Oregon Business Plan Health Care Strategic Framework Updating the Strategies Input Sessions, Fall 2015
Oregon Business Plan and Health Care Reform Planning Goals for 2015 • Provide clear and useful discussion material on the current state of health care reform in Oregon. What have we accomplished and where are there still significant challenges? • Articulate a clear Oregon Business Plan strategic framework for the next 3+ years that capitalizes on past reforms. Where do we focus public and private resources going forward? • Create policy documents and presentations that are useful for policymakers and business leaders to build on momentum and initiatives. 2
Oregon Business Plan Health Care Strategies OBP strategies have focused on… 1) Ensuring affordable insurance coverage for all Oregonians. 2) Creating a healthy, competitive market where everyone is motivated to improve health, deliver quality, and controls costs. 3) Ensuring all Oregonians have access to high quality, coordinated care 4) Developing the right data tools and resources so consumers, employers, providers, and insurers can make the best health, purchasing, clinical, and coverage decisions. 5) Engaging in collaborative efforts in Oregon’s communities to embrace healthy lifestyles. 6) Articulating how Oregon’s businesses can provide leadership in health reform, collaborate on initiatives, and advocate for policies and funding that support and further the OBP goals. 3
Oregon Business Plan Health Care Strategies OBP strategies have focused on… We’re going to get your input on these two 1) Ensuring affordable insurance coverage for all Oregonians. strategies first, hitting on others if time allows. 2) Creating a healthy, competitive market where everyone is motivated to improve health, deliver quality, and controls costs. 3) 3) En Ensurin uring all Orego gonia nians ns have acces ess s to high h qua uality ty, , coor ordina dinated d care re 4) 4) Developi eloping ng the right t data a tool ols s and d resour source ces s so consu nsumer mers, s, emplo loyers, , provi vider ders, , and insu sure rers s can make e the e best t health alth, , pur urchas asing, ing, clinic ical al, , and covera erage ge deci cisi sion ons. s. 5) Engaging in collaborative efforts in Oregon’s communities to embrace healthy lifestyles. 6) Articulating how Oregon’s businesses can provide leadership in health reform, collaborate on initiatives, and advocate for policies and funding that support and further the OBP goals. 4
Oregon Business Plan Health Care Strategies Goal 3. All l Or Oreg egonia ians s have e acces ess s to hig igh h qu quality lity, , coordinat dinated d care when en they y ne need ed it that supp pports s thei eir r physic ysical al health, alth, as we well l as ment ntal al health alth and nd social al we well ll-bei being. g. Oregon Business Plan Oregon’s Progress Oregon’s Challenges? 2016-2020 Priorities? Strategies Implement medical home and Extensive medical home CCOs are not fully Evaluation of efficacy and other innovative approaches implementation implemented. Further financial sustainability of that support integrated care, integration of mental health, delivery system reforms (e.g., increase quality, and reduced Coordinated care model addiction, and dental health medical home for everyone) unnecessary services implementation through services needed Medicaid Coordinated Care Full implementation of CCO Ensure access to providers for Organizations (CCOs) and PEBB Continued access concerns for model (mental health, Oregon Health Plan patients state employee coverage Medicaid enrollees, rural, and addiction, dental services) by increasing provider traditionally underserved payments and reduce the cost Implementation and regular residents overall Continued focus on outcome shift to privately-insured update of CCO performance metrics and staying within patients metrics budget Support the implementation New models of care for of OHP Coordinated Care complicated social and Organizations behavioral health concerns Increased health care workforce capacity (primary 5 care/ underserved pops)
Oregon Business Plan Health Care Strategies Goal 4. Consu nsumer mers, s, emplo ployers, s, provid vider ers, s, and nd ins nsur urer ers s have e the ri righ ght t tools s and nd informat nformation ion to make e informed nformed servi vice ce, purc rchasing, sing, clin inical ical and nd coverage verage decisi cisions. ons. Oregon Business Plan Strategies Oregon’s Progress Oregon’s Challenges 2016-2020 Priorities? Meaningful information and Progress standardizing and Dashboards and quality Continue expansion of metrics on costs and quality fostering the electronic metrics are not fully aligned electronic health records and readily available for consumers, exchange of health care across public and private electronic information employers, providers, and insurers data (e.g., EDIE/ payers exchange PreManage, Strategies to improve consumer OneHealthPort) Transparent health care cost Truly align outcome metrics health literacy and support more data still very difficult to and dashboards across informed decision making (e.g. Many efforts to make obtain and use in many cases stakeholders Advance Care Planning, Palliative meaningful cost and care) quality data available A sustainable model for cost Develop a model for across physicians, and quality reporting is still collaborative and impartial Improve health care information hospitals, and insurers. needed cost and quality reporting that infrastructure (electronic health can be sustained and records, secure exchange of health adequately involves necessary data among providers) stakeholders 6
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