Excel Sample Sheet 33673 | Carecoordinationreporttemplate 5 2022

Partial file snippet.

Sheet 1: CCO Info

	
	
	
	
	
		

		

		

		

	
	
		CCO Name & Contract #
		

		< == please select from dropdown list
	
	
		

		

		

		

	
	
		Reporting Period
		Jan-Jun 2022
		< == please select from dropdown list
		

	
	
		

		

		

		

	
	
		CCO Contact Person for this Report
		

		

		

	
	
		Name
		 
		

	
	
		

		

		

		

	
	
		Email
		 
		

	
	
		

		

		

		

	
	
		

		

		

		

	
	
		Please also identify your CCO and the last day of the reporting period in the filename (e.g., ABCCCO_06302022). 
		

		

		

	



Sheet 2: Guidance

	
	
	
	
	
		
 
		
		

		

	
	
		

		

	
	
		

		

	
	
		Guidance for CCO Care Coordination Report 
		

		

		

	
	
		

		

		

		

	
	
		Purpose
		

		

		

	
	
		This document provides guidance to Coordinated Care Organizations (CCOs) on the biannual Care Coordination Report (CCR) referenced in Exhibit B, Part 4, Section 7 h. of the 2022 CCO contract and described in detail in OAR 410-141-3860(19). 
		
	
		

		

		

		

	
	
		Instructions 
		

		

		

	
	
		The CCR consists of two components: Data and Narrative. They are reported using the worksheets of the same names in the CCO Care Coordination Report template provided on the CCO Contract Forms webpage.
Data elements reported as percentages on Report 1 and Report 2 will auto-calculate based on figures entered into numerator and denominator fields. 


		
	
		

		

		

		

	
	
		

		

		

		

	
	
		

		

		

		

	
	
		Timeline & Submission Process 
		

		

		

	
	
		Each CCO will submit its completed biannual CCR to CCO.MCODeliverableReports@dhsoha.state.or.us on the following  schedule for 2022.  Due date is  60 (per revised rule) days after the end of the reporting period:
		
	
		

		Reporting Period
		

		Due Date
	
	
		

		January 1-June 30, 2022
		

		8/29/2022
	
	
		

		July 1-December 31, 2022
		

		3/1/2023
	
	
		

		

		

		

	
	
		

		

		

		

	
	
		

		

		

		

	
	
		Each submitted report must have the CCO name and the last day of the reporting period in the filename (e.g., ABCCCO_06302022). The “CCO Info” worksheet  in the report template must be completed.
		
	
		

		

		

		

	
	
		Technical Specifications
		

		

		

	
	
		Technical specifications for the CCR are provided on the worksheet of the same name in the reporting template.
		



Sheet 3: Report 1 of 3 (Data)

	
	
	
	
	
	
		Terminology 
(use hyperlinks to navigate to Tech Specs tab)
		Data
		Numerator
		Denominator
		Notes & CCO Definitions
	
	
		CCO lives
		

		

		

		

	
	
		Member identified for care coordination outreach & engagement by REALD
		Use Report 2 of 3 (REALD)
		

		

		

	
	
		Member receiving care coordination by REALD
		

		

		

	
	
		Member eligible for ICC services by REALD
		

		

		

	
	
		Member receiving ICC services by REALD
		

		

		

	
	
		Member eligible for ICC services (%)
		

		

		

		

	
	
		Member receiving ICC services (%)
		

		

		

		

	
	
		Member assessed for ICC services who declined or refused (%)
		

		

		

		

	
	
		Reason for refusal
		

		

		

		

	
	
		Not Interested
		

		

		

		

	
	
		Did not Respond to Outreach
		

		

		

		

	
	
		Other - please define
		

		

		

		

	
	
		Member in Prioritized Population assessed for ICC within 10 days (%)
		

		

		

		

	
	
		Other Member assessed for ICC within 30 days (%)
		

		

		

		

	
	
		ICC assessment Referral - Response within one business day (%)
		

		

		

		

	
	
		Intensive Care Coordinator assignments within 3 business days (%)
		

		

		

		

	
	
		ICC services by CCO staff (%)
		

		

		

		

	
	
		Reassessments based on known reassessment trigger(s)
		

		

		

		

	
	
		Type of reassessment trigger that led to reassessment
		

		

		

		

	
	
		New hospital visit (%)
		

		

		

		

	
	
		New high-risk pregnancy (%)
		

		

		

		

	
	
		New chronic disease (%)
		

		

		

		

	
	
		New behavioral health (%)
		

		

		

		

	
	
		Opioid drug use (%)
		

		

		

		

	
	
		IV drug use (%)
		

		

		

		

	
	
		Suicide attempt, ideation, or planning (%)
		

		

		

		

	
	
		New I/DD diagnosis (%)
		

		

		

		

	
	
		Adverse child experiences (%)
		

		

		

		

	
	
		Homelessness (%)
		

		

		

		

	
	
		Z code diagnoses within one month (%)
		

		

		

		

	
	
		Caregiver placements within 6 months (%)
		

		

		

		

	
	
		Exclusionary practice (%)
		

		

		

		

	
	
		New/ongoing behavioral health needs (%)
		

		

		

		

	
	
		Discharge from residential setting (%)
		

		

		

		

	
	
		Severe alcohol or benzodiazepine usage (%)
		

		

		

		

	
	
		Readmissions to acute care psychiatric hospital (%)
		

		

		

		

	
	
		Readmissions for emergency department for psychiatric reason (%)
		

		

		

		

	
	
		Type of sentinel event that led to reassessment
		

		

		

		

	
	
		Sentinel event - please define (%)
		

		

		

		

	
	
		Sentinel event - please define (%)
		

		

		

		

	
	
		Members with MA or DSNP plans and LTSS

The words contained in this file might help you see if this file matches what you are looking for:

...Sheet cco info name amp contract lt please select from dropdown list reporting period janjun contact person for this report nbsp email also identify your and the last day of in filename eg abccco guidance care coordination purpose document provides to coordinated organizations ccos on biannual ccr referenced exhibit b part section h described detail oar instructions consists two components data narrative they are reported using worksheets same names template provided forms webpagedata elements as percentages will autocalculate based figures entered into numerator denominator fields timeline submission process each submit its completed ccomcodeliverablereports dhsohastateorus following schedule due date is per revised rule days after end january june july december submitted must have ldquo rdquo worksheet be technical specifications terminology use hyperlinks navigate tech specs tab notes definitions lives member identified outreach engagement by reald receiving eligible icc services as...


CCO Name & Contract #			< == please select from dropdown list

Reporting Period	Jan-Jun 2022	< == please select from dropdown list

*CCO Contact Person for this Report*
Name

Email


*Please also identify your CCO and the last day of the reporting period in the filename (e.g., ABCCCO_06302022).*

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Guidance for CCO Care Coordination Report

*Purpose*
This document provides guidance to Coordinated Care Organizations (CCOs) on the biannual Care Coordination Report (CCR) referenced in Exhibit B, Part 4, Section 7 h. of the 2022 CCO contract and described in detail in OAR 410-141-3860(19).

*Instructions*
The CCR consists of two components: Data and Narrative. They are reported using the worksheets of the same names in the CCO Care Coordination Report template provided on the CCO Contract Forms webpage. Data elements reported as percentages on Report 1 and Report 2 will auto-calculate based on figures entered into numerator and denominator fields.



*Timeline & Submission Process*
Each CCO will submit its completed biannual CCR to CCO.MCODeliverableReports@dhsoha.state.or.us on the following schedule for 2022. Due date is 60 (per revised rule) days after the end of the reporting period:
	Reporting Period	Due Date
	January 1-June 30, 2022	8/29/2022
	July 1-December 31, 2022	3/1/2023



Each submitted report must have the CCO name and the last day of the reporting period in the filename (e.g., ABCCCO_06302022). The “CCO Info” worksheet in the report template must be completed.

*Technical Specifications*
Technical specifications for the CCR are provided on the worksheet of the same name in the reporting template.

Terminology (use hyperlinks to navigate to Tech Specs tab)	Data	Numerator	Denominator	Notes & CCO Definitions
CCO lives
Member identified for care coordination outreach & engagement by REALD	Use Report 2 of 3 (REALD)
Member receiving care coordination by REALD
Member eligible for ICC services by REALD
Member receiving ICC services by REALD
Member eligible for ICC services (%)
Member receiving ICC services (%)
Member assessed for ICC services who declined or refused (%)
Reason for refusal
Not Interested
Did not Respond to Outreach
Other - please define
Member in Prioritized Population assessed for ICC within 10 days (%)
Other Member assessed for ICC within 30 days (%)
ICC assessment Referral - Response within one business day (%)
Intensive Care Coordinator assignments within 3 business days (%)
ICC services by CCO staff (%)
Reassessments based on known reassessment trigger(s)
Type of reassessment trigger that led to reassessment
New hospital visit (%)
New high-risk pregnancy (%)
New chronic disease (%)
New behavioral health (%)
Opioid drug use (%)
IV drug use (%)
Suicide attempt, ideation, or planning (%)
New I/DD diagnosis (%)
Adverse child experiences (%)
Homelessness (%)
Z code diagnoses within one month (%)
Caregiver placements within 6 months (%)
Exclusionary practice (%)
New/ongoing behavioral health needs (%)
Discharge from residential setting (%)
Severe alcohol or benzodiazepine usage (%)
Readmissions to acute care psychiatric hospital (%)
Readmissions for emergency department for psychiatric reason (%)
Type of sentinel event that led to reassessment
Sentinel event - please define (%)
Sentinel event - please define (%)
Members with MA or DSNP plans and LTSS

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