Medicaid Advisory Committee December 6, 2017 9:00-12:00pm Oregon State Library, Room 102-103 Salem, OR 1
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Welcome & Introductions
Meeting objectives • Regular business (e.g. approve minutes) • Hear updates from OHA and DHS on the Medicaid program • Understand the process for developing expectations for “CCO 2.0” (the next five years of CCOs) and provide input on CCO 1.0 (the first five years) • Begin discussing and developing recommendations on the role of CCOs in addressing social determinants of health • Hear highlights from additional CCOs and a community partner about their work in social determinants of health, especially with regard to health-related services and community health workers 4
AGENDA Purpose Time Item Presenter Welcome and Introductions Co-chairs Action 9:00 Adopt minutes Don Ross (OHA), 9:10 Agency Medicaid update Informational Anna Lansky (DHS) CCO 2.0 Update: Building on Oregon’s Lori Kelley, Jeff Informational and 9:20 Health Care Transformation Gains Scroggin (OHA) Discussion 9:50 Break 10:00 Public comment 10:10 The Role of CCOs in Addressing Social All Discussion Determinants of Health Using health-related services to Elizur Bello, Next address social determinants of health Door, Inc. AllCare Sam Engel, All Care Informational & Next Door, Inc. Health 10:45 Discussion Health Share Rachel Arnold, Q&A and Discussion (30 minutes) Health Share of Oregon Closing Co-chairs 11:55
Agency Medicaid Update Don Ross, Integrated Health Programs, OHA Anna Lansky, Office of Developmental Disabilities Services, DHS
CCO Maturity Assessment Framework Update Lori Kelley, OHA, Health Policy Unit Manager Jeff Scroggin, OHA, Health Policy Analyst December 6, 2017
Overview • The first five-year contract cycle for Oregon’s Coordinated Care Organizations (CCOs) is ending December 31, 2018. • To ensure that the next contracting cycle capitalizes on the health care transformation progress made by CCOs, the Oregon Health Authority will be extending current contracts for one year to allow more time to develop the new five- year contracts. HEALTH POLICY Health Policy andAnalytics 8
Why is OHA extending current contracts? Lengthening the new contract development process will allow for: • Deeper engagement of stakeholders, partners, and legislators • Better understanding of existing successes, challenges, and best practices • Clearer targets for 2.0 goals • Space to consider unforeseen changes (e.g., federal reform) • Opportunity for CCOs and communities to plan for future changes • Review and consideration of changes to rate-setting processes and methodology HEALTH POLICY Health Policy andAnalytics 9
Policy goals Based upon the OHPB’s Action Plan for Health and direction from the Governor, the Board will: • Focus on social determinants of health and equity • Increase value and pay for performance • Improve the behavioral health system • Maintain a sustainable cost growth A key part of this work will be the engagement of stakeholders and community partners and measuring progress HEALTH POLICY Health Policy andAnalytics 10
CCO 1.0 Maturity Assessment GOALS: • Reflect : Assess coordinated care model to inform a data driven picture of what was accomplished from an output and outcome perspective. • Analyze : Provide an analysis of what processes experienced challenges and where outputs and outcomes were not as expected. Not a CCO by CCO analysis. • Focus and Contextualize : Organize qualitative and quantitative data in a cohesive and goal orientated structure, to allow for more careful and clear policy development. • Prepare : Set the stage with more qualitative and quantitative information and analysis to inform future CCO model. 11
CCO 2.0 DRAFT DEVELOPMENT TIMELINE All dates are estimated 2017 2018 2019 2020 Phase 1 - Current Contracts O N D J F M A MJ J A S O N D J F M A M J J A S O N D J F M A Final phase of CMS review/approval for 2018 contracts Contract period 2018 contract period Develop/revise 2019 contract provisions * Finalize and sign 2019 contracts Amended contract extension period 2019 contract period Phase 2 - New Contracts Evaluation of CCO 1.0 Public input process on 2.0 goals Final OHPB recommendations Procurement development & process New contract period begins To date: Confirmed 2.0 timeframe Formally notified stakeholders and CCOs of one-year contract extension In process of drafting CCO 2.0 project plans and timelines Confirmed internal governance structure Developed draft maturity assessment data sources and measures Continued developing work plan for one-year extension 12
CCO 1.0 Maturity Assessment Timeline MA Draft Logic MA Draft MA Final Draft Model, Timeline Framework Presented for and Design Presented Review and Presented for for Feedback Approval Feedback & & Approval Approval CCO 2.0 Goals Developed Policy development and Incorporating Maturity recommendations, public input continues Assessment Findings Nov Meeting Dec Meeting Retreat Jan Oct Nov Dec Feb-Jul 2018 Logic Model OHA Staff Develops OHA Solicits Feedback on Public Input Process CCO 2.0 : Developed Logic Model with Focus and Content: • Medicaid Advisory Committee Information from to Assess Feedback (Including, not limited to) • Health Equity Policy Committee existing resources: CCO 1.0 received from • CCOs • Health Information Technology Oversight Council OHPB, and • Medicaid Advisory • • Healthcare Workforce Committee Waiver SME Committee • Public Health Advisory Board Evaluation Incorporated • External Subject • • Primary Care Collaborative Outcomes Data in Final MA Matter Experts, • • Behavioral Health Collaborative Cost Data Partners & • Action Plan Stakeholders • Transformation Center Work 13
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