Consumer Confidence Project
To apply to be a member of the Analysis and Review Council or to nominate someone, email Consumer Confidence Project’s project manager, David Spencer, at email@example.com. Applications are due June 20.
The rollout of the new groups designed to manage Medicaid patients across Oregon hasn’t exactly been without its bumps in the road.
The Oregon Legislature in 2011 created 16 coordinated care organizations that will oversee everything from registration, eligibility, providers and coverage for members of the Oregon Health Plan, the state’s version of Medicaid. In some parts of the state, however, CCOs’ rapid influx of people and limited number of providers has made it difficult for some patients to get their needs met.
The Oregon Health Authority is tracking the CCOs’ progress according to a set of measures such as emergency department visits, primary care visits, hospital readmissions and per-member spending.
But a citizen group has surfaced that wants to study the CCOs from the patient’s perspective. Rather than looking at whether the state is saving money, the Consumer Confidence Project wants to find out whether patients are able to find the information they need and whether they’re satisfied with their experiences.
David Spencer, project manager with the Consumer Confidence Project, said he’s had to reassure CCO leaders — including those at PacificSource Community Solutions, which oversees Central Oregon’s CCO — that this is not a muckraking campaign.
“We’re not out to make anybody look bad or anything like that,” he said. “The idea is if one group is doing something that seems to be valuable to consumers and we can show that and other people see it and say, ‘We can do that,’ well, good, do it. Everybody will get better.”
Of the nine people currently involved in the CCP, most work in the health care industry, but some — Spencer, for example — come from other fields. Spencer is a retired communications professional for Intel Corp. who works for the CCP through a fellowship from Social Venture Partners, a Portland group that works to strengthen nonprofits. He is the only paid member of the group. Liz Baxter, another CCP member, directs the Oregon Public Health Institute. John Santa is the medical director at Consumer Reports’ patient resource division, Consumer Health Choices, although his participation in the CCP is separate from his professional role.
Here in Central Oregon, several OHP patients have complained they’re having trouble getting paired with doctors who will see them. Some doctors say the reimbursement is too low to allow them to take on any more patients. People across the state say that’s not just a local problem. Total enrollment across the state has risen to roughly 935,000 — the expansion brought on more than 300,000 people — and CCO leaders say the influx of new members was more than they expected sooner than they expected.
In gathering its information, the CCP will mainly use information that’s publicly available. Its members will inspect each CCO’s website, for example, and find out whether there are people members can call. They’ll try to judge whether the websites are clear and understandable. They’ll check out the sign-up process.
Each metric, which the group is still working to finalize, will be assigned points, and each CCO will be scored according to its accessibility and other factors, Spencer said.
One thing the CCP’s members will be careful not to do: duplicate what the Oregon Health Authority is already doing in its effort to keep tabs on the CCOs, Spencer said.
Eventually, the CCP will publish a report that will compare all 16 coordinated care organizations. Spencer said the tentative goal is to publish the report in February 2015. Depending on how that goes, the hope is that the group will be able to secure more funding and put out more reports in the future.
CCP member and Corvallis resident Joe Zaerr draws his CCO experience from sitting on the community council that advises the Intercommunity Health Network CCO, which includes Benton County. He believes there is not enough community member representation on the board of directors that oversees CCOs in Oregon. He sees the CCP as a way to compensate for that.
“We thought that the CCP would be maybe a different kind of lever, which would use public opinion as a lever to help the CCO deliver better health care to the people in the community,” said Zaerr, a retired forestry professor at Oregon State University.
The CCP is in the process of recruiting for its Analysis and Review Council, which will ensure the group’s work accurately reflects the perspectives of the individuals and communities served by CCOs. The members of that group should either be CCO members, the families of CCO members, community members or health care providers who are not currently practicing (to avoid potential conflicts of interest).
Zaerr said the council will have between 10 and 20 members, ideally from a wide spectrum of groups.
“We want people from the city, people from rural areas, we want different races and ethnicities,” he said. “People from different walks of life. It needs to represent the people of Oregon as best we can.”
— Reporter: 541-383-0304, firstname.lastname@example.org
Editor’s note: This article has been corrected. In an earlier version of the story, the legislation that resulted in CCOs being formed in Oregon was incorrect. The Bulletin regrets the error.