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June 14, 2013 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

Next steps for coordinated care

"We are what we repeatedly do. Excellence, then, is not an act, but a habit." ~Aristotle

Oregon's coordinated care vision is pretty simple and it can be broken down into six basic concepts:

  1. Do what works. Use best practices.
  2. Have shared responsibility for health among providers, patients and the health plans.
  3. Measure performance.
  4. Pay for outcomes and health.
  5. Provide information so that patients and providers know price and quality.
  6. Maintain costs at a sustainable level.

This is the model that the coordinated care organizations are using.

The thing is, CCOs are in the same health care system as everybody else. So if this model works for them, it should work for others. And we believe it will.

That's why the Governor last week asked the Oregon Health Policy Board (OHPB) to start looking at how to align the coordinated care vision with the health plans that are offered by PEBB and OEBB, and also the commercial plans that will be offered through Cover Oregon.

At its heart, the vision of coordinated care is improving health and reducing the 30 percent waste and inefficiency in the health care system. Waste that drives up cost. Inefficiency that hurts our health. Imagine if that model was spread throughout the health care system and the difference it would make for patients and for us all.

As we work to learn more about how coordinated care can be used outside Medicaid, there is another health care front that must be addressed, and that's the cost of health insurance. While we are seeing promising signs through Cover Oregon that real competition lowers costs, there is more that can be done.

To that end, Governor Kitzhaber has asked the Health Policy Board to begin looking at ways to make health care more affordable and to increase overall transparency and accountability in the insurance industry. The Oregon Insurance Division has a public and thorough rate review process that requires insurance companies to justify every premium increase request. As part of this effort, the board will look for ways to build on that important work to provide more transparency and consumer protections.

It is exciting to be working in a state which recognizes that health happens outside the doctor's office, and that Medicaid doesn't operate in a vacuum. We all share the same health system, we all share the same costs one way or another, and we all share responsibility for our health and the health of our communities. This is a great next step.

OHA on the web