The Indiana Family andSocial Services Administration

Oregon and CCOs

October 2009

Definition of a CCO • CCOs are local health entities that deliver

care and coverage to Medicaid and potentially state employees. They include:– Community level accountability for better

health, better care, and lower costs– A focus on elimination of health disparities– New models of integrated care that are

patient-centered and team focused with an emphasis on prevention

Definition of CCOs continued– A global budget that grows at a fixed rate for

behavioral, physical, and dental care– Flexibility within the budget to deliver the

outcomes expected– Incentives for improved care– Governed by a partnership between providers

of care, community members, and the stakeholders in the health system who have financial responsibility and risk

Impetus For Change

• Budget issues and business community reaction• Resulting reduction in funding• State Direction• Provider response

• Managed care penetration• Lack of substance abuse penetration• Three to four plans for everyone• Carved out populations

Background

Provider Reaction

• Disbelief to action• Some will lead others will follow• Change on the table• Jury still out

The “Deal”

• $1.9 Billion• Detail negotiations complete and

available• Replication possible, but not guaranteed

Applicability To Indiana

• Are we ready for Community wide?• Smaller geography?• Everyone covered?• Non health care outcomes?• Reduced requirements for more risk on

outcomes?