ccos

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.

Financial Filings Portray Ups and Downs of CCOs Early Growth

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FamilyCare reported strongest profits among Oregon CCOs, while others had low cash reserves, but regulators aren’t worried

Oregon’s 16 coordinated care organizations, born out of the Affordable Care Act to provide healthcare to people on Medicaid, appear to be entering their financial adolescence: reporting stronger profits as they grow, but not yet fully mature or ready for long-term independence.

Basic Health Bill Goes to Brown, Asks OHA to Hammer Out Plan

Oregon could move private health insurance subsidies to the CCOs to provide coverage for an additional 87,000 people, including thousands of uninsured legal immigrants, but HB 2934 merely keeps the bureaucratic work going to shape the policy for possible 2017 implementation.

A bill that keeps the hopes of immigrant- and low-income advocates alive for a Basic Health Plan passed the Senate by a 22-7 vote, leaving just Gov.

Health Republic Hopes to Recoup $10.5 Million from Risk Corridor

Those dollars represent the higher costs experienced by Health Republic from medical claims and are partially response for its 38 percent rate request for individual plans in 2016.

Moda Health isn’t the only Oregon insurer expecting to receive millions of dollars because its individual members had significantly higher medical claims last year – in what’s known as the federal risk corridor program created under the Affordable Care Act.

Southern Oregon CCOs Provide Unique Perspectives to Health Policy Board

The four counties along the California border going east from the Pacific Ocean have 10 percent of the population, but four CCOs are experimenting with the delivery of healthcare.

Southern Oregon has the state’s most concentrated presence of coordinated care organizations, with four organizations serving four counties with less than 10 percent of the state’s population.

Health Share Seeks to Improve Cultural Competency

Of the CCO’s members, half are people of color with 50,000 identifying themselves as Hispanic/Latino

On July 1, Health Share of Oregon, the state’s largest coordinated care organization, intends to submit its first “cultural competency platform” to Oregon Health Authority’s Office of Equity and Inclusion.

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