OHA releases 2018 CCO Metrics Report

The Oregon Health Authority released the 2018 CCO Metrics Report on Tuesday, detailing Coordinated Care Organizations’ (CCOs) progress on various quality measures in 2018.

The report includes information on Oregon’s pay-for-performance program, where CCOs receive payment based on their performance on specified incentive metrics. The metrics, which are selected by OHA’s Metrics and Scoring Committee, aim to improve the quality and access of care, control costs, and eliminate health disparities.

The 2018 report evaluated 17 different incentive metrics which include measurements of childhood immunization status, developmental screenings, adolescent well-care visits, and effective contraception use. Two new measurements were included in this report — emergency department utilization among those with mental illness, and weight assessment, nutrition, and activity counseling for children and adolescents.

 

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CCOs are paid out of a quality pool for reaching certain benchmarks or improvements on the various incentive measures. The 2018 quality pool is 4.25% of the total amount all CCOs were paid in 2018 – about $188 million.

According to the report, 12 of 15 CCOs earned 100% of their quality pool dollars. This was achieved, in part, by reaching their benchmarks/improvements on 12 of 16 measures.

 

Oregon Health Authority

 

Other findings highlighted in the report’s executive summary include:

  • The percent of children in foster care who received physical, mental, and dental health assessments increased 4.3% since 2017, and increased over 200% since the measure was first incentivized in 2014.
  • The proportion of children ages 6-14 receiving dental sealants increased by 34% from 2015 to 2018.
  • Emergency department utilization by individuals with mental illness decreased. The average monthly ED utilization for members with mental illness decreased from 106.3 per 1,000 in 2017, to 100.3 per 1,000 in 2018 — a 5.6% decrease.
  • The percentage of adults who had appropriate depression screenings and follow-up more than doubled since the measure was first incentivized, and saw a 10% increase compared to 2017.

The report also points to measurements that should be monitored moving forward. These include follow-up after hospitalization for mental illness, diabetes management, reproductive health, and the initiation and engagement of alcohol or other drug treatment.

 

Oregon Health Authority

“This is a good opportunity to take a temperature check on where we’ve succeeded and where we need greater focus for the next five years,” said Jeremy Vandehey, OHA’s director of health policy and analytics in a press release. “We know that incentives work. Oregon’s CCO metrics will continue to play a key role in driving performance improvements in priority areas such as behavioral health, health equity, and children’s health.”