Oregon Health Authority Director's Message
March 25, 2011 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

A wake-up call

"We came together because of a budget crisis. But this is really about people being able to get access to care."
~Bart McMullan, M.D., member of the Health System Transformation Team

For the past eight weeks, more than 45 people from across the state have been meeting and publicly discussing how to strengthen our health care delivery system to better serve Oregonians who get care through our Medicaid program.

This Health System Transformation Team was made up of individuals who provide health care (doctors, nurses, a chiropractor, and more), those who get care, hospital executives, insurance representatives, senior advocates, patient advocates, mental health advocates, the Oregon Health Policy Board and lawmakers from both sides of the aisle.

Wednesday night they held their final meeting and handed their plan to Oregon lawmakers for the next step. More information about the team and its plan is available on the Transformation Team website.

The plan recognizes several important realities:

First, Oregon's budget shortfall is a wake-up call. We do not have enough money to continue to afford the ever rising costs of health care. We can use this opportunity to make smart, long-term changes that will reduce waste and inefficiency, cuts costs, and improve value and quality for everyone.

Second, we have to do more to focus on prevention and on those Oregon Health Plan clients who are needlessly suffering through expensive treatments and hospitalizations because the system isn't set up to help them earlier.

Third, care can be better coordinated to improve health and lower costs -- and such coordination happens best at the local level.

To that end, the plan sent to the Legislature includes local coordinated care organizations (CCOs) for Medicaid clients that will help break through the barriers that today stand in the way of delivering the right care at the right time in the right place. These local organizations would operate with a set budget for all the care paid for with public dollars and they would determine how to best focus those resources. While this is still in the early concept phase, it's easy to envision that a community with a high rate of childhood obesity may allocate health dollars differently than a community with a high rate of alcohol and drug abuse. CCOs also could have as part of their charter that they support teams of health care and service providers who focus on the highest-need patients with chronic conditions to improve their health and lower costs.

The team that met over the past eight weeks did extraordinary work. Addressing the group Wednesday night, Governor Kitzhaber said that they had exceeded his expectations. And, as he said, this is also the first step. Now the plan will go to the Legislature for discussions about the best way to advance this work in the most effective and efficient way.

So although the work is not finished, we have moved forward considerably. The Transformation Team has created a workable foundation. I believe that Oregon is going to seize the opportunity before it and rebuild our health system for our most vulnerable citizens -- make it more responsive, more effective, more humane, and more affordable. That's work to be proud of.

Also, I want to send my deep gratitude to each and every person from our agency who worked tirelessly to support and enhance the Transformation Team's work. You, too, have helped create the foundation for a better future for Oregon.

OHA on the web