Why Is Harmony Island Underwater In Prodigy SALEM—Oregon continues to reap the benefits of its ongoing health system transformation, delivering improved health outcomes, expanded health coverage, and reduced state costs, even amidst uncertainties in federal healthcare policies.
The Oregon Health Authority (OHA) has unveiled its quarterly legislative report, providing the state’s lawmakers with comprehensive data and outcomes related to Oregon’s healthcare transformation. The report underscores the critical importance of healthcare access for children and financially struggling families, including those with low incomes.
“Oregon has a distinguished history of bipartisan healthcare reform
Which has significantly enhanced access to affordable, high-quality healthcare,” remarked OHA Director Lynne Saxton. “While the impact of the national healthcare debate on our state remains uncertain, this report underscores the tangible and measurable progress being made here in Oregon.”
The Oregon Health Plan (OHP) plays a pivotal role in offering essential healthcare coverage to over one million Oregonians, representing more than 25% of the state’s population and over one-third of residents in numerous rural counties. OHP is the largest health plan in Oregon and serves as the driving force behind the health system transformation that has yielded improved health outcomes and saved both federal and state governments a total of $1.4 billion since 2012.
One-third of Medicaid recipients covered under the Affordable Care Act
The newly released quarterly report highlights that as of September 2016, more than 378,000 Oregonians, or one in three Medicaid beneficiaries, had gained access to healthcare coverage through the revised income eligibility criteria permitted by the Affordable Care Act (ACA). The report also reveals that nearly 40% of working-age OHP members enrolled in a coordinated care organization (CCO) statewide are employed, with 8% working full-time or more.
CCOs maintain financial stability while operating margins stabilize
The increased enrollment stemming from ACA expansion generally led to growth in the net assets and restricted reserves of Oregon’s CCOs. At the state level, CCO operating and total margins have experienced a declining trend since their peak in 2014, which is a natural stabilization given the report’s financial data for Oregon’s 16 CCOs from 2014 through the first two quarters of 2016.
The quarterly legislative report also sheds light on financial pressures confronting the Medicaid program and CCOs, including the impact of rising pharmacy costs. In 2015, pharmacy expenses reached $674 million, a notable increase from $533 million in 2014. Expenditures on hepatitis C drugs have seen significant growth, with $38 million spent in 2015 compared to $16.6 million in 2014.
The 2016 mid-year CCO metrics report, released alongside the quarterly report
Outlines the progress of Oregon’s CCOs in terms of quality measures as of June 2016. Assessing quality and access to care is crucial for advancing health system transformation, ensuring high-quality care for Oregon Health Plan members.