Coordinated care organizations met most performance measures last year
SALEM, Ore. — Oregon’s Medicaid insurers generally improved care quality and particularly improved behavioral health services in 2024, according to a new Oregon Health Authority report.
OHA contracts with coordinated care organizations, or CCOs, to administer benefits for the vast majority of Oregon’s Medicaid members. In 2024, OHA measured CCOs against 15 quality incentive metrics that ranged from providing comprehensive diabetes care to ensuring young children receive well-care visits.
OHA found CCOs were most improved on behavioral health measures in 2024. For example, across all CCOs, screening, brief intervention and referral to addiction treatment increased:
- from 60.2% in 2023 to 65.0% in 2024 for members receiving screening for alcohol or other substance use
- from 38.9% in 2023 to 43.3% in 2024 for members who use alcohol or other substances and received a brief intervention or a referral to treatment
At the same time, two behavioral health measures related to substance use disorder treatment largely remained the same:
- OHP members who began treatment within 14 days of being diagnosed went from 42.4% in 2023 to 41.7% in 2024
- OHP members who had at least two visits or treatment sessions within 34 days of beginning treatment went from 16.6% in 2023 to 16.5% in 2024
Other changes in 2024 CCO quality performance include:
- Preventive dental and oral health services increased:
- from 56.0% in 2023 to 61.1% in 2024 for children ages 1-5
- from 61.8% in 2023 to 63.7% in 2024 for children ages 6-14
- Oral evaluation of adults with diabetes increased from 26.8% in 2023 to 29.2% in 2024
- Poor diabetes management decreased from 24.6% in 2023 to 22.9% in 2024
- Immunization for youth, which increased slightly:
- from 32.7% in 2023 to 33.9% in 2024 for adolescents receiving recommended vaccines between their ninth and 13th birthdays
- from 59.0% in 2023 to 60.0% in 2024 for children receiving recommended vaccines before their second birthday
CCOs earned $325 million for meeting established performance metrics through OHA’s CCO Quality Incentive Program in 2024.