Oregon Health Policy Board Healthcare Workforce Committee

1. Oregon Health Policy BoardHealthcare Workforce Committee Committee Update March 30, 2011

2. Agenda review • Quick OHA and OHPB news • Updates on current delivery system transformation initiatives • Governor’s Health System Transformation Team • OHA patient-centered primary care home implementation planning • Action on Workforce Committee’s 2010 recommendations and related topics • Plans for April meeting

3. Health Systems Transformation Team • Collaboration between OHPB and Governor’s Office to develop plans for a new, integrated health and services delivery system for Oregon's Medicaid programs, which can then be built upon for broader statewide markets • Aim to better coordinate benefits for Medicaid clients, provide more integrated care, and achieve cost savings • 45+ member Team convened in February and asked to deliver recommendations in early April • Team members include health care and social services leaders and advocates from around the state and six legislators • Rapid timeline due to budget situation and potentially serious reductions in OHP

4. CCO Summary (Switch to PDF)

5. Draft Transformation Timeline (Switch to PDF)

6. Questions on HST initiative? More information:www.oregon.gov/OHA/health-system-transformation.shtml

7. Patient-centered Primary Care Homes • OHA is moving forward to establish patient-centered primary care homes (PCPCHs) across all lines of coverage in the agency • Building on past work: • PCPCH Standards Advisory Committee • PCPCH Pediatric Standards Advisory Committee • Incentives and Outcomes Committee, which developed a framework for aligning the standards with payment • In the process of gathering feedback from plans, providers, and other stakeholders on a proposal that sets: • Clear goals and performance standards, phased in over time to allow work processes and information infrastructure to shift from a visit-based to a health value-based financial model • Centralized web-based reporting structure

8. Patient-centered Primary Care Homes (2) • Developmental process with 3 tiers: • Tier 1: single base payment for a predictable set of basic primary care services, performance measure reporting, standardized experience of care survey • Tier 2: base payment, reporting on a broader performance measures, and potential for shared savings based on improvements in quality and patient experience • Tier 3: base payment, reporting on a full set of performance measures, and potential for shared savings based on meeting or exceeding quality and patient experience benchmarks • OHA initial roll-out over the coming year • Goal to work with private-sector partners to give 75% of Oregonians access to a PCPCH by 2015.

9. Shared Savings Shared Savings Shared Savings Initial PCPCH Base Payment Full PCPCH Base Payment Intermediate PCPCH Base Payment FFS FFS FFS Current Transition Robust Primary Care Payment Transition Over Time Full Reform Intermediate Reform Initial Reform Current FFS

10. Questions on PCPCHs? More information:http://www.oregon.gov/OHPPR/HEALTHREFORM/PCPCH/docs/FinalReport_PCPCH_Updated.pdf

11. Workforce Committee Updates • Legislature is considering several bills directly related to 2010 recommendations: • HB 2400 (funding for primary care loan repayment program) • SB 879 (standardization of prerequisites for clinical rotations) • SB 856 (review/revise adverse impact) • SB 96 (expansion of healthcare workforce database) • Other relevant bills: • SB 608 (extend rural liability subsidy) • HB 2366 (physician recruitment) • SB 225 (scope of practice review panels)

12. Workforce Committee Updates (2) • Hot off the presses! • The Economic Contributions of Oregon's Health Care Workforce http://oregonhwi.org/resources/documents/FinalEconORHCW211.pdf • Oregon Health Professions: Occupational and County Profiles 2010 (Link forthcoming)