Legislators Face Timeline Crunch for OHP Transformation

After a meeting of governors from across the nation at the White House earlier this year, Kitzhaber said he believes the federal government intends to dramatically reduce Medicaid and Medicare spending.

 

“I believe they will be doing it in a budgetary context without a lot of consideration about what it means to the delivery system,” Kitzhaber told the Joint Special Committee on Health Care Transformation Wednesday afternoon.

 

“We have an opportunity to be architects in this state of what that new delivery model looks like, or we can be victims of the budget balancing frenzy that will consume large and partisan proportions at our nation’s capitol,” Kitzhaber said.

 

The newly-appointed legislative committee, which held its first meeting yesterday, is charged with creating a framework over the next five weeks for a system that coordinates care among physical health, mental health, chemical dependency and dental health providers. The 60,000 dual eligibles, those people enrolled in both Medicaid and Medicare, who drive 70 percent of the costs, will participate initially.  

 

Coordinated care organizations that could be run by existing Medicaid managed care plans or commercial insurance companies will operate under a global budget to foster innovation in primary care.

 

Once legislators approve the new concept, the state intends to apply for federal waivers with the goal of having a bid proposal readied by November, with an implementation date of July 2012.  

 

“We have a profound impact to really lead the way toward a more rational and cost-effective system that can work here and at the national level,” Kitzhaber said.

 

At the same time, the state faces a 39 percent shortfall in the budget for the Oregon Health Authority.

 

“Many people won’t like the changes we’re going to make,” said Sen. Alan Bates (D-Ashland). “But if those changes aren’t made, the system is going to collapse.”

 

Others questioned the limited time frame.

 

“This is such a broad effort compressed in such a short amount of time,” said Sen. Frank Morse (R-Albany) “We run the risk of not getting it right.”

 

Ktizhaber’s healthcare advisor, Mike Bonetto, assured legislators they wouldn’t have to redesign the healthcare delivery system in a little more than a month, but only create a framework that directs the Oregon Health Authority to move forward. Several federal waivers will be needed and lawmakers can sign off on the final legislation through the Emergency Board after the legislative session, Bonetto promised.

 

Contentious issues still remain unresolved such as whether to include tort liability protection for physicians  who provide care through these coordinated care organizations, which could bare increased risk if their treatment options are limited under restrictive budgets.

 

“To go down this way in capping managed care under the tort system we have I think is irresponsible on our part,” Morse said.

 

 

For a preliminary discussion draft of proposed legislation click here.