Oregon's fourth Health System Transformation report indicates the "coordinated care" model is continuing to improve key areas of care for Oregon's Medicaid population, while keeping costs down, officials said Tuesday.
The new report shows coordinated care organization progress for the first nine months of 2013 on key performance and cost measurements.
"Emergency department visits and spending are decreasing under the coordinated care model," said Tina Edlund, acting OHA director. "Measurements indicate Oregon's CCOs are lowering unnecessary hospitalizations for conditions that can better be treated elsewhere. "
"There are also reductions in hospital readmissions, largely due to community efforts to achieve the highest quality care and to keep people at their healthiest," she said.
At the same time emergency department use is decreasing, primary care use is increasing. As hospitalizations are decreasing in key areas, Oregon Health Plan members are receiving better and more appropriate care in the right place, at the right time, the report said.
Patient-centered primary care enrollment, a key element of coordinated care, is also showing continued improvement.
This report also points to improvements in early developmental screenings. The percentage of children 36 months of age or younger who were screened for the risk of developmental, behavioral and social delays increased from a 2011 baseline of 21 percent, up to 32 percent in the first nine months of 2013.
By identifying and addressing a child's needs early, this transformational work leads to better health outcomes, reduced costs, and improved learning in these critical early years.
* Decreased emergency department visits: Nine full months of reporting shows that emergency department visits by people served by CCOs has decreased 13 percent from 2011 baseline data.
* Decreased hospitalization for chronic conditions: Coordinated care organizations reduced hospital admissions for congestive heart failure by 32 percent, chronic obstructive pulmonary disease by 36 percent, and adult asthma by 18 percent.
* Increased primary care: Spending for primary care is up more than 18 percent. Enrollment in patient-centered primary care homes has also increased by 51 percent since 2012, the baseline year for that program. More than two-thirds of CCO members are now enrolled in patient-centered primary care homes.
* Increased adoption of electronic health records: Electronic health record adoption among measured providers has doubled. In 2011, 28 percent of eligible providers had adopted electronic health records. By September of 2013, 58 percent of eligible providers were using them.
* All-cause readmission: The percentage of adults who had a hospital stay and were readmitted for any reason within 30 days of discharge dropped from a baseline of 12.3 percent to 11.3 percent in the first nine months of 2011, a reduction of 8 percent.
"Each quarterly report shows us more than we knew before and more than has ever before been gathered and reported publicly in Oregon's Medicaid program," the announcement said. "We can use the metrics as a tool for improvement, CCO members learn more about what to expect from care, and we can use it as a standard to guide other types of health plans."
More than 600,000 Oregonians were enrolled in OHP in 2013. More than 180,000 Oregonians became new OHP members so far in 2014. Over the next several years, more Oregonians will continue to join OHP. By using the coordinated care model, focused on improved quality and lower costs, we can ensure a more sustainable system.