Changes will transform our health care system
- John Kitzhaber
- Portland Tribune - Opinion
My View • Oregon shouldn't let this historic opportunity for better care slip away
When Ted Hanberg landed in the hospital in March, it was par for the course. After all, he suffered from several chronic illnesses - including diabetes, kidney disease and congestive heart failure - and even with the 13 medications he takes daily and the in-home care he receives from his family - he had already been hospitalized three times during the preceding three months, with each stay lasting six days or more.
About 80 percent of health care costs come from treating chronic conditions like Hanberg's - often in expensive hospital settings - even though such conditions can be managed more effectively and at a lower cost at home and in the community.
Yet this kind of after-the-fact acute care is the standard in our current system, costing the state hundreds of millions of dollars a year without improving the health of Oregonians.
This explains why health care is becoming less affordable for all of us and eating up more of the state's budget.
Fortunately, there is a better way to deliver health care - and Oregon has an historic opportunity this legislative session to begin to transform our system into one that improves the health of Oregonians, at a lower cost and without sacrificing quality.
This will require two things: first, creating an insurance marketplace (or 'exchange') to ensure that all Oregonians have access to affordable care; and, second, by changing the way care is organized and delivered to focus on prevention, wellness and community- based management of chronic conditions.
Senate Bill 99 (which creates Oregon's insurance exchange) and House Bill 3650 (which transforms the health care delivery system) will help move Oregon toward a more affordable, sustainable and patient-centered model of health care. By creating community-based organizations that coordinate and integrate the delivery of mental, physical and oral health services we can ensure that Oregonians are getting basic preventive care and appropriate in-home management of chronic conditions instead of waiting for them to show up in the emergency room for far more costly acute services.
This, in turn, can drastically reduce waste and inefficiency, provide a higher quality of care with better health outcomes and at a lower cost.
Within our reach
Ted Hanberg is one of many patients across our state proving just how effective coordinated care can be. When he left the hospital after his fourth stay in three months, he started working with a new health team through a community-based organization to manage his chronic conditions.
He was matched up with a nurse who acts as his case manager and coordinates his care with doctors and other providers; and he started seeing his primary care doctor weekly. He also calls his case manager once a week to report his blood pressure, weight and any health changes; and in an emergency he pages his team instead of automatically heading to the emergency room.
The result? Since he started his coordinated care program Hanberg has seen 'care' put back into his health care; his health has improved; he has stayed out of the hospital for three months. This coordinated care model will not only make Hanberg healthier and immeasurably improve his (and his family's) quality of life - it will save the state of Oregon tens of thousands of dollars.
But passing SB 99 and HB 3650 is just the first step. During the next six months we will need hospitals, physicians and other care providers, consumers, employers and insurers to come together and think creatively about how we can further improve the way we do business when it comes to health care. But just imagine the difference it will make in the lives of Oregonians - and for our state - if we can successfully create a system that actually improves the health of our people at a lower cost.
That is our goal and it is now within our reach.
John Kitzhaber is Oregon's governor.