Friday, October 28, 2011

Oregon's leaders hope a new medical model will help people with limited access to care

Oregon's governor and legislators hope the state will become the latest national model for health-care reform after they start "coordinated care organizations" that will resemble the old medical model of doctors treating people in their homes. The program would help people with limited access to care, such as elderly and rural residents and Medicaid beneficiaries. Gov. John Kitzhaber signed legislation to start the program in June and said national health  reform doesn't go far enough: "Expanding coverage to give more people access without changing the system people have access to will only serve to increase cost and expand national debt."

Christine Vestal of reports that coordinated care organizations would establish local health-care teams to combine medical and dental services with behavioral-health and substance-abuse services. Preventive care will be offered and those on Medicaid will get help navigating the system. Services provided will be varied and include everything from giving young pregnant women rides to receive prenatal care, translating for non-English speakers, and providing depression counseling.

All services will be provided to people under a fixed fee per customer. The groups will be licensed and monitored by the state, but governed by a local board containing health care providers, consumers and local government officials. Kitzhaber told Vestal that even though the program seems expensive, it will actually save the state "a considerable amount of money" because patients will be healthier and need less care and it will be more efficient.

The program will provide care to Medicaid beneficiaries first, then teachers and state employees. Universities and small businesses may join the program later. Vestal reports the plan's backers hope the program will eventually be able to provide care to anyone who wants it. To reach that point, the viability of the plan will be tested by measures of whether or not coordinated care organizations improve health outcomes, save money and please consumers. Right now, the plan has unanimous support in the Oregon legislature. The state is awaiting federal waivers needed to implement it. (Read more)

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