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+

Origins In Oregon: The Alternative Payment Methodology Project

How the country pays for health care is currently at odds with its vision of how health care should be delivered. Traditional fee-for-service health care payments are linked to the volume of visits, rather than the quality of patient-centered care.

News Author: 
Craig Hostetler, Laura Sisulak, Erika Cottrell, Jill Arkind, and Sonja Likumahuwa

Origins In Oregon: The Alternative Payment Methodology Project

How the country pays for health care is currently at odds with its vision of how health care should be delivered. Traditional fee-for-service health care payments are linked to the volume of visits, rather than the quality of patient-centered care.

News Author: 
Craig Hostetler
Laura Sisulak
Erika Cottrell
Jill Arkind
Sonja Likumahuwa

Accountable Care as a Strategy for Achieving Population Health Goals

2014-03-12 15:00 to 16:30

As states seek to improve quality of care and health outcomes while reducing costs, many have turned to accountable care models. One key aspect of accountable care models is that organizations or structures assume responsibility for the care and outcomes of a defined population across a continuum of care and across different parts of the health system. These models generally hold providers accountable through payments linked to value and performance measurement.

Announcement Type: 

Coordinated Care Organization Progress Data Shows Continued Reduction in Emergency Department Visits, Lower Costs

Oregon‘s fourth Health System Transformation report indicates that the coordinated care model is continuing to improve key areas of care for Oregon’s Medicaid population, while keeping costs down. The report released today shows coordinated care organization (CCO) progress for the first nine months of 2013 on key performance and cost measurements.

News Author: 
Oregon Health Authority

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Patient Centered Primary Care Home' Is More Than a Catchphrase

Some medical practices around Portland have earned a special designation. And while patients may not be aware that their doctor’s office is actually a Patient Centered Primary Care Home, they may notice extra efforts being made to reach out to them and catch problems early.

News Author: 
Elizabeth Hayes

Oregon on front lines of health care innovation

Most Oregonians recently secured access to a new, innovative way of receiving health care, and this little-known success had nothing to do with insurance exchanges or websites.

Nearly all Oregon insurers just agreed to begin paying for care received in clinics that have been re-organized to focus on you, the patient, and providing you the best care possible. This announcement went largely unnoticed, even though these clinics make your health care easier, more connected and more affordable. But getting this high-quality, high-value care all depends on your asking for it.

News Author: 
Evan Saulino

CMS State Innovation Model (SIM) Test Award - Oregon

The Centers for Medicare and Medicaid Innovation awarded a State Innovation Model (SIM) grant to Oregon for up to $45 million for three and a half years. Oregon was one of six states to receive the grant for testing innovative approaches to improving health and lowering costs across the health care system, including Medicaid, Medicare, and the private sector.

Oregon Coordinated Care Organizations (CCOs)

Oregon implemented a statewide accountable care model in 2012 with the launch of CCOs. CCOs are partnerships of payers, providers, and community organizations that work at the community level to provide coordinated health care for children and adult Oregon Health Plan Enrollees. CCOs build on pre-existing initiatives in the state including the Patient-Centered Primary Care Home (PCPCH) Program created in 2009 to enhance primary care across the state by encouraging practices to adopt the medical home model. 

Aetna Patient-Centered Medical Home Program - Oregon

Aetna is proud to be the first non-Oregon Health Authority contracted plan to offer per-member-per-month payment incentives using the PCPCH tiers. Starting on April 1, 2013, Aetna’s Patient Centered Medical Home (PCMH) recognition program will be available to physician practices in Oregon that meet certain criteria: Directly contracted with Aetna; Received recognition by the NCQA or by the State of Oregon Patient Centered Primary Care Home program as a PCPCH; Have 10 or more attributed Aetna members; and be reimbursed at 100% of the Aetna Market Fee Schedule (AMFS).

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