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

MAY 9, 2012

In this month's edition of Health News from OHA and OHPB:
Governor John Kitzhaber and Obama Administration announce agreement to improve care for Oregonians on Medicaid
Coordinated Care Organizations: Technical applications submitted for first wave
Rules Advisory Committee (RAC) to meet in May
Uncoordinated care harms patients, costs more
For up-to-date CCO community meetings, materials, and stories, go to…
In the news

Governor John Kitzhaber and Obama Administration announce agreement to improve care for Oregonians on Medicaid

The agreement between Governor Kitzhaber and the Obama Administration will help Oregon launch Coordinated Care Organizations across the state, bringing better care and better health at a lower cost to Oregonians. Estimates show that CCOs will save Oregon and the federal government $11 billion over the next decade. The new model of care aims to reduce the cost trend in Oregon's Medicaid program by at least two percentage points within two years while improving health outcomes.

The U.S. Department of Health and Human Services (HHS) gave preliminary approval to a five-year, $1.9 billion demonstration of a federal-state partnership to transform the way that care is delivered in Oregon's Medicaid program. The initial investment of $620 million in the second year of the state's current biennium will allow Oregon's new care organizations to better deliver higher-quality, coordinated care for Medicaid patients while reducing preventable errors.

"This is a defining moment for health care transformation in Oregon, and the Obama Administration is a true partner in our efforts to reduce health care costs while improving care," said Governor John Kitzhaber. "With unprecedented collaboration between local communities, health care providers and our federal partners, Oregon is on the right track to create a system that will both improve care and reduce costs."

Read Governor Kitzhaber's full press release.

Coordinated Care Organizations: Technical applications submitted for first wave

Oregon made another big step in its CCO implementation efforts last week. Fourteen Oregon-based entities submitted the technical application to become a CCO by the April 30 deadline. If all were approved, more than 90 percent of OHP clients would have access to care through a CCO. You can see a list of CCO Applicant names on OHA's website and the technical applications will be available online shortly. OHA will be spending the next several weeks reviewing the applications and the first CCOs will be certified May 28.

The deadline for prospective CCOs to submit the second part of the application, the financial application, is May 14.

Rules Advisory Committee (RAC) to meet in May

The RAC will meet four times in May to adopt administrative rules that will establish requirements for CCOs.

The committee, composed of 29 members representing a broad spectrum of health care providers, activists, and partners, was selected by Oregon Health Authority Director Bruce Goldberg, M.D. RAC will meet May 10, 14, 16 and 18.

Go to health.oregon.gov for more information on the Temporary CCO Administrative Rules and the upcoming Rules Advisory Committee meetings.

Uncoordinated care harms patients, costs more

Bart Clifford's story makes a compelling case for prevention: for lack of a new $57 shower chair, Clifford suffered an injury and infection that put him in the hospital for months, required multiple surgeries and skin grafts, and ran up more than $2 million in medical costs.

Shower chairs usually last two years, but Clifford's chair bent and cracked after 18 months. His application for a new one was rejected by his health plan, which covered replacement chairs only every two years. Clifford, a paraplegic, continued to use his broken chair, which caused a cut in his groin. Because of his lack of sensation below the waist, Clifford did not realize the severity of the cut, which became infected. By the time he landed in the hospital, the infection was a life-threatening gangrene. He underwent several abdominal surgeries, a colostomy and skin grafts on his buttocks.

Clifford's is an extreme version of an all-too-common story in the medical field in which we refuse to pay a little upfront and end up paying a lot more later. Coordinated Care Organizations will aim to eliminate that practice. You can read Clifford's story and many more in the OHA Newsroom.

For up-to-date CCO community meetings, materials, and stories, go to…

The best way to find all the most up-to-date information on Oregon's transition to Coordinated Care Organizations is through our website, health.oregon.gov. The site contains CCO fact sheets, dates of upcoming CCO community meetings around the state, implementation timelines, client and provider information, and much more. You can also find stories about how coordinated health care has already helped real Oregonians across the state.

In the news

The Oregonian
A healthy victory for Oregon
Governor John Kitzhaber and OHA Director Bruce Goldberg had a successful week in Washington D.C., "but the big winners in this are all Oregonians."

The Wall Street Journal
Oregon gets extra funds to test new Medicaid method
The federal government has backed Oregon in a plan that Oregon believes will cut health care costs by two percentage points in two years, while improving outcomes.

With federal money, Oregon kicks health care reform into high gear (video)
Oregon's new model of care could lead the way for other states by improving care while lowering costs.

The Register-Guard
Here come the CCOs Oregon is setting up health care ‘pit crews'
Dr. Atul Gawande spoke to a group of physicians and policy makers in Eugene last month to discuss the potential benefits of CCOs.

OHPB's next meeting

Thursday, May 24
8:00 a.m. to 5:00 p.m.
Keizer Heritage Center
980 Chemawa Rd. NE, Keizer

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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.