Oregon health reforms proceeding as issues arise, lawmakers told

By Nick Budnick, The Oregonian

A top state health administrator told lawmakers Thursday that reform of the state's Oregon Health Plan is proceeding quickly but not without issues, while some lawmakers questioned whether it is moving quickly enough.

In laws passed in 2011 and 2012, lawmakers approved new provider organizations called coordinated care groups to rein the growth of state Medicaid spending. Since August, 13 of these groups have started up and three more are awaiting approval, meaning about 75 percent of the health plan's 650,000 members will be enrolled, Bruce Goldberg, director of the Oregon Health Authority, said in a joint meeting of the state Senate and House health care committees.

"I wouldn't say there's been absolutely no problems," Goldberg said. "There always are some issues."

Among the issues, according to Goldberg and lawmakers: ensuring enough primary care providers in rural areas, as well as complaints from dental care groups, chiropractors, naturopathic doctors and other practitioners that say they're being shut out of the new care groups.

The state is setting up rules and a process to mediate such disputes, said Goldberg: "We are working through these issues."

State Rep. Mitch Greenlick, D-Portland, said his impression is the new groups are not much different from the managed care organizations they replaced, that it's "business as usual."

Goldberg disagreed, saying conversations are well under way and providers seem committed to change. But he said it could take time before cost-cutting efforts start bearing fruit.

More
Continuing coverage of efforts to reform health care in Oregon.
Another topic was plans to track performance measures to ensure the new care groups improve care starting in November. Sen. Alan Bates, D- Ashland, questioned whether that is too soon for the new system. "Can we get some breathing room here?"

Goldberg said, however, the quality measurements are a priority for federal regulators. The federal government has promised to fund the reforms with $1.9 billion over the first five years. "I don't think we're going to get any leeway," he said.

Sen. Chip Shields, D-Portland, asked when the new groups' boards would be required to hold public meetings, saying he's heard complaints of secrecy in the Portland area. "This is billions of dollars in state money," he said.

Goldberg replied that while he agrees transparency is important, there is no plan for the groups' boards to meet publicly. "These CCOs are not public bodies."

Rep. Jason Conger, R-Bend, asked about progress in enrolling people into the new care groups who had not been enrolled before. Goldberg responded that the state is negotiating with the care groups over how much the new enrollees will cost, and how much risk the state will bear if costs exceed projections.

 -– Nick Budnick