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Organized Health Care Arrangements (OHCA)

What does OHCA stand for in healthcare compliance?
In healthcare compliance, OHCA is a term that stands for Organized Health Care Arrangements. 


What is Organized Health Care Arrangements (OHCA)?
The term Organized Health Care Arrangements (OHCA) was first mentioned in the Health Insurance Portability and Accountability Act (HIPAA). The Health Insurance Portability and Accountability Act allows healthcare providers that work with similar patients to work together as an Organization Health care Arrangement. According to the Mayo Clinic Health System, Organized Health Care Arrangements are organized healthcare systems in which multiple covered entities participate, the covered entities publicly acknowledge their participation in joint activities, and the covered entities participate in joint activities outlined in the Privacy Rules. 

Organization Health Care Arrangements are useful for the following reasons:

    • Allows covered entities within the OHCA to use joint notice of privacy practices

    • Allows covered entities within the OHCA to complete quality assessments, utilization reviews, payment activities, and improvement activities together

    • Allows covered entities within the OHCA to share patient health information for healthcare services, treatment plans, and payment options

Examples of Organized Health Care Arrangements include the Tennova Cumberland healthcare Alliance, the Lutheran Health Quality Alliance, Community Health Alliance of the Ozarks, and the Appalachian Community Physicians Alliance. Each one of these Organization Health Care Arrangements is responsible for providing quality care to the patients they serve. 

To give an example of the covered entities within an Organized Health Care Arrangement, let’s look at all of the covered entities within the Lutheran Health Quality Alliance. According to the Lutheran Health Quality Alliance, this OHCA’s covered entities include the following:

    • Bluffton Health System

    • Bluffton Physician Services

    • Dukes Health System

    • Dukes Physician Services

    • Dupont Hospital

    • Hospital Care Group

    • IOM Health System

    • Karim Moshref

    • Kosciusko Medical Group

    • Lutheran Medical Group

    • Lutheran Musculoskeletal CenterQHG for Fort Wayne Company

    • MedStat

    • Rehab Hospital of Fort Wayne General Partnership

    • St Joseph Health System

    • St Joseph Medical Group

    • Warsaw Health System

As you can see, there are a number of providers that are part of this OHCA. In cases such as these, being able to use a joint notice of privacy practices, share patient health information, and working together to complete quality assessments save both time and money for the covered entities. 

Organized Health Care Arrangements (OHCA) offer many benefits. Such benefits include the following:

    • Bettering patient care quality

    • Creating patient care programs

    • Identifying patients that are at-risk

    • Personalizing patient care

    • Providing data that helps treat patients

    • Reducing medical costs

Organized Health Care Arrangements are important because they benefit their covered entities while also allowing the covered entities to ensure quality care for each and every one of their patients. 

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