The Legislature signed off last month on a plan to create regional "coordinated-care organizations" responsible for patients on the Oregon Health Plan, the state's version of Medicaid, a health plan for low-income patients funded by the state and federal governents.
The coordinated-care organizations will be charged with integrating mental health and medical care, which are currently fractured into separate systems with minimal communication. The CCOs will be paid a fixed price for each patient, rather than a fee for each service they provide.
Kitzhaber, who is a physician, and other proponents hope the model will create financial incentives to invest in preventive care, community health workers and other ways to keep patients healthy and away from expensive emergency rooms. They're especially interested in improving the management of chronic conditions like diabetes and asthma to reduce hospitalizations. Opponents worry the government will have too much control over healthcare.
The plan envisions a significant restructuring of the health industry that, in some cases, changes the business model for care providers or encourages longtime competitors to work together. The documents due April 2, set to be released publicly the next day, are likely to show how health companies are lining up in the delicate dance, and also could expose any fissures between them.
"It is an important milestone in creating the coordinated-care organizations to better serve the state," said Patty Wentz, a spokeswoman for the Oregon Health Authority. "It's also going to be important to the local communities, to see who's working to become a coordinated-care organization."
Progress varies widely around the state, and so does the level of agreement about the best way forward.
A group of nine organizations in the Roseburg area—including an independent physicians group, mental health providers, the hospital and the county—announced weeks ago that they'd agreed to apply to be a CCO for Douglas County, the first organization to do so.
"This is a bit daunting. It's a small town, and for us to be doing this we feel we're really on the leading edge," Dr. Bob Dannenhoffer, the chief executive of the local physicians group who has been active in the work, said recently. "We're doing this with a little bit of trepidation but a lot of hope."