Advocates Insist Psychological and Social Factors Integral to Coordinated Care Organizations’ Goals
February 7, 2012—Legislation that would require coordinated care organizations (CCOs) to take into consideration psychological and social factors impacting a patient’s health received a lukewarm reception in the Senate’s Healthcare Committee yesterday afternoon.
Under Senate Bill 1522, these CCOs would have to incorporate goals related to the sociological and psychological challenges of their patients.
About 600,000 people on the Oregon Health Plan are expected to receive healthcare services under CCOs if legislators pass Senate Bill 1580 and state officials receive the necessary federal waivers.
The CCOs, which would start providing care by July at the very earliest, would integrate physical, mental and dental healthcare in an attempt to reduce overall costs and improve quality by focusing more attention on preventive services and keeping people out of hospital emergency rooms.
Craig Hostetler, the executive director of the Oregon Primary Care Association, argued that homelessness, substance abuse, being low-income and other sociological factors impact a person’s ability to not only seek healthcare, but actually become healthier as a result of accessing services.
“It does take time and resources [to provide care] to patients who have severe barriers,” to healthcare, Hostetler told legislators.
The current healthcare system is not good at providing services to “diabetics who are homeless and have substance abuse issues,” for example, he added, saying, unless legislators pass Senate Bill 1522, “there will be health disparities.”
This legislation is also extremely necessary because the current implementation proposal that will lead to the creation of CCOs does not detail how they’ll care for people who have non-medical challenges, said Kevin McChesney, the lobbyist for the Oregon Residential Providers Association.
“We feel that it’s important that the CCO’s outcomes reflect the special needs of these particular populations,” he said. “It’s crucial to controlling healthcare costs.”
The legislation appeared to have the support of the Senate Healthcare committee, with the exception of Sen. Alan Bates (D-Medford), who worried that, “While I agree with all that you’re saying here, I’m not sure I see the necessity of this.”
A similar argument, Bates said, could be made for other people on the Oregon Health Plan with special needs, such as diabetics and asthmatics. “The goal of the CCOs is to take care of these people. If the CCOs do what we expect them to do, I don’t think we need to call it out any more than we are.”
He also appeared hesitant to place too many requirements on CCOs as they begin providing services. “This just throws one more thing in the fire,” he said. “It’s not time to do that right now.”
Bates’ comments were odd given that Rep. Tim Freeman (R-Roseburg) and he spoke out last week, urging the Senate Healthcare Committee to adopt amendments to the implementation bill (Senate Bill 1509) and include specific criteria about the governing board of a CCO and ways to deal with dispute resolution. That bill, however, passed out of committee without those amendments.
Legislators will consider moving the bill out of committee and to a Senate floor vote on Monday.