Oregon Health Policy Board: November 2016
The Oregon Health Policy Board met for their regularly scheduled meeting on Tuesday November 1, 2016.
The primary focus of the meeting was a review of the recent CCO listening sessions. The Oregon Health Policy Board was asked to review the vision of coordinated care and provide recommendations to advance health system transformation related to the Coordinated Care Organizations. The listening session were convened in 6 different locations around the State and allowed participants to provide feedback on five different policy areas: CCO Coordination, CCO Integration, Health equity, Value based payment, and CCO governance and structure. The questions asked of attendees were developed by a compilation of legislative directives, Health Policy Board input, stakeholder feedback, and OHA.
There is also a survey available online until November 4, 2016 for interested individuals unable to attend in person.
The Health Policy Board was provided listening session themes and a sampling of feedback that was gleaned throughout the sessions. Unfortunately, there is no indication of the location where the statements originated nor the type of person providing the feedback (e.g. provider, consumer, advocate, etc.) which would allow for additional context.
Also, based on some of the listening session feedback and policy themes, there is a lack of clarity and understanding regarding the scope of responsibility of a CCO. For example, statements reflecting the need for a CCO to get credit for high school graduation rates and recidivism and CCOs need to help more with housing. While CCOs have been stood up to coordinate across services, at their core business model, they are in the practice of transforming health care delivery.
There were several draft policy option areas identified that the Health Policy Board reviewed and started prioritization for their final recommendations. However, it is unclear who the recommendations are for: the Oregon Health Authority, the CCOs, the Legislature, or a combination. Many of the draft options may be under the purview of the legislature, but several can be managed at the agency level without need for a legislative concept.
The common areas of prioritization for the Oregon Health Policy Board members include the desire for increased transparency related to the financial information of a CCO, including flexible services, governance, and accountability, increase in resources for social determinants of health, increase in traditional health workers by including a payment mechanism for their services in a clinic, continue to increase early childhood coordination and trauma informed care.
Oddly, patient experience was not mentioned in these prioritization areas at the meeting. It was a cornerstone of conversations at the listening sessions, and a brief mention in the draft policy areas.
The second half of the meeting related to pharmacy costs and the impact rising spending on medications has on the State. Dr. Jim Rickards, Chief Medical Officer for OHA spoke in regards to what the State was working on to address costs and the limitations that the State has on the ability to directly reduce costs. One option that was discussed in both the policy discussion and this discussion was the possibility of creating one single aligned preferred drug list (PDL). This would simplify drug lists across the Medicaid plans, but would increase administrative burden for companies that have multiple lines of business, whose formularies are aligned with their prescription benefits manager. The State of working with other states and regions to increase purchasing power and try to reduce costs for medications.
At the next meeting, the Oregon Health Policy Board will continue their recommendations and have planned for an extended meeting to have ample time to provide thoughtful consideration of their priority areas. The December meeting is scheduled for December 6, 2016.