Oregon's Health System Transformation

November 2013 Health System Transformation Quarterly Report

The report highlights statewide performance on key measurements, rates of health care utilization, and costs through the coordinated care organizations that serve Oregon’s Medicaid population. These measurements are designed to show how the state is doing in meeting the triple aim of better health, better care and lower costs. Public reporting of this sort is a key element in Oregon’s work to transform the state Medicaid system to be more transparent to members, stakeholders and the public. The report shows where we started, where we are, and where we want to go in improving our health delivery system. Over time, it will show which CCOs are meeting targeted improvements and where improvements are still needed. It also will help us in determining the readiness of the coordinated care model to serve hundreds of thousands of new enrollees into Medicaid over the next few years. Indicators show emergency department use declining, for example, while primary care is increasing. While progress will not be linear – in the months and years to come there will be movement in the right direction and there will be setbacks – this report is both promising and encouraging. It signals that the state is on the right track with the coordinated care model and shows tangible results of all the 
work of the local CCOs to improve health and create a more sustainable health care system. 

Summary

This report compiles nine months of utilization and cost data based on claims made for payments from the coordinated care organizations. There is a lag time for some claims to be filed so information should be considered preliminary, but most of the claims are complete. This report also shows six months’ worth of several statewide performance metrics. In the months to come, analysis on more metrics will be completed and published. Also, for the first time, this report shows baseline race and ethnicity data for performance measures. This critical information will help highlight areas of greatest disparity and potential improvement.