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Oregon communities jump into health care reform by figuring out coordinated care organizations

May 24, 2012

Oregon is definitely on our radar as a state to watch in the coming year. Network readers will enjoy this enlightening opinion piece by Doug Riggs at Oregonlive.com. Doug Riggs is executive director of CCO Oregon, a group of leaders from health plans, hospitals, provider groups, community health centers, mental health providers, nonprofits and others formed to educate communities about health reforms.

  • Oregon is set to receive a nearly $2 billion windfall from the federal government. That’s good news. Gov. John Kitzhaber, the one who secured the funding, is betting that this lifeline will prevent our fragile health system for low-income Oregonians from collapsing as the state rushes toward a dramatic and ambitious reform of the health delivery system called coordinated care organizations.

    Essentially, the state is betting that local communities can make better, more efficient decisions for patient care than the state bureaucracy in Salem, so the health system is being de-centralized. Local communities will get a lump-sum payment (called a global budget) and that will be it. That amount will have to cover Medicaid patients’ physical, mental and (starting in 2014) dental health.

    These local CCOs will be forced to reduce costly emergency room visits, identify and treat mental/behavioral issues up front (before they balloon into physical health problems or expensive chronic conditions), and focus on patient responsibility and primary/preventive care. They are being asked to incorporate the social determinants of health, such as housing and employment, into the health model. They will be expected to make the populations they serve healthier so that the state and the federal government can reduce the explosive rate of growth in the health care system.

    That’s a tall task, but communities throughout the state appear to agree that it’s worth the risk. Continue reading here.

 

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