Medicaid Advisory Committee October 26, 2016 Oregon State Library - PowerPoint PPT Presentation

Medicaid Advisory Committee October 26, 2016 Oregon State Library Salem, Oregon

Time Item Presenter Opening remarks 9:00 Co-Chairs • Committee transitions CCO Listening Tour: Part Two Stephanie Jarem, • Presentation 9:15 OHA • Discussion of committee recommendations 10:15 Break Transformation Center and Patient-Centered Primary Alissa Robbins & 10:30 Care Home Program: Updates from OHA Chris Carrera, OHA Oregon Ombuds Advisory Council Ellen Pinney, OHA 11:00 11:20 MAC Retreat Discussion Committee Staff 11:50 Public Comment Closing comments Co-Chairs 11:55

Oregon Health Policy Board CCO Listening Sessions Medicaid Advisory Committee Discussion Steph Jarem September 28, 2016

Coordinated Care Organizations: The Model • Locally governed by a partnership between health care providers, community partners, consumers, and those taking financial risk. • Consumer advisory council requirement • Behavioral health, physical, dental care held to one budget. • Responsible for health outcomes and receive incentives for quality 4

Listening Sessions: The Future of Coordinated Care • The Oregon Health Policy Board is gathering input from key stakeholders, including consumers, advocates, and providers about coordinated care in Oregon. • Input to help shape recommendations for a report to the legislature and OHA about the future of Oregon’s coordinated care organizations. • Report release: January 2017 5

CCO Listening Sessions around Oregon Data Time Region Location 9/1/2016 11-1:30 Bend Deschutes National Forest Supervisor's Office Aspen Ponderosa Conference Room 63095 Deschutes Market Road 9/9/2016 4:00-6:30 Tillamook Port of Tillamook Bay Officers' Mess Hall 6825 Officers Row 9/21/2016 5:30-8:00 Rogue Valley Inn at Commons (Medford) Crater Lake and Rogue River Rooms 200 North Riverside Avenue 9/26/2016 12:00-2:30 Eugene Unitarian Universalist Church 1685 West 13 th Avenue Pendleton – 10/7/2016 12:00-2:30 Eastern Oregon Trade and Event Center Hermiston 1705 East Airport Road 10/18/2016 4:30-7:00 Portland Ambridge Event Center Ballroom 1333 NE MLK Boulevard 6

Next steps: CCO Assessment November January • Survey closes; analysis; • OHPB • board considers recommendations preliminary results & submitted to recommendations Legislature December 2016 • Board approves recommendations for future of coordinated care 7

Coordinated Care: What’s next • 5 years since implementation of CCOs – How are we doing? – Where should the next 5 years take us? We need YOUR input to drive Health Transformation 2.0 8

Social Determinants of Health/ Flexible Services How can CCOs can strengthen their efforts to address the social determinants of health (e.g. housing) for members? For example: • Are there ways CCOs can change/improve use of flexible services? • Do you have innovative ideas for how CCOs can connect with community-based organizations and resources? 9

Integration One of the goals of health care transformation is to integrate physical, oral and behavioral health. What evidence are you seeing that health care is more integrated since the launch of the CCOs? How can the CCO model change to encourage greater integration? 10

Cultural Competency What changes or improvements are needed to strengthen CCO cultural competency and increase availability of culturally appropriate services for members? 11

Governance • What changes or improvements are needed to ensure the “right” people are at the table to make decisions at CCOs? • Should all CCO decision-makers be locally-based and part of the CCO regional community? • Are there opportunities to enhance the governance relationship between CCOs and Consumer Advisory Councils (CACs)? 12

Committee Feedback/Memo to Health Policy Board • Charge to the Board “…shape recommendations about the future of Oregon’s CCOs…” • Please identify top three issues or considerations the committee would like to share with the Health Policy Board • Group by CCO topic…?(e.g. social determinants, governance, cultural competency) • Looking ahead, in your role as community members and members of the state’s Medicaid Advisory committee, what should Oregon’s CCOs look like to better support health system transformation? 13

Next Steps Take the full survey: https://www.oregon.gov/oha/OHPB/Pages/cc-future.aspx 14

To learn more…. www.health.oregon.gov 15

Transformation Center Update Alissa Robbins, OHA Chris Carrera, OHA

Agenda • Health System Transformation & the Transformation Center • Phase 1: 2013-15 • Phase 2: 2015- today • Accomplishments • Patient-Centered Primary Care Home • Phase 3: Continuing our work in 2017 and beyond POLICY AND ANALYTICS Transformation Center 17

Oregon’s Health System Transformation & The Transformation Center • Health System Transformation – Oregon began implementing the coordinated care model in 2012 within coordinated care organizations (CCOs) • Transformation Center – Oregon’s h ub for health system innovation and quality improvement • The Transformation Center helps good ideas travel faster

Oregon’s Health System Transformation & The Transformation Center • Mission: The Transformation Center is the hub for innovation and quality improvement for Oregon’s health system transformation efforts to achieve better health, better care, and lower costs for all. • Goals: The Transformation Center identifies, strategically supports, and shares innovation at the system, community, and practice levels. Through collaboration, we promote initiatives to advance the coordinated care model. POLICY AND ANALYTICS Transformation Center 19

Transformation Center: Phase 1 • Phase 1 goals (mid-2013 to mid-2015) – Champion and promote transformation – Build an effective learning network • Focus on learning collaboratives and large events – Foster relationships across CCOs • We learned CCOs wanted deeper dives and more targeted support • Needed help reaching goals metrics, alternative payment models, and behavioral health integration

Transformation Center: Phase 2 • Phase 2 goals (mid-2015 to now) – Provide targeted technical assistance to support coordinated care model implementation, including: • Responding to challenges within CCOs based on performance metrics and evaluation outcomes; and • Advancing integration of population and behavioral health within the health system

Phase 2: Accomplishments • Behavioral Health Integration – Technical Assistance consultation and follow-up to all CCOs – Project Echo Telementoring Program: pediatric psychiatry; 24 providers from 17 counties participating – Behavioral Health Integration resource library • Population health – Supported community advisory councils’ member recruitment and retention efforts by: • Public service announcements for recruitment • All-day event for CAC leaders to focus on CAC member recruitment and engagement strategies. – Awarded grants to all 16 CCOs to support implementation of their community health improvement plan priorities . POLICY AND ANALYTICS Transformation Center

Phase 2: Accomplishments • Supporting CCO incentive metrics through technical assistance – Tobacco cessation, childhood immunization, colorectal cancer screening and adolescent well-visits • Value-based payment models: – Convening the Senate Bill 231 Primary Care Payment Reform Collaborative, – Supporting the implementation of the Comprehensive Primary Care Plus (CPC+) program for OHA’s Fee -for-Service population. – Additionally, the center awarded grants to two CCOs to implement a value-based payment model for integrated care. – Technical assistance to CCOs • Health Equity – National health equity expert consultation with all CCOs across the state – follow-up technical assistance in health equity to those CCOs that request it. POLICY AND ANALYTICS Transformation Center 23

Phase 2: Accomplishments • Technical Assistance Bank – 60 requests from 15 CCOs, for a total of 875 expected technical assistance hours. • Council of Clinical Innovators – Forty fellows participated in the first three cohorts, representing all 16 CCOs. Twelve fellows are in the current cohort. • CHIP and Transformation Plan Analysis POLICY AND ANALYTICS Transformation Center 24

Patient-Centered Primary Care Home Program • HB 2009 established the PCPCH Program: • Create access to patient-centered, high quality care and reduce costs by supporting practice transformation • Joined the Transformation Center in late spring 2016 • Site Visits • Key PCPCH program functions:  PCPCH recognition and verification  Refinement and evaluation of the PCPCH standards  Technical assistance development  Communication and provider engagement 26

Oregon’s Primary Care Home Model • Core Attributes – Standards - Measures • Tiers 27