Oregon Health Authority yearly report finds improvement in performance of Medicare care networks

Salem, Ore. – The Oregon Health Authority released the state’s 2023 annual report on the performance of coordinated care organizations (CCOs), local health networks that administer coverage to Oregon Health Plan (OHP / Medicaid) members. The report found that CCOs generally improved their performance in most categories statewide from 2022 to 2023.

Oregon is unique in providing Medicaid benefits through a coordinated care model, which is designed to deliver local and regional solutions to primary care. Through this design, CCOs receive monetary incentives in exchange for improving their performance on the quality measures outlined in the annual report.

The 2023 CCO performance report included the following findings:

• For children preparing for kindergarten, dental and oral health services rose above pre-pandemic rates. Dental and oral health services were some of the measures most negatively affected by the pandemic. After falling 27% in 2020, CCO statewide performance on preventive dental or oral health services for children ages 1-5 gradually improved each year.
• CCOs mostly improved on behavioral health care measures. Among behavioral health measures, CCOs improved most on age-appropriate screening for alcohol or other substance use, as well as depression screening and follow-up.
• Disruptions in care during the pandemic continued to affect immunization measures. Immunizations for children and adolescents largely held steady in 2023 and have not yet recovered from the pandemic. Evidence shows that vaccine hesitancy grew during the pandemic, which may have contributed to lower immunization rates.
• CCOs increased capacity to address social determinants of health (SDOH). In 2023, OHA’s CCO Quality Incentive Program launched a SDOH screening and referral measure, which aims to ensure that member’s social needs are acknowledged and addressed. CCO statewide performance also improved on the health equity measure related to meaningful language access, which tracks the percent of health care visits where a qualified and certified interpreter was provided. From 2022 to 2023, this percentage increased from 5.6% to 10.7%.

Last year, CCOs earned $326 million for meeting established performance metrics through the CCO Quality Incentive program.

Access the full report here.