Oregon

Chapter 595 of the 2009 Oregon Laws established the Patient Centered Primary Care Home (PCPCH) Program by the Office for Oregon Health Policy and Research . Through this program, the Office shall:

  • Define core attributes of the patient centered primary care home; 
  • Establish a simple and uniform process to identify patient centered primary care homes that meet the core attributes defined by the Office;
  • Develop uniform quality measures that build from nationally accepted measures and allow for standard measurement of patient centered primary care home performance; and
  • Develop policies that encourage the retention of, and the growth in the numbers of, primary care providers.

This law created a learning collaborative to assist practices in developing the infrastructure for PCPCH. The law also allowed for changes in payment for practices who provide care in medical homes including payment for interpretive services and rewards for improvements in health quality. The PCPCH program serves as the pathway for primary care practice participation in all patient-centered medical home related programs in Oregon including the Comprehensive Primary Care initiative, Coordinated Care Organizations, and 2703 Health Homes. 

Chapter 602 of the 2011 Oregon Laws established the Oregon Integrated and Coordinated Health Care Delivery System. This law requires the Oregon Health Authority (OHA) to establish standards for using PCPCHs within Coordinated Care Organizations (CCO) and requires CCOs to implement PCPCHs to the extent possible. Standards may require the use of Federally Qualified Health Centers (FQHCs), rural health clinics, school-based health clinics and other safety net providers that qualify as PCPCHs.

The Oregon Health Authority and the Northwest Health Foundation, in partnership with the Oregon Health Care Quality Corporation, launched the Patient-Centered Primary Care Institute in September 2012 to support primary care practice transformation in Oregon. A broad array of resources are available to primary care practices through this program including behavioral health integration support, learning collaboratives and expert networks.

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
Yes
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
3,941,300
Uninsured Population:
13%
Total Medicaid Spending FY 2013: 
$5.1 Billion 
Overweight/Obese Adults:
60%
Poor Mental Health among Adults: 
40%
Medicaid Expansion: 
Yes
CPC+: 
CPC+

Integrating Primary Care and Behavioral Health next Priority in CCO Transformation

The CCO’s goal was to reduce the number of “million-dollar babies born to drug-using women with mental health issues,” said Shelly Uhrig of Options for Southern Oregon.

Now the CCO will sustain that financing – and start screening earlier at well-woman visits. “Waiting until a woman is pregnant is too late,” Johnstun told the 2015 CCO Summit.

Josephine County has a 58 percent rate of unintended pregnancies, higher than the national average. Now all women – not just the Medicaid population -- receive screening and care.

News Author: 
Jan Johnson

Without primary care doctors, 9,000 Oregon Health Plan patients forced to use urgent care, emergency rooms

They’re known as the “undoctored” — the 9,000 Oregon Health Plan patients in Lane County who don’t have a primary care doctor.

They are adrift without doctors because Medicaid rolls in Lane County have surged to more than 96,000 people at the same time the county suffers from a shortage of primary care providers.

News Author: 
Sherri Buri McDonald

Year Two: Capturing The Evolution Of Oregon’s CCOs

Oregon’s Coordinated Care Organizations (CCOs) are a type of accountable care organization (ACO); these multi-sector partnerships accept upside and downside risk for both health care costs and quality metrics. And yet CCOs deviate from the traditional accountable care model. Unlike most ACOs, CCOs were created by state regulation, are geographically defined, and are accountable for the Medicaid population, a group of individuals at high risk for psychosocial challenges that impact health outcomes.

News Author: 
Lauren Broffman
Kristin Brown

Leaning In: Oregon’s Coordinated Care Organizations (CCOs)

2015-05-07 14:00 to 15:00

Far from the epicenter of Washington, DC, and the federal government’s efforts to expand health insurance coverage and usher in health care delivery and payment reform, states are moving ahead with amazing innovations of their own these days. Medicaid waivers, which offer states running room to experiment with public dollars, are one big reason. And one big example of what’s possible is unfolding in Oregon.
 

Announcement Type: 

Chapter 595 of the 2009 Oregon Laws

The legislation established the Patient Centered Primary Care Home (PCPCH) Program by the Office for Oregon Health Policy and Research. This law created a learning collaborative to assist practices in developing the infrastructure for PCPCH. The law also allowed for changes in payment for practices who provide care in medical homes including payment for interpretive services and rewards for improvements in health quality.

Chapter 602 of the 2011 Oregon Laws

This law established the Oregon Integrated and Coordinated Health Care Delivery System. It requires the Oregon Health Authority (OHA) to establish standards for using PCPCHs within Coordinated Care Organizations (CCO) and requires CCOs to implement PCPCHs to the extent possible.

Transforming safety net practices into patient-centered medical homes

A recently concluded demonstration project made meaningful progress toward introducing a "patient-centered medical home" approach at "safety net" practices serving vulnerable and underserved populations. Lessons learned in the course of developing and implementing the Safety Net Medical Home Initiative (SNMHI) are featured in a special November supplement to Medical Care.

Oregon setting the trend for medical home movement

You know the painstaking chore of taking your child to the doctor, or even just making it there yourself? Your days are already filled with spreadsheets and spilled coffee, muddy paw prints and picking up kids from soccer practice. Doctors’ offices are often closed on the weekends, and who has time to make it during lunch or pull the kids out of school?

Of course after the visit, while speeding off to your next appointment across the city, don’t forget to stop at the pharmacy for cold medicine and lozenges before you head back to work.

Reform Update: CMS won't limit flexibility of Oregon CCOs, state says

The CMS and Oregon are stepping back from an apparent clash over how the state is paying the managed-care organizations serving Medicaid beneficiaries in its nationally watched Medicaid demonstration. State officials and leaders of Oregon's coordinated-care organizations had expressed strong concern that the CMS was limiting their flexibility in providing services to keep patients healthy.

News Author: 
Virgil Dickson

Report: Oregon Health Plan Shows Improvements

More than 340,000 new people have joined the Oregon Health Plan since January, and a new report says it's a system that has shown major improvement in the past year. The state tracked what coordinated care organizations (CCOs) are doing for Oregon Health Plan or Medicaid patients. It found that the number of outpatient primary-care visits increased by 11 percent in 2013, an indication that more people are getting care sooner and not at emergency rooms.

News Author: 
Chris Thomas

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