Oregon's healthy new approach
Health care reform has become a bad word in this country, at least among critics of the national effort known by its detractors as "Obamacare." But Oregon lawmakers and state officials are working steadily toward a planned overhaul of the Oregon Health Plan they hope will lead to better outcomes for patients and lower costs to taxpayers.
The 2011 Legislature passed House Bill 3650 with bipartisan support. The measure, titled Health System Transformation, calls for the state to create Coordinated Care Organizations around the state.
These CCOs will be responsible for coordinating medical care, mental health treatment, dental care, alcohol and drug abuse treatment and senior services for Oregon Health Plan patients. Patient histories and medical records will be shared among the various providers to eliminate redundant services and medical errors.
Under the current system, when a patient visits the emergency room, doctors have no way of knowing if that patient may suffer from a mental illness that contributes to their medical problem.
In one actual case, a Medicaid patient came to the emergency room 21 times in two months with a variety of injuries. Doctors finally determined that the patient was severely mentally ill and the injuries were self-inflicted. Under the CCO system, all that patient's records would have been available to doctors the first time the patient was seen, preventing multiple expensive visits.
Another example is an elderly patient with congestive heart failure who lives in an apartment with no air conditioning. When summer temperatures rise, the patient drinks excessive fluids, causing her congestive heart failure to worsen and sending her to the emergency room. Purchasing an air conditioner for that patient's apartment would cost far less than a single hospital visit, but that's not possible under the current fragmented system.
The new system will use a global budgeting process designed to reward efficiency. The details of the new system are being developed now, in a series of meetings around the state. Community meetings also are being held, including one in Medford last week.
The Oregon Health Policy Board will prepare its final report and recommendations for creating Coordinated Care Organizations to the 2012 Legislature, which will have to approve the plan. The federal government also must approve waivers to permit Oregon to use its federal Medicaid funds to implement the new system. If all goes as planned, the first CCOs should begin operating next summer.
Government gets a lot of criticism, much of it deserved, for maintaining bloated bureaucracies that spend tax dollars inefficiently. This is a case of government recognizing the problem and taking steps to fix it.
Oregonians should welcome and support the new approach.