s 16 coordinated care organizations.

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 Fight Claw Back Provision in 2016 Contract

A new clause in their 2016 contracts will require CCOs to return any excess payments.

The state’s coordinated care organizations are poised to challenge a provision in their 2016 contracts requiring them to payback any excess revenue when legislators convene on Feb. 1.

Greenlick Wants State to Improve 2016 Rate Process, Hopes for Flexibility from Feds

Health Share CEO Janet Meyer refutes the idea that profits in the Health Share system raised its costs. Rep. Mitch Greenlick said the state should move away from basing rates on cost data for 2016 and appeal to CMS that rolling back the 2015 rates to January will badly disrupt Oregon’s healthcare transformation.

Rep. Mitch Greenlick, D-Portland, has proposed two possible remedies to the turmoil of proper and adequate payments for the Oregon Medicaid system that could improve the situation both as a matter of policy and politics, even though everyone’s not likely to be pleased.

Saxton Close to Choosing Chief Health Systems Officer; Dannenhoffer in Running

She also briefed the Health Policy Board on the financial deficits facing her agency over the next six years.

Lynne Saxton’s very close to deciding on a chief health systems officer to oversee the coordinated care organizations, and expects to announce her decision by late September, and also hire a Medicaid director by mid-October, along with an external relations director  and business IT lead.

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