There is established in the Oregon Health Authority the patient centered primary care home program and the behavioral health home program. Through these programs, the authority shall:
Define core attributes of a patient centered primary care home and a behavioral health home to promote a reasonable level of consistency of services provided by patient centered primary care homes and behavioral health homes in this state. In defining core attributes related to ensuring that care is coordinated, the authority shall focus on determining whether these patient centered primary care homes and behavioral health homes offer comprehensive primary and preventive care, integrated health care and disease management services;
Establish a simple and uniform process to identify patient centered primary care homes and behavioral health homes that meet the core attributes defined by the authority under paragraph (a) of this subsection;
Develop uniform quality measures that build from nationally accepted measures and allow for standard measurement of patient centered primary care home and behavioral health home performance;
Develop uniform quality measures for acute care hospital and ambulatory services that align with the patient centered primary care home and behavioral health home quality measures developed under paragraph (c) of this subsection; and
Develop policies that encourage the retention of, and the growth in the numbers of, primary care providers.
(a) The Director of the Oregon Health Authority shall appoint an advisory committee to advise the authority in carrying out subsection (1) of this section.
The director shall appoint to the advisory committee 15 individuals who represent a diverse constituency and are knowledgeable about patient centered primary care home delivery systems, behavioral health home delivery systems, integrated health care or health care quality.
Members of the advisory committee are not entitled to compensation, but may be reimbursed for actual and necessary travel and other expenses incurred by them in the performance of their official duties in the manner and amounts provided for in ORS 292.495 (Compensation and expenses of members of state boards and commissions). Claims for expenses shall be paid out of funds appropriated to the authority for the purposes of the advisory committee.
The advisory committee shall use public input to guide policy development.
The authority will also establish, as part of the patient centered primary care home program, learning collaboratives in which state agencies, private health insurance carriers, third party administrators, patient centered primary care homes and behavioral health homes can:
Share information about quality improvement;
Share best practices that increase access to culturally competent and linguistically appropriate care;
Share best practices that increase the adoption and use of the latest techniques in effective and cost-effective patient centered care;
Coordinate efforts to develop and test methods to align financial incentives to support patient centered primary care homes and behavioral health homes;
Share best practices for maximizing the utilization of patient centered primary care homes and behavioral health homes by individuals enrolled in medical assistance programs, including culturally specific and targeted outreach and direct assistance with applications to adults and children of racial, ethnic and language minority communities and other underserved populations;
Coordinate efforts to conduct research on patient centered primary care homes and behavioral health homes and evaluate strategies to implement patient centered primary care homes and behavioral health homes that include integrated health care to improve health status and quality and reduce overall health care costs; and
Share best practices for maximizing integration to ensure that patients have access to comprehensive primary and preventive care, integrated health care and disease management services.
The Legislative Assembly declares that collaboration among public payers, private health carriers, third party purchasers and providers to identify appropriate reimbursement methods to align incentives in support of patient centered primary care homes and behavioral health homes is in the best interest of the public. The Legislative Assembly therefore declares its intent to exempt from state antitrust laws, and to provide immunity from federal antitrust laws, the collaborative and associated payment reforms designed and implemented under subsection (3) of this section that might otherwise be constrained by such laws. The Legislative Assembly does not authorize any person or entity to engage in activities or to conspire to engage in activities that would constitute per se violations of state or federal antitrust laws including, but not limited to, agreements among competing health care providers or health carriers as to the prices of specific levels of reimbursement for health care services.
The authority may contract with a public or private entity to facilitate the work of the learning collaborative described in subsection (3) of this section and may apply for, receive and accept grants, gifts, payments and other funds and advances, appropriations, properties and services from the United States, the State of Oregon or any governmental body or agency or from any other public or private corporation or person for the purpose of establishing and maintaining the collaborative. [Formerly 442.210; 2019 c.536 §1]