To fix our health care system, we need to improve health care for each person, improve health for the community and lower cost at the same time.
It won't be easy. But it is possible if we focus on engaging individuals and communities in collaboratively guiding their own health.
But it will take a new approach to health care. It will take considering the whole person and coordinating all care: for oral, physical and mental health, and substance abuse issues. It means recognizing that significant health issues are related to what happens outside the walls of the doctor's office.
Here in Oregon, we have started on the path to this new way of approaching health care. We've come together as Oregonians — Republican and Democrat, rural and urban — to rebuild the Oregon Health Plan as a first step toward better health care, less expensive health care, for us all.
We've created coordinated care organizations (CCOs), unique to each community, as the engines to take us on this journey. CCOs bring patients, doctors, mental health workers, hospitals and social service providers to the same table. By working together, considering the care and services needed for each patient, we can overcome some of the obstacles to good health erected by our previous disjointed system and rigid rules.
In talking about the need for health care reform, State Sen. Alan Bates, D-Medford, tells of patients with multiple chronic illnesses and a variety of economic challenges who show up at the emergency room many times a year. This is an example of treating an urgent situation but not resolving the total health care needs of those patients
Instead, we can hire community care workers at a fraction of the cost who can go into the community, meet patients at their homes, find and address the nonmedical issues that prevent them from staying as healthy as they possibly can. Maybe an air conditioner will save someone with heart or lung problems a costly trip to the emergency room when the temperature goes over 90. Perhaps coaching will help a patient with diabetes eat better and avoid the need for hospitalization. It may help a patient establish a more effective relationship with a doctor and eliminate the need for costly emergency room visits.
CCOs also bring together patients and community members who are committed to making health better for all.
The community must be actively involved with the CCOs. We are the people who know our community and what we need to do to make it a healthier place. And we, as the community, are the ones who must hold CCOs accountable. We can do that if we can see what is going on and have a say in it.
Each CCO must have a community advisory council with at least 51 percent consumer membership. I have the honor of participating on both local community advisory councils: Jackson Care Connect and AllCare Health Plan, the two CCOs that serve Oregon Health Plan members in Jackson County.
In the few months since the councils were formed, we have been learning about delivering health care through the CCO. But our higher function is to educate the CCO about what "health" means here in Jackson County and the ways the system gets in the way of health.
Bringing everyone to the same table — consumers and representatives from physical health, mental health and social services providers—helps us recognize and overcome obstacles.
Not everything we try is going to work at first. We'll have some missteps, but hopefully a lot of long strides forward. But the whole community needs to participate.
Even if you are not receiving or providing care through the Oregon Health Plan, it is to your benefit to be aware of the work we are doing and to join in the conversation.
One of our primary tasks is to conduct a health needs assessment. We are working with the 15 assessments for Jackson County that already exist, to simplify them into one. From that will come a community health improvement plan that will set the strategic direction for the CCO.
As a "Community" Advisory Council, we are committed to being transparent. If you would like to know more about us, or to contribute to what we're doing, please visit the CCOs' websites, www.jacksoncareconnect.org and www.allcarehealthplan.com.
Rich Rohde is the regional organizer for Oregon Action in Southern Oregon and a member of the community advisory councils for the Jackson Care Connect and AllCare Health Plan coordinated care organizations.