Fast-tracked waiver approved before Federal Government administration change
(BEND, Ore.) Jan. 13, 2017-- PacificSource Community Solutions is pleased to learn that the 1115 waiver renewal application submitted by the Oregon Health Authority (OHA) in August 2016, has been approved by the Centers for Medicare and Medicaid Services (CMS). Oregon's existing five-year waiver--which authorizes transformation of the Oregon Health Plan (OHP) through coordinated care organizations (CCOs)--expires on June 12, 2017. This fast-tracked waiver, is valid from Jan. 12, 2017 through June 30, 2022.
The OHA contracts with 16 CCOs across the state to serve OHP members in a managed care model. Oregon's efforts to transform Medicaid, bend the cost curve, and promote improved health outcomes through a partnership between the OHA and the CCOs require a waiver.
"PacificSource Community Solutions greatly appreciates the tireless work by the OHA and Gov. Brown to support the CCO model and the 1115 waiver," said Ken Provencher, president/CEO of PacificSource. "This waiver promotes critical continuity of care for Oregonians during a time of uncertainty at the Federal level."
The OHA had originally requested additional financial support from CMS, but this waiver does not come with enhanced funding for transformation efforts
"We remain committed to working with OHA during this next phase of CCO development and performance," said Dan Stevens, PacificSource's executive vice president of product management. "This waiver represents stability and an opportunity for CCOs to continue to innovate and work together with stakeholders to build healthier communities."
About PacificSource Community Solutions
As part of the PacificSource family of companies, PacificSource Community Solutions serves Medicaid members through its coordinated care organizations in Central Oregon and the Columbia Gorge. Founded in 1933, PacificSource employs 900 people, serves more than 275,000 individuals, and has 3,900 employer clients throughout the Northwest. For more information visit PacificSource.com.
PacificSource Health Plans has been selected by The Centers for Medicare & Medicaid Services (CMS) as a partner in its new Comprehensive Primary Care Plus (CPC+) model. The five-year CPC+ model, the largest multi-payer initiative launched by CMS, began on January 1, 2017 in 14 regions across the United States.
CPC+ is an advanced primary care medical home model, with a goal to strengthen primary care through regionally based, multi-payer reform and care delivery transformation. The initiative brings together a collaboration of Medicare fee-for-service, commercial insurance payers and state Medicaid agencies, and includes two tracks with incrementally advanced care delivery requirements and payment options.
"Many payers are interested in strengthening primary care, but a single payer has limited potential to transform primary care practices," said Peter McGarry, PacificSource vice president of provider network. "With collaboration, we can achieve better care, smarter spending and healthier communities."
CPC+ builds on the Comprehensive Primary Care initiative CMS launched in 2012 that ended on December 31, 2016. The goals of CPC+ include:
* Supporting patients with serious or chronic diseases to achieve health goals.
* Engaging patients and their families in their own care.
* Working together with insurers, hospitals and other clinicians, including specialists, to provide better-coordinated care.
* Giving patients access through enhanced in-person hours and 24/7 telephone or electronic means.
* Proactive care management for high-risk patients to improve outcomes.
* Comprehensive physical and mental care including preventive services.
* Patients receiving timely follow-up after emergency room or hospital visits
PacificSource payer partners in CPC+ include: AllCare Health, Inc, Atrio Health Plans, CareOregon, Eastern Oregon CCO, FamilyCare Health, Medicare fee-for-service, MODA Health Plan, Oregon Health Authority (Medicaid), BlueCross BlueShield of Montana, Montana Medicaid, Primary Health of Josephine County, Providence Health Plan/Assurance, Tuality Health Alliance, Umpqua Health, Western Oregon Advanced Health, Willamette Valley Community Health, and Yamhill Community Care Organization.
About PacificSource Health Plans
PacificSource Health Plans is an independent, regional, not-for-profit community health plan serving the Northwest. Founded in 1933, PacificSource is based in Springfield with local offices throughout Oregon, and in Idaho and Montana.
The PacificSource family of companies employs 900 people, serves more than 280,000 individuals, and has 3,900 employer clients throughout the Northwest. For more information visit PacificSource.com.