Oregon Medicaid Managed Care



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Oregon Medicaid Managed Care

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Managed Care in OregonMedicaid.gov

www.medicaid.gov

Overview of Current Managed Care Programs. In July 2011, nearly all Medicaid
beneficiaries were enrolled in fully-capitated managed care plans. In 1994,
Oregon phased out the Physician Care Organization program (a limited benefit
prepaid plan model) in the favor of the full-risk, capitation-based Oregon Health
Plan, …

Oregon Health Plan (MCO and CCO) Administrative … – Oregon.gov

www.oregon.gov

Jan 13, 2017 procedures to procure managed care services pursuant to ORS 414.725. The.
Authority may award Qualified Managed Care Organizations (MCO) a contract as
a prepaid health plan (PHP) for purposes of administering the Oregon Health
Plan. (OHP);. (b) The OHP is funded with Federal Medicaid funds.

CMS Managed Care Final Rule Implementation Status – Oregon.gov

www.oregon.gov

Nov 14, 2017 About the CMS 2390-F Managed Care Final Rule Implementation Project. The
project comprises 11 phases, according to the implementation dates outlined by
the Centers for · Medicare & Medicaid Services (CMS). The Oregon Health
Authority (OHA) is currently working on Phase. III-B, to identify and …

Oregon DHS, OHP, Oregon Health Plan, Medicaid … – Oregon.gov

www.oregon.gov

FULLY CAPITATED HEALTH PLANS, PCO's, COORDINATED CARE
ORGANIZATIONS and FEE FOR SERVICE COVERING PHYSICAL HEALTH BY
COUNTY. County Name. Allcare. Health. Plan, Inc. (CCO) …. Oregon Health Plan
: Coordinated Care, Managed Care and Fee for Service Enrollment for November
15, 2017.

Coordinated Care Organizations – Oregon.gov

www.oregon.gov

Oct 9, 2012 Right now, most Oregon Health Plan (Medicaid) members are moving into
Coordinated Care … CCOs will have more flexibility to provide services than
many managed care plans had before. This … Under managed care, OHP clients
may have one health plan for physical health, one for mental health,.

Assessing the Effects of Coordinated Care … – Oregon.gov

www.oregon.gov

Dec 16, 2016 2 Assessment of the effect of CCO implementation on health service use and
quality of care among dual-eligibles in Oregon. Specifically, we use a difference-
in-differences approach and compare changes in health service use and quality
for dual-eligibles enrolled in Medicaid managed care with changes …

CMS Managed Care Final Rule Implementation Status – Oregon.gov

www.oregon.gov

6 days ago About the CMS 2390-F Managed Care Final Rule Implementation Project. The
project comprises 11 phases, according to the implementation dates outlined by
the Centers for · Medicare & Medicaid Services (CMS). On December 14, 2017,
the Oregon Health Authority (OHA) transitioned to implementation …

The Medicaid Program Could Have Achieved Savings if Oregon

oig.hhs.gov

Inspector General review found that Medicaid could have achieved further
savings if New York had required its Medicaid MCOs to meet MLR standards
similar to those established by the. ACA. In Oregon, CCO plans serve
beneficiaries enrolled in the State's Medicaid managedcare program. Effective
January 1, 2014, the …

Oregon Health Authority Managed Care 2015 External … – Oregon.gov

www.oregon.gov

behavioral, and dental health services for Oregon Health Plan (OHP) members
across the state. Federal law requires states to conduct an annual external
quality review (EQR) of. Medicaid services delivered through managed care. The
Oregon Health Authority. (OHA) contracts with Acumentra Health to perform the
annual …

GAO-17-28, MEDICAID PERSONAL CARE SERVICES: CMS Could …

www.gao.gov

Nov 23, 2016 MEDICAID. PERSONAL CARE. SERVICES. CMS Could Do More to Harmonize.
Requirements across. Programs. Report to Congressional Requesters …. (
Attendant) in Oregon Personal Care Services (PCS) …. 2The amount of spending
on PCS through managed care is often not quantifiable because.

Coverage and Delivery of Physical and Behavioral … – Initiatives

healthtransformation.ohio.gov

Medicaid Managed. Care Plans. Physical Health. Providers. Mental Health and.
Chemical Dependency. Providers. Medicaid. P A T I E N T. Behavioral Health …..
establishment of CCOs and directed the state to examine how to spread the.
Coordinated Care Model to state employees. Legislative Mandate. Oregon.
Maryland.

The Oregon Health Plan: An historical overview – Society for …

webarchive.library.unt.edu

Jul 4, 2006 The Oregon Health Plan (OHP) is a public and private partnership to ensure
access to health care for …. This prompted a debate about what health services
Oregon's Medicaid program should ….. Legislature establishes Medicaid
managed care plan and hospital provider taxes (HB 2747) to begin in 2004.

Value Based Payment Arrangements Involving Risk Sharing

www.health.ny.gov

Oregon began a Medicaid Redesign Program in 2012 which will end in 2017. A
main feature of the Oregon. Medicaid Demonstration (2012) is the transition in
organizational structure from Oregon's traditional. Managed Care Organizations (
MCO) to Coordinated Care Organizations (CCO). A CCO is an MCO that is.

Perspectives on Shaping Medicaid's Future – Center for Health Care

www.dhhs.nh.gov

launched the Medicaid Managed Care Program (MMCP) to help state Medicaid
agencies … Health Share of Oregon. ▫ Bob Master, MD, Chief …. private
insurance.6. Medicaid in many states is far beyond commercial purchasers —
and even. Medicare — as a purchaser in effective use of managed care. —Jim
Verdier, PhD …

Comprehensive Study on Health Care and Health Care Costs in …

www.nmlegis.gov

In 1993 and 1994, six states — Oregon, Hawaii, Kentucky, Rhode Island,
Tennessee and. Florida — applied for Section 1115 waivers to use savings
gained through managed care to expand Medicaid coverage to persons with
higher incomes. Florida and Kentucky did not implement their demonstrations as
approved, but in …

Oregon's Proposal for a 1915(i) – Maine.gov

www.maine.gov

ADDICTIONS AND MENTAL HEALTH DIVISION. Oregon's Proposal for a 1915(i)
Home and. Community-Based Services State Plan. Amendment. Jay Yedziniak,
Medicaid Policy Unit …

Health Data Systems Report – Nebraska Legislature

nebraskalegislature.gov

Oct 7, 2016 selecting a qualified Contractor to provide full-risk, capitated Medicaid managed
care …. The change in the administration of Medicaid managed care is
happening concurrently with several ….. the State Medicaid agency), Oregon
Health Leadership Council (OHLC), and Oregon hospitals and health.

Program of All-Inclusive Care for the Elderly (PACE)

hijossaludablesoregon.gov

expands Medicaid eligibility. The Oregon Health Plan relies substantially upon a
prioritization of health services and managed care to achieve the policy
objectives of access, cost containment, efficacy, and cost effectiveness in the
allocation of health resources. (34) PACE — The Program of all Inclusive Care for
the Elderly …