Legislators Weigh in on Business Plan for Healthcare Transformation
December 15, 2011—Getting legislative approval for a business plan that sets the course for transforming the Oregon Health Plan may not come down to simply a yes or no vote, according to Sen. Alan Bates (D-Ashland) and Rep. Tim Freeman (R-Roseburg), who appeared before the Oregon Health Policy Board on Tuesday.
For example, legislators could require the Oregon Health Authority to come before its Emergency Board to provide updates. That board, comprised of 20 representatives and senators, meets while the Legislature is not in session and often deals with budgetary issues. Legislators could also decide not to release funding for these CCOs until certain conditions are met.
“We will do the work necessary to move the process forward,” Freeman said, adding that the Legislature needs to feel “comfortable” when it approves the business plan.
The Legislature must approve the business plan—which will define a coordinated care organization (CCO) and how it will integrate physical, mental and dental healthcare—during its February session. Once that plan is approved, the Oregon Health Authority will seek federal waivers, and begin soliciting proposals from healthcare provider groups and insurers. These CCOs are expected to become operational in July.
Freeman and Bates anticipate the Legislature will give the go-ahead in February, particularly because of the projected $239 million savings for the Oregon Health Plan next fiscal year.
“I think we will be giving [the Oregon Health Policy Board] broad authority to move forward,” Bates told the Health Policy Board.
Freeman said it’s essential that the business plan have bipartisan support, given the 30-30 Democratic and Republican split in the House, and the Democrats razor thin majority in the Senate. Freeman and Bates are not sure that the business plan will have the same bipartisan support House Bill 3650 had when it passed the Legislature earlier this year. It passed the Senate unanimously, and only one House representative voted against it.
There’s tremendous support around the state for transformation, but keeping legislators engaged in the process is critical, Freeman told the board, so they don’t put the brakes on.
Bates said it will be important to have a “fast track” and a “slow track” for organizations interested in becoming CCOs. “If we don’t have the ability to move these forward quickly, we’re going to have some real problems,” Bates said.
In his testimony, Freeman was fairly explicit when explaining what he expects to see in the business plan. “It’s important that we start talking about examples,” he said.
When it comes to the governance board for CCOs, Freeman believes at least two people should be community members, and said that each CCO should be required to have a community advisory council. “Key to making this successful is that those people receiving care have a voice in how that care is delivered,” he said.
That council should have representation from county and local government, as well as consumers who may not be on the Oregon Health Plan. “There might be a role for people who are taxpayers,” he said.
And, that council should have regular, public meetings, create a wellness plan to “tell CCOs how well [it’s] programs will work,” and develop an annual “Health of the CCO” report
The overall business plan for these CCOs shouldn’t be too prescriptive and have too many requirements, Freeman added. “It’s got to be developed from the community.”
The criteria “should be broad enough that they cover all CCOs, but not narrow enough that they’re not meaningful,” Bates said.
“I’m optimistic we’re on similar paths,” the board’s chair, Eric Parsons, told the legislators.
Next Tuesday, December 20, the House and Senate healthcare committees are expected to review the draft business plan.