Faced with a state budget deficit and 400,000 new patients projected to enroll in expanded Medicaid in Oregon by 2022, Oregon Governor Kitzhaber arranged a deal with the Obama Administration for $1.9 billion in federal funding over five years, with the requirement that Oregon’s expanded Medicaid program expenditures must grow at a rate that is 2% slower than the rest of the country, while maintaining high-quality care. If successful, the program will generate $11 billion savings within the next ten years; if it fails, federal funding would be withdrawn.

CCOs Provide Smarter Less Expensive Care

Rather than using old cost saving methods of cutting people from coverage, cutting payment rates, or cutting benefits to manage health care costs, the new model is high-quality health care that is smarter and less expensive. To achieve this, 15 coordinated care organizations (CCOs) are now operating in communities around Oregon, and are accountable for health outcomes of the people they serve.

A Network of Health Care Professionals

A coordinated care organization is a network of health care providers who work together to serve people in their local community who receive health care coverage under the Oregon Health Plan (Medicaid). The goal of a CCO is higher-quality care that leads to better outcomes, all delivered at a lower cost. CCOs are focused on prevention and helping people manage chronic conditions, to reduce unnecessary emergency room visits. They are required to meet quality standards or “metrics” that are posted publicly four times a year.

Governor Kitzhaber estimates that, if every state cut its Medicaid costs as Oregon plans to, the federal government would save $1.5 trillion.

In 2014, there are 15 CCOs operating in communities around Oregon. For information about enrollment in the Oregon Health Plan and to find coordinated care organizations located throughout the state, visit: https://www.oregon.gov/oha/hsd/ohp/pages/index.aspx.

Author: Rizk Law

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