Oregon's health care system is at a crossroads, facing a series of challenges and lofty goals.
The state is facing a behavioral health crisis, made worse by a lack of qualified health care providers to treat people. The health care system is complex and access to services, whether primary care or drug addiction treatment, is difficult for vulnerable people on the margins of society. And the Oregon Health Authority and state leaders hope to eliminate health care inequities in six years.
At a forum in Portland on Wednesday, Oregon health leaders said the state has an opportunity to improve the system and should look for ways to make significant changes rather than accept the status quo. Stated. Approximately 300 people attended the event. oregon health foruma non-profit organization and its affiliates. lund report, a news organization covering the healthcare industry. The event was moderated by Emily Harris, journalist and senior advisor to the Oregon Health Forum.
The panelists are: Oregon Health Authority Director Dr. Sejal Hati; Former Governor John Kitzhaver. Rep. Rob Nosse, D-Portland. Dr. Bruce Goldberg, former health authority director; Mary Monat, president and CEO of LifeWorks NW, which provides mental health and addiction treatment in the Portland area.
The Oregon Health Plan is a Medicaid-funded program that provides coverage to more than 1 million low-income Oregonians and plays a critical role in the state's goal of improving care for Oregonians. The plan provides free medical, dental, and behavioral health care to Oregonians through a network of 16 coordinated care agencies that contract with the state and provide coverage to people through a network of regional providers.
The state is currently planning changes to the next version of its affiliated health care provider contracts, which are expected to go into effect in 2027. For Oregonians, this change could determine how health care providers and insurance companies invest in the communities they serve and how they deliver health care. For Oregonians, how do we direct people to other services that improve their overall health, like housing assistance?
As this work progresses, the Oregon Health Authority is committed to eliminating health disparities by 2030 so that people of different communities and races are no longer disproportionately affected by poor health and access to health care providers. The aims. Oregon Health Authority Director Hattie said the Oregon Health Authority plans to release a strategic plan in June charting a path to that goal and other innovations, which experts say will help the state move toward Medicaid federal and states that it is a feature of the use of state funds.
“We know it's a mission,” Hattie said. “I know it’s ambitious, but it’s a goal we absolutely have to set and if we work together we can definitely achieve it.”
Hattie said authorities and health systems cannot achieve the goal of eliminating health disparities alone. Other partners will also need to support, she says, such as academia and the business sector.
Panelists call for reduction in bureaucracy
For the average Oregonian, coordinated care organizations are a hidden, behind-the-scenes part of the health care system. But they have access to millions of dollars and the ability to put money into community projects that support the overall health of Oregonians.
Oregon received permission from the federal government to organize its state Medicaid system under the Oregon Health Plan and to organize one or more affiliated health care organizations to serve patients in each region. Kitzhaber, a former emergency room physician, founded the organization with Goldberg and others in the belief that local organizations are best able to control costs and improve health outcomes for people in their communities. I led the way.
Kitzhaber said that over time, regulations have become tighter and the relationship between states and coordinating health care organizations has become a top-down, intransigent, and sometimes adversarial relationship rather than a partnership for the most effective innovations. Stated.
“I think we need to figure out how to strike a balance” between regulation and flexibility, he said.
Hattie agreed, saying current administrative requirements are a burden not only to Medicaid insurers but also to local public health officials and other health departments.
“We need to do more distillation and consolidation to stop the cascading of administrative burdens and get these communities all rowing in the same direction,” Hattie said.
Nosse, who chairs the state House Health Care Committee, has listened to hearings of complaints from leaders of coordinated care organizations. He said frustrations could be alleviated if the state could cut down on paperwork and red tape.
“If we can reduce that a little bit, we have a better chance of providing care and doing what we actually want the model to do,” Nosse said. “Someone's really important report is someone else's really stupid.”
Employee challenges
Panelists also said limited behavioral health personnel make it difficult to get programs up and running even with increased state funding.
Goldberg, a former health authority director, said the wait times for people to access mental health care are significantly different compared to other medical issues.
“If you come to a hospital emergency room with a heart attack, you can be treated within three minutes,” he says.
But if you go to the emergency room with a mental health problem, you may be able to receive treatment within a week to a year, he said.
Panelists also recommended that Oregon consider drastic ways to transform its system. Goldberg proposed that the state provide financial incentives to recognize coordinated care organizations that provide mental health and addiction care within 24 hours.
The state currently has a program that awards insurers based on improved health outcomes in about a dozen areas, including health assessments, dental care and high blood pressure treatment. Goldberg suggested narrowing the list down to one thing: indicators of timely mental health and addiction treatment.
The crowd applauded.
“Maybe we can actually start to move the needle,” Goldberg said. “It’s not going to happen overnight, but we have no responsibility for who does it.”
Another idea is to increase incentives to get people into the behavioral health field. Mona, president and CEO of LifeWorks NW, proposed that the state pay for people to attend school so they don't need student loans. According to Monna, LifeWorks NW currently has about 100 job openings.
Hattie said the $1.5 billion the state has invested in behavioral health over the past four years is impressive, but “it's a drop in the bucket.”
“At the end of the day, you can't just throw darts at a board and hope you find a cure-all,” Hattie said. “We need a real vision and strategy for how to transform the system.”
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