Coordinated Care Organization will allocate the funds back to care providers.
PacificSource Community Solutions’ Central Oregon Coordinated Care Organization (CCO) announced that it will receive payback of more than $10 million dollars from Quality Pool payments that the Oregon Health Authority (OHA) withheld from all CCO’s payments during 2015.
The money earned from the Quality Pool will go back to the care providers for the Central Oregon CCO, as well as create a pool of funds over which PacificSource and the Central Oregon Health Council have joint decision-making authority. The pool of funds will be used for pay-it-forward quality initiatives throughout Central Oregon, strategically aimed at improving the health of those within the CCO.
PacificSource’s Central Oregon CCO met 15 of 17 quality measures and excelled in providing screenings for colorectal cancer, depression, and childhood development, as well as diabetes control and rapid follow-up after mental health hospitalization. Quality measures are used by the OHA to determine how successful CCOs have been at improving care, making quality care accessible, eliminating health disparities, and curbing the rising cost of health care for the populations they serve. Performance on these quality measures in the Central Oregon CCO earned the maximum eligible payout from the OHA.
“The Central Oregon Health Council and our CCO have worked together with our community providers to improve the health and wellness of Central Oregon residents,” said Tammy Baney, chair of the Central Oregon Health Council. “We look forward to using the funds we received from our quality performance to reinvest in community projects to further improve the health of our region.”
Together, PacificSource Community Solutions and the Central Oregon Health Council lead PacificSource’s Central Oregon CCO, which includes most health-care providers in Crook, Deschutes, Jefferson, and Northern Klamath counties and serves approximately 52,000 members of the Oregon Health Plan (OHP), Oregon’s Medicaid program. Medicaid currently covers approximately one in four residents in the four counties.
“We are very proud of the collective work our region has done to focus on the quality and health of our members,” said Dan Stevens, executive vice president of product line management at PacificSource. “The work that has been done to meet these quality measures has ultimately improved the health of our regional community.”
The OHA has published a 2015 Performance Report that includes all of Oregon’s CCOs. It can be found online at Oregon.gov/oha.
About the Central Oregon Health Council
The Central Oregon Health Council (COHC) is a not-for-profit, tax-exempt public and private community governance entity. The COHC is dedicated to improving the health of the region and providing oversight of the Medicaid population and the Central Oregon CCO. COHC was officially created by Senate Bill 204 in 2011 to promote the health of the region’s residents and seeks to achieve the triple aim of improving health outcomes, increasing satisfaction with the health system, and reducing cost. The COHC’s mission is to serve as the governing Board for the CCO and to connect the CCO, patients, providers, Central Oregon, and resources. The COHC and Central Oregon’s CCO work together to transform health care in the region and to use integrated and coordinated health-care systems to improve health, reduce the cost of care, and to increase quality, reliability, availability, and continuity of care.
About PacificSource Community Solutions
As part of the PacificSource family of companies, PacificSource Community Solutions serves Medicaid members through its coordinated care organizations in Central Oregon and the Columbia Gorge. Founded in 1933, PacificSource employs 700 people, serves more than 275,000 individuals, and has 3,900 employer clients throughout the Northwest. For more information visit PacificSource.com.
