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Our View: Oregon seeks public input on health care

What should health care in Oregon look like?

Published on June 21, 2018 10:22AM

Family nurse practitioner Terrance James examines Kamiyan Cooper, 1, as his mother Kesha Wilson looks on, in 2012 at Multnomah County’s Mid County Health Center in Portland.

AP Photo/Rick Bowmer

Family nurse practitioner Terrance James examines Kamiyan Cooper, 1, as his mother Kesha Wilson looks on, in 2012 at Multnomah County’s Mid County Health Center in Portland.

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What should health care in Oregon look like?

The state’s top health official is traveling the state, asking that question at 10 public meetings. The responses will help shape health care for about one-fourth of Oregonians, those who are on the state Medicaid program known as the Oregon Health Plan. Many of those clients work at low-wage jobs that lack health insurance.

However, the question matters to all Oregonians. The answers will help determine how our state and federal tax dollars will be used and, over time, how private health care will adapt and mirror the innovations in the Oregon Health Plan. Such practices as developmental screenings for children can become the statewide norm when instituted for the health plan, according to Patrick Allen, director of the Oregon Health Authority.

Allen has substantially improved the management, responsiveness and transparency of the state health agency since taking charge last year. Now he is on the road to hear from Oregonians before his agency takes its next steps in transforming health care.

A public meeting in Astoria is scheduled for 11 a.m. to 1 p.m. June 27 at the Astoria Armory, 1636 Exchange St. Meetings also are set for Bend, Coos Bay, Corvallis, Hermiston, Hood River, Klamath Falls, Ontario, Portland and Springfield.

In 2012, Oregon took a bold step to improve health care and control costs.

Coordinated care organizations — now commonly referred to as CCOs — were established throughout the state to ensure that physical, mental and dental health care worked together for people on the Oregon Health Plan.

CCOs are to health care what a high-quality, lifetime bumper-to-bumper warranty is to auto maintenance.

Traditional health care is fee-for-service. Hospitals, physicians and other providers get paid according to the scope of care provided. (Fees can vary widely based on government programs, private insurance or out-of-pocket payments).

In contrast, CCOs receive a set amount of government money each month for Oregon Health Plan clients. The CCOs are responsible for all the patients’ care regardless of cost. Their financial incentive is to keep the patients healthy, thereby saving money — an incentive that can broaden how health care is delivered.

For example, consider a person with high blood pressure who forgets to take his medications and thus repeatedly winds up in the hospital emergency room. It makes more sense — financially, socially and psychologically — for a nurse to call or visit the patient each day to ensure he takes his medication.

Research indicates Oregon’s CCO model is effective but imperfect. Mental and dental health care are not as well-integrated into the holistic approach. CCOs have saved the state money, but health-care costs continue to grow faster than the overall economy.

State officials have dozens of ideas for improvement. But they want, and need, to hear what the public thinks.


On the Web


Provide feedback on direction of the Oregon Health Plan: bit.ly/future-of-coordinated-care



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