1. Investments in Primary Care
Evidence suggests strengthening primary care will lead to improved outcomes and lower costs OHIC required increase primary care spending by 1 %/year
Friedberg et al., 2010

2. Transforming the Healthcare Delivery System
The Affordability Standards transform the way primary care is delivered -- higher quality and lower cost care mutually reinforced by healthcare financing.
Target: 80% of primary care practices contracting with each health insurer will be designated Patient Centered Medical Homes (PCMH) by the end of 2019
The Care Transformation Advisory Committee develops an annual plan for achieving this target
Insurers are obligated to financially support PCMH practices

3. Aligning Quality Measures
OHIC requires commercial insurers to use the same “Aligned Measure Sets” in any contract that has a financial incentive tied to quality.
Core Measures standard in contracts.
Any measure beyond the Core must be selected from the list of Menu Measures.
Measure Sets
2018 Measures
ACO
10 core, 49 menu
Primary Care
6 core, 24 menu
Hospital
8 core, 13 menu
Maternity
2 core, 7 menu
Mental Health
3 core, 11 menu
Substance Use
1 core, 2 menu