2023 CCO Metrics Methodology
This update applies to Advanced Health (OHP) providers.
The Oregon Health Authority (OHA) Coordinated Care Organization (CCO) Incentive Metrics Program uses quality health metrics to demonstrate how well CCOs are improving the health of the communities they serve. Incentive metrics are integral to the success of the CCO model, encouraging health plans and their provider partners to develop innovative approaches to serve Oregon Health Plan members. These metrics measure quality of care, access to care, and health outcomes for individuals enrolled in CCOs. OHA develops the measures and awards funds from the quality pool to CCOs based on their annual performance on the measures. Each CCO establishes the methodology for distributing the incentive funds to participating providers.
The Advanced Health methodology is developed in partnership with the provider community and is reviewed and approved by both Advanced Health’s Boards of Directors. Advanced Health deducts the administrative fee and taxes from funds received from OHA prior to distribution. The methodology outlined below is effective for calendar year 2023.
If you have any questions, please contact Advanced Health’s Quality team.
Thank you for your partnership in helping our members stay healthy.
To view the Advanced Health Quality Distribution Plan, click HERE.
Oregon Health Authority Quality Incentive Measure Program
How the quality incentive measures work:
OHA allocates quality pool funding from a percentage of aggregate payments made to all CCOs for the year.
The CCO’s performance as a whole is measured by OHA.
OHA sets a Benchmark target for all CCOs in Oregon to work toward.
OHA also sets an Improvement target that is unique to each CCO, based on their performance from the previous year.
To meet an incentive measure, the CCO must reach either the state-wide Benchmark target or the individual CCO’s Improvement target.
2023 Quality Metrics
2023 CCO Incentive Measure List
- Assessments for Children in DHS Custody
- Childhood Immunization Status
- Cigarette Smoking Prevalence
- Depression Screening and Follow-Up
- Diabetes: HbA1c Poor Control
- Health Aspects of Kindergarten Readiness: CCO System-Level Social Emotional Health
- Immunizations for Adolescents
- Initiation and Engagement of Alcohol and Other Drug Treatment
- Oral Evaluation for Adults with Diabetes
- Preventive Dental or Oral Service Utilization
- Screening, Brief Intervention and Referral to Treatment (SBIRT) for Drug and Alcohol Use
- Timeliness of Postpartum Care
- Child and Adolescent Well-Child Visits for Ages 3-6
- Health Equity Meaningful Language Access
- Social Determinants of Health: Social Needs Screening and Referral
Resources & Contacts
Technical Specifications and Guidance Documents for CCO Incentive Measures
Amanda McCarthy, Director of Social Determinants of Health – email@example.com