Oregon's coordinated care organizations cut ER use, chronic condition admissions

Report finds room for improvement for emergency department use by disabled patients
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Coordinated care organizations cut admissions and emergency department use for several costly conditions, according to a new report from the Oregon Health Authority that examined the outcomes of 16 CCOs.

CCOs are a network of healthcare providers who work together to serve patients who receive healthcare coverage under the Oregon Health Plan (Medicaid). They focus their efforts on prevention and helping patients manage chronic conditions like diabetes.

The latest report examined outcomes between July 2014 and June 30, 2015. It found:

  • All-cause readmissions rate decreased from nearly 13 percent in 2011 to less than 10 percent, below the state's 10.5 percent benchmark
  • ED use also fell, dropping 23 percent from 2011's baseline.
  • Admissions for short-term diabetes complications dropped 32 percent from 2011
  • Admissions for chronic obstructive pulmonary disease in patients 40 and older declined 68 percent

However, the data also reveals an area for improvement. Among Medicaid beneficiaries with severe mental illnesses, ED use remains far higher than the declining statewide rate of overall ED use.

"Oregon will continue to monitor this metric to determine if additional community services made possible by recent investments lead to a decreased utilization of emergency departments for individuals with severe and persistent mental illness," the report states.

ED use also remained higher than statewide averages for disabled patients in general, mirroring the national trend, which the report suggests can be improved through timely follow-up after hospitalization. The report also found smaller spending growth among CCOs, finding a reduction of 2 percent, as part of an agreement with the federal government the CCOs made upon establishment in 2013.

This is significantly better news than reports last summer that two of the state's CCOs were struggling to meet state requirements, with the tight schedule contributing to high turnover and burnout risk, FierceHealthcare previously reported.

To learn more:
- read the full report (.pdf)

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