Over the past two years, OPCA has been meeting with a workgroup of clinics and state Medicaid agency staff to frame an Alternative Payment Methodology (APM) for community health centers (CHCs). The methodology converts each CHC’s federally defined Prospective Payment System (PPS) rate to a capitated equivalent for their scope of primary care services. Phase 1 (see below) went live with the APM on March 1, 2013.
The primary goal of offering an alternative payment model to health centers in Oregon is to make available a payment option that does not link to the traditional patient encounter, removing the incentive to produce more patient visits as a measure to maintain practice revenue and providing care that is patient centered. Tying clinic reimbursement to quality management of the health of a population is better aligned with the Triple Aim of improving the experience of care, improving the health of populations and reducing per capita costs of health care.
The Social Determinants of Health (SDoH) are the conditions in which people are born, live, work and age. They are shaped by the distribution of money, power and resources at global, national and local levels. SDoH account for an estimated 40 percent of health outcomes and are largely responsible for health inequities. OPCA leads several initiatives that are focused on impacting the social determinants of health.
The Data Transparency Project is a collaboration between OPCA and Oregon’s community health centers. Our goal: Improve the performance of Oregon’s health centers on six key measures. These measures, identified as a top priority by clinic leaders, will be shared transparently by each clinic with OPCA and with other health centers in the clinic's cohort as they work to improve outcomes.
It Takes a Neighborhood is a project focused on piloting a new role, called the Health Instigator, within the transformation of Oregon’s healthcare system. A Health Instigator is a full-time community resource working at a systems level rather than with individual patients. Health Instigators support the communities they work with to improve the health, healthcare experience, and health equity of a specific population (such as homeless), as well as reduce the cost of their healthcare.