Medicaid Coordinated Care Organizations (CCOs) in Oregon have seen dramatic results over the past nine months, achieving significant gains on quality measures like emergency department visits and hospitalizations for chronic diseases. Following positive results from its six-month report in November, the last quarter of 2013 has even more good news to share, with a 13% drop in the number of ED visits and a 51% increase in enrollment in patient-centered medical homes. All-cause readmissions for adults within thirty days of discharge were cut by 8%, and EHR adoption rates surged past state benchmarks for most of the sixteen CCOs involved in the project.
“Data from the first nine months of coordinated care point to trends of improved care and a shifting of resources toward primary care. While this is not yet a full year of data, this is the first report showing 2013 CCO-level progress data for most measures,” the report says. “Data continue to show reduced emergency department visits and spending. This shows we are reducing unnecessary hospitalizations for conditions that can better be treated elsewhere, such as in a primary care office. It also indicates improvements in hospital readmissions, largely due to community efforts to achieve the highest quality care.”
“At the same time there is an increase in primary care enrollment and use, suggesting that as hospitalizations are decreasing in key areas, OHP members are receiving better and more appropriate care. Patient-centered primary care enrollment, key to coordinated care, is also continuing to improve,” the study continued. “These are all good trends.”
“We are seeing some encouraging trends in the data,” added Lori Coyner, the Oregon Health Authority’s director of quality and accountability. “The idea is to provide intervention early. This is new for providers. We’re seeing signs of improvement.”
The CCOs have increased screenings of children for developmental delays by 11% since baseline data was collected in 2011, and are making effort to improve their interventions for alcohol abuse, even though a lack of medical coding data makes it difficult to judge the frequency and effectiveness of alcohol use screenings. Patients at the CCOs are generally satisfied with their care, with most feeling that they received appointments and attention when necessary.
“We expect continued movement in the right direction as well as occasional possible setbacks,” the report concludes. “We are encouraged by the first nine months of progress data and favorably impressed with the innovative work the CCOs are doing to improve health and lower costs. Over time, our understanding of what’s happening in the health system will grow richer. Each quarterly report tells us more than we knew before. Each report shows us more than has ever before been gathered and reported publicly. The metrics are a tool for not only understanding where we are, but for improvement, and we can use them as standards to guide improvement in other types of health plans.”