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State health care reforms showing results

By Rep. Brad Witt, D-Clatskanie


As you know, one of the state’s main responsibilities, along with education and public safety, is human services. Under this huge umbrella is health care.

(Image is Clickable Link) Rep. Brad Witt Every session, we see bills introduced to try and make the health care system more accessible, affordable and appropriate. This session, we again have some interesting bills to consider, several of which follow, but before we discuss the new, I’d like to update you on the remarkable journey that Oregon embarked upon back in 2011, when a team of people devoted eight weeks of their life to designing a health care delivery system that would provide care to Medicaid recipients in a more cost-effective manner.

This new delivery system was called a Coordinated Care Organization (CCOs).  

A coordinated care organization is a network of all types of health care providers — physical health care, addictions and mental health care and sometimes dental care providers — who have agreed to work together in their local communities to serve people who receive health care coverage under the Oregon Health Plan — Medicaid. CCOs are focused on prevention and helping people manage chronic conditions, like diabetes. This helps reduce unnecessary emergency room visits and gives people support to be healthy. CCOs are locally governed networks that fundamentally change the way health care is delivered and paid for, making it a more accountable, effective and cooperative venture.  

So now, almost three years later, how are we doing?

We currently have 16 CCOs operating across the state, and the 2014 Mid-Year Performance Report is both enlightening and encouraging. Approximately 990,000 Oregonians are now enrolled in the Oregon Health Plan and the coordinated care model continues to show improvements in a number of areas. Here, based on 2011 benchmarks, are just a few examples:

n Decreased emergency department visits — down 21 percent 

n Decreased hospital admissions for short-term complications from diabetes — down 9.3 percent

n Decreased rate of hospital admission for chronic obstructive pulmonary disease — down 48 percent

In District 31, Columbia Pacific CCO serves Columbia County, as well as Clatsop and Tillamook counties. Because we do not have a hospital, our members spend less on physicians and professional services and more on outpatient hospital care.

At 8 percent of all healthcare spending, our CCO’s emergency room costs were higher than the 4.4 percent state average. Even at that, Columbia Pacific, as well as all CCOs in the state, are managing to reduce costs and still operate in the black. And twice per year, the Oregon Health Authority publishes a report showing quality and access data, financial data, and progress toward reaching certain benchmarks.  

There are more good ideas brewing. This session, several bills have been introduced to improve services and address specific areas of concern. Here are three that I felt you would like to know about:

n SB 663 and HB 3100 These two bills, generated by a public health task force, lay out a 10-year plan for fundamental changes to our public health system. Counties provide these services now, but much of their funding comes from federal grants, which are not always available or dependable. CCOs may be able to pick up some of the clinical services, but a redesign of this important local service will depend on increased state funding.

n HB 2300 Tagged the “Right-To-Try” bill, this measure would allow patients with terminal illnesses to use drugs that have not yet been approved by the US Food & Drug Administration. Providers and insurers would be protected from liability, and the drugs must have passed at least the first phase of testing to insure they are not toxic.

n HB 3301 Insurance coverage varies widely for naturopathic care, even though some clinics use them interchangeably with nurse practitioners. Patients are often made to pay a deductible or a higher copay because they are considered a “specialty.” This bill would allow Naturopathic physicians to be classified as primary care providers.  

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