Oregon Health Authority Health News | Updates from the Oregon Health Policy Board

JANUARY 12, 2012

In this month's edition of Health News from OHA and OHPB:
Coordinated Care Organizations will lead to significant cost reductions
Momentum building toward Coordinated Care Organizations
Public input and timeline
Primary care homes at center of Oregon health reform
Coordinated care improves quality of life for one young Oregonian
In the news

Coordinated Care Organizations will lead to significant cost reductions

Estimates show that, pending final approval by lawmakers in February, CCOs could reduce costs in Medicaid by more than $1 billion in state and federal funds over the next three years and more than $3 billion over five years, according to financial projections presented to the Oregon Health Policy Board this week. If local communities move to the coordinated care model faster, the cost reductions to the state would come earlier.

The analysis by Health Management Associates projects potential savings in six areas:

  • Improved management of the population
  • Integration of physical and mental health
  • Implementation of the mental health preferred drug list
  • Increased payment recovery efforts
  • Patient-centered primary care homes
  • Administrative savings from Managed Care Organizations' reductions

In a statement about the projections, Governor Kitzhaber said, "Coordinated Care Organizations give local health systems the tools they need to shift the focus from the emergency room and acute care to prevention, early intervention and chronic disease management. With bold movement forward we will get improved health and the cost reductions that we know will follow. Next month we will send the implementation plan to the Legislature, and upon approval, we will be ready to move quickly to make this vision a reality."

As established with bi-partisan support in 2011, CCOs are local health entities that deliver health care and coverage for people eligible for Medicaid. CCOs have a single point of accountability for health outcomes and have one budget for mental, physical and ultimately dental care.

A summary of the analysis can be found in Draft Two of the CCO Implementation Proposal.

Momentum building toward Coordinated Care Organizations

This week the board also heard a presentation from the Tri-County Medicaid Collaborative, which brings together CareOregon, Clackamas County, Kaiser Permanente, Legacy Health, Metro Area Community Health Centers, Multnomah County, Oregon Health & Science University, Providence Health & Services and Washington County. Together these public and private health partners are designing a Coordinated Care Organization to provide better physical, behavioral and dental health care for more than 200,000 people in the tri-county region – home to some 35 to 40 percent of state's Medicaid/OHP clients plus thousands of uninsured people.

Since the passage of HB 3650, health system representatives from Lane County, Southern Oregon and Central Oregon have also presented to the board about their efforts to work in new kinds of partnerships under Coordinated Care Organizations. New estimates of huge long-term savings give added momentum to Oregon's proposal to transform health care for more than 600,000 Oregonians by improving quality and lowering costs.

Public input and timeline

On January 24, the Oregon Health Policy Board will hold a special meeting to put the finishing touches on the CCO Implementation Proposal. The board will deliver the proposal to the Legislature on Feb. 1, 2012.

Public input on the proposal is being collected between now and January 18, and will be sent to board members and Oregon Health Authority staff for their review.

For everything health transformation-related, go to health.oregon.gov.

Primary care homes at center of Oregon health reform

Patient-centered primary care homes offer a team-based approach to care focused on keeping people healthy. At its heart, this model of care focuses on a team-based approach that creates strong relationships with patients and their families to treat the whole person. This allows providers to catch problems earlier, focus on prevention and wellness, integrate behavioral health care and reduce costs.

Across the state, practices have been adopting the primary care home model and more than 80 clinics have already applied to be officially recognized through a state program. The first recognized practice in Oregon was Mountainview Family Practice in Grants Pass.

"We saw the opportunity to become recognized for the way we already practice medicine," said Richard Williams, M.D., a family physician in the clinic. "For example, we coordinate care by having a mental health professional come once a week to meet with patients."

Any type of provider can apply to be recognized as a patient-centered primary care home. In addition, this kind of primary care is central to the state's efforts to improve quality and lower costs for people served by the Oregon Health Plan. Under proposed Coordinated Care Organizations, patient-centered primary care homes will be a required element of any health systems provider network.

Criteria, application forms and technical assistance are available online at primarycarehome.oregon.gov.

Coordinated care improves quality of life for one young Oregonian

Malik Wilkerson, an 8-year-old third-grader, used to have to go to the emergency room once or twice a month for asthma attacks – a hospital visit that costs an average of $12,000. Today, that almost never happens. The primary care team at Multnomah County's Northeast Health Center has helped Malik bring his asthma under control and drastically reduce his trips to the hospital. The new coordinated approach involves reduced exposure to household asthma "triggers"; a home nebulizer to convert his medication into a quicker-acting mist; and a portable mini-inhaler to help him overcome wheezing attacks at school or on the playground.

Read more about Malik and find other stories about how we can better coordinate care in the OHA Newsroom.

OHPB's next meeting

Tuesday, January 24, 8:30 a.m. to noon. Visit the board's website for Portland location and directions.

In the news

OPB News
Consultant: Oregon's Health Care Revamp Saves Money Down The Road

KTVZ-Central Oregon
Oregon Health Plan Changes

Statesman Journal
Consultant shares financial projections analysis with Ore. Health Authority

Statesman Journal
Health care reform is working in Oregon

Stay involved!

Connect with us: Use Facebook.com/OregonHealthAuthority and Twitter.com/OHAOregon to find out about OHA events, public input opportunities, transition updates, and federal and state health reform news.

Send input and comments to OHPB at ohpb.info@state.or.us
View calendar of health reform meetings

OHA logo The Oregon Health Authority is overseen by the nine-member citizen Oregon Health Policy Board working toward comprehensive health and health care reform in our state.