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HEALTH CARE REFORM SUCCESS — IN MEDICAID, IN OREGON

 

[PERSPECTIVE FROM THE 19TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was a reporter for the Daily Astorian (in Astoria, Oregon) and I went on from there to practice writing in all of my professional positions, including as an Oregon state government manager and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing pubic policy – to what I write. If you are reading this, thanks for doing so and please don’t hesitate to respond so we can engage in a dialogue, not just a monologue.]

Given all of the controversy over health care reform, one key fact has tended to escape much attention lately.

It is this: Health care reform is working in Oregon, at least in terms of the state’s participation in the Medicaid program, the joint state-federal program that serves low income Oregonians.

There may be continuing tension over the operation of a health insurance exchange in Oregon, with the legislature’s decision, in the aftermath of the controversy over former Governor John Kitzhaber, to scrap Cover Oregon and turn responsibility for the exchange over to the Department of Consumer and Business Services.

Of course, the recent U.S. Supreme Court decision only adds to the tension as the Court, in a ruling that caught many observers by surprise, decided that four words in the national health care law (“established by the state,” as in health insurance exchanges established by states that would yield approval for federal tax credits) didn’t mean much.

So be it, I guess.

But should be no controversy over the Medicaid program here.

To verify this, I give you a piece written by Oregon’s Health Authority (OHA) Director Lynne Saxton in a message to all OHA employees. It should be added that Lynne is a great friend of mine as we forged a friendship as I represented her former employer, Youth Villages-Oregon, over a number of years.

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Measuring success through positive outcomes
Last month, we released the 2014 Health System Transformation report that lays out the progress of Oregon’s coordinated care organizations (CCOs) on key quality and financial measures. More than 434,000 Oregonians have enrolled in the Oregon Health Plan since January 1, 2014, and the coordinated care model continues to show improvements to Oregonians’ care for the second straight year. We know where the future challenges lie, and are focused on addressing these transformation issues.The report shows improvement in several areas including decreased emergency department visits, decreased hospital admissions for short-term complications from diabetes, decreased rate of hospital admissions for chronic obstructive pulmonary disease and an increase in patient-centered primary care home (PCPCH) enrollment. But there are areas for improvement as well, including the rates of cervical cancer and chlamydia screenings for women.

Metrics are the best way to keep us accountable for the work we do and the outcomes we strive for. Having measurable goals focuses our efforts and determines our success. Last month, we also posted the CCO financial reports for 2014. CCOs are continuing to hold down costs. Oregon is staying within the budget that meets its commitment to the Centers for Medicare and Medicaid Services to reduce the growth in spending by 2 percentage points per member, per year. We are required to stay within a 3.4 percent growth rate and we are meeting that requirement. (The national growth rate from fiscal 2010 to 2013 was 4 percent. Some states including California (13.7 percent) and Indiana (10.7 percent) saw double-digit growth during those years, according to CMS data analyzed by the Kaiser Family Foundation.)

As we continue our internal work of aligning our divisions to reflect health system transformation, these reports remind us the coordinated care model is helping us achieve the triple aim of better health, better care and lower costs. Oregon’s health system is continuing to improve care for the nearly 1.1 million Oregonians who need it most. Thank you for the part you play in our collected efforts.

Before she took over as OHA director, Lynne established solid track record at a major Oregon non-profit organization, Youth Villages-Oregon, that serves at risk children and their families. At Youth Villages, she placed substantial on producing outcomes – success in the services for children that could be measured six, 12 and 18 months after discharge. The rate of positive outcomes was greater than 80 per cent.

Now, in her new roll for the State of Oregon, Lynne is leading her staff to emphasize outcomes again and there is no better record that what is happening with the state’s Medicaid program.

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