Oregon pilots alternative payment plans at several community clinics to curb costs

Community health centers in two Oregon counties will begin piloting a year-long alternative payment program this month with the goal of lowering healthcare costs, according to a Corvallis Gazette-Times report.

Under the pilot program, Corvallis, Ore.-based InterCommunity Health Network — the coordinated care organization for Benton, Lincoln and Linn counties — will pay a flat monthly rate to the community clinics in Benton and Linn counties.

The pilot method will serve as an alternative to having the clinics bill the state's version of Medicaid, the Oregon Health Plan, on a fee-for-service basis.

The monthly payments the clinics will receive range from $15 to $86.36 a month per patient, depending on their risk-weighted rate group, adding up to roughly $170,000 per month per clinic, or $2 million annually.

In addition to the flat monthly rate, IHN will provide $400,000 to the clinics to cover the salary and benefits for five additional full-time staff members to increase patient access to care. Additionally, a team of registered nurses will be created to act as care coordinators, scheduling visits with clinicians, making outreach calls to patients, teaching patients self-management, double-checking medication use and following up with individuals post-surgery.

COO for IHN, Kim Whitley, told the Corvallis Gazette-Times that increasing access and allowing physicians to treat minor ailments early will save money in the long run by keeping the minor ailments from turning into more severe and costly conditions.

IHN and the community health clinics have agreed to set benchmarks to measure how well the system meets access, quality and utilization goals under the program. Then, each clinic will have the autonomy to decide which kind of alternative payment method they will use to meet the benchmarks set.

At the end of the pilot, the outcomes of each method and each clinic will be evaluated, and observations and suggestions for future payment strategies will be discussed, according to the report.

IHN is piloting a similar program with two other medical groups in the region, Samaritan Internal Medicine in Corvallis, Ore., and Coastal Health Practitioners in Lincoln City, Ore.

 

 

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