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For the past few years, I have traveled around the state to speak with our community partners about health system transformation. As I listened to what behavioral health providers had to say, it became clear that one of the most important things we need to do for successful health reform is to get out of the way and let providers do their work.
Just last week I heard a story about a woman who was seeking help for problem gambling. She had already completed 30 pages of personal history before she ever sat down with her provider. Then she spent the first 30 minutes of her visit signing paperwork and the next hour and a half going over with her provider the information she had already put in the paperwork. I can only imagine how frustrating this experience must have been, and it's simply not acceptable. We need to streamline our business processes so providers spend less time cutting through red tape and more time helping people get well.
That's why the Oregon Health Authority has convened a workgroup to conduct a thorough review and revision of the Integrated Services and Supports Rule (ISSR), which governs certification, licensing and billing standards for addiction and mental health services. Comprising representatives from coordinated care organizations, community mental health programs and service providers as well as staff from AMH, this workgroup is tasked with aligning ISSR with Oregon's new vision for health care.
I have asked the group to be comprehensive and thorough with its revisions, but to also work quickly and have its work completed by the first of the year. It's imperative that we get this work done now, because it will be critical for the success of our health reforms.
The original rules were written in a time when providers were paid by the number of services delivered. But these rules don't make sense any longer, particularly when we are working to integrate physical and behavioral health care. As such, we need to replace the old quantity-driven system with a new system – based on quality and health outcomes – that supports true integration of care. More than a set of rules, we need to create a delivery system that encourages and supports better health and better care, in which providers can spend more time taking care of people and less time on paperwork.
As we move toward integrated behavioral and physical health care, this work is even more important. Undiagnosed and undertreated mental health and addiction problems drive up health care costs, and we need to address these at the start. The key is to revise these rules and bring balance to the delivery system. The workgroup has my full support and dedication to do whatever is necessary as it completes this essential step toward reaching our goals of better health, better care and lower costs.
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