A performance improvement project (PIP) is a project designed to achieve significant improvement, sustained over time, in health outcomes and Medicaid member experience. As part of two Centers for Medicaid & Medicare Services (CMS) 1115 waivers, all coordinated care organizations (CCOs) are expected to participate in two statewide PIPs. Each statewide PIP is intended to have a common goal and common measure with the flexibility for each CCO to develop unique interventions to meet the needs of their community.
The current statewide PIPs focus on (1) integration of health services – physical, behavioral and oral – across Oregon and (2) reduction in substance use disorder (SUD) in Oregon. Previous statewide PIPs addressed diabetes monitoring in people with schizophrenia or bipolar disorder (2013–2015) and safety of prescription opioid management (2015–2017).
Integration statewide PIP
The most recent statewide integration PIP was closed out at the end of 2024. OHA and the CCOs are currently designing a new statewide integration PIP.
The previous statewide integration PIP topic was
Mental Health Service Access Monitoring.
This project focused on increasing access to mental health services for Oregon Health Plan members ages 2 years and above who have an identified mental health service need. To support the project, a custom measure with multiple age stratifications was developed. Metric specifications and value sets to calculate the measure are listed below:
PIP timeline
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2021: PIP topic selection, PIP project design and measure develpment; baseline measurement
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2022: Begin PIP topic selection and project design; baseline measurement
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2023: CCOs initiate improvements
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2024: Revise and continue improvement initiatives; analyze remeasurement 1 data
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2025: Revise and continue improvement initiatives; analyze remeasurement 2 data; determine whether to continue PIP
Measurement periods
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Baseline: January 1–December 31, 2021
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Remeasurement 1: January 1–December 31, 2022
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Remeasurement 2: January 1–December 31, 2023
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Remeasurement 3: January 2–December 31, 2024
Substance use disorder (SUD) PIP
The current statewide SUD PIP topic is
Initiation, Engagement and Treatment (IET) of Alcohol and Other Drug Use Disorders.
This project focuses on increasing initiation of and engagement in SUD treatment for Oregon Health Plan members ages 13 years and above who have a newly identified SUD episode. The measures for this project align with the OHA CCO IET incentive metric and HEDIS specifications. Please see the
OHA CCO Metrics Program page for up-to-date measure documentation including specifications (search for “Initiation and engagement of alcohol and other drug abuse or dependence treatment" in the document library).
PIP timeline
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2022: Begin PIP topic selection and project design; baseline measurement
-
2023: CCOs initiate improvements
-
2024: Revise and continue improvement initiatives; analyze remeasurement 1 data
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2025: Revise and continue improvement initiatives; analyze remeasurement 2 data; determine whether to continue PIP
Measurement periods
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Baseline: January 1–December 31, 2022
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Remeasurement 1: January 1–December 31, 2023
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Remeasurement 2: January 1–December 31, 2024
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Remeasurement 3: January 2–December 31, 2025
External Quality Review PIP Reporting
Statewide performance improvement projects undergo annual validation by an external quality review organization (EQRO). Oregon's EQRO is Health Services Advisory Group (HSAG). CCOs must complete their validation reporting to HSAG each year by July 31. Reporting forms and information resources are listed below.
Reports
2023 Statewide PIP Report (December 2023)