Facts About New Oregon Law

What's being proposed?

House Bill 3650, signed into law in June, proposes that organizations in Oregon called coordinated care organizations (CCOs) coordinate care for Oregon Health Plan (OHP) clients. The criteria for how CCOs would operate are being developed with input from consumers, care providers, stakeholders, and the public.

How would the practice environment be different from today's for OHP providers?

Local providers would have the means and incentive to work together. There would be more flexibility for preventive care and chronic-disease management. The CCO would manage a global budget, and if performance standards were met, providers could share in the savings.

How would mental health care for OHP/Medicaid clients change under the CCOs?

Mental health care for Medicaid/OHP beneficiaries would be integrated into other medical services. The patient's primary care providers would work as a team with the patient's mental health professional to ensure that the patient receives the right care at the right time. The CCO's vision is to give providers the flexibility they need to focus on a patient's overall wellness.

What would a CCO look like?

CCOs would be community-based networks of patient-centered care, driven by local need. The legislation provides for flexibility to set them up in a way that will work best locally, because health care needs may vary among communities.

How would CCOs be different from existing managed care organizations?

Today more than 80 percent of OHP clients get mental health and other medical services through a type of managed care organization that receives a set rate per patient for health care. Under the CCO model, a CCO in a community would be responsible for coordinating all mental, physical, and dental care for OHP patients through collaborative relationships. Also, a CCO would be paid differently from managed care organizations. There would be a global budget for all care, rather than a set rate or a "capitated rate" for each type of care. Also, the CCO would have more flexibility to manage dollars in a way that pays for improved health rather than having to rely on approved billed services. And performance measurements that CCOs will have to meet should provide incentives for better care.

Where can I get more information?

More information is posted at <www.health.oregon.gov>.;