Health System Transformation Report & SB 440 Oregon Health - PDF document

2/29/2016 Health System Transformation Report & SB 440 Oregon Health Policy Board March 1, 2016 Lori Coyner, MA Medicaid Director Oregon’s Health System Transformation: CCO Metrics Report • Published January 20, 2016 • Includes state and CCO level performance on 31 metrics • Measurement period: July 1, 2014 – June 30, 2015 • Measures reported for members with disability, with mental health diagnosis, and with severe and persistent mental illness. www.oregon.gov/oha/Metrics/Pages/HST-Reports.aspx 1

2/29/2016 Oregon Health Plan Population Oregon Health Plan Population 2

2/29/2016 Oregon Health Plan Population Key Findings • Most (26 of 31) measures continue to show improvement despite increase in Medicaid population. – ED utilization and hospital admissions continue to decline. – PCPCH enrollment continues to increase. – Developmental screening is approaching the benchmark. • Several measures remain flat: – Adolescent well care visits – Initiation of alcohol or other drug treatment • Several measures have declined: – Diabetes care: LDL-C screening – Engagement of alcohol or other drug treatment 3

2/29/2016 4

2/29/2016 N=128,298 N=97,125 N=120,600 5

2/29/2016 New Measures This report includes several new measures: • Effective contraceptive use • Dental sealants on permanent molars for children • Assessments (including dental) for children in foster care • SBIRT for adolescents 6

2/29/2016 7

2/29/2016 8

2/29/2016 Measures by Disability The report includes 12 measures reported for CCO members with disability. With disability = people who qualify for Medicaid based on an impairment that has prevented them from performing substantial gainful activity for at least one year, or is expected to prevent them from performing substantial gainful activity for at least one year. This may include physical, mental, emotional, learning, developmental, or other disabilities. 9

2/29/2016 Measures by Mental Health Diagnosis and Severe & Persistent Mental Illness (SPMI) The report includes 14 measures reported for CCO members with mental health diagnoses, and 3 measures for members with SPMI. With mental health diagnosis = people who have had two or more services in the past 36 months with any of the qualifying diagnoses for schizophrenia, bipolar, delusional, developmental, anxiety, personality or depressive disorders, as well as other mental health disorders (ICD9 295-302.9 and 306.51-347). With SPMI = people ages 18+ who have had two or more services with any of the qualifying diagnosis codes in the past 36 months (ICD9 295xx, 297.3, 298.8, 298.9, 300.3, 309.81, 301.22, 301.83, and 296xx). 10

2/29/2016 11

2/29/2016 Are we measuring the right things? • Across the next five years, what are the most important health indicators or outcomes to improve? • What would tell you that health system transformation has been successful? • What areas of health and healthcare should be the focus for Oregon? Lori Coyner, MA Medicaid Director 503.569.3160 Lori.A.Coyner@state.or.us 12