The director of the Oregon Health Authority, Patrick Allen, just finished a 2,000 mile trip around the state to 10 cities and two tribes, to talk about how to make Coordinated Care Organizations better.
A CCO is a health care provider network that serves people under the Oregon Health Plan, or Medicaid.
The state’s five year contract with the 15 CCOs it works with is ending and is in need of renegotiation.
On his tour, Allen said he heard that Oregonians are generally happy with how CCOs have improved care and saved money over the last five years, “But there’s a lot of work still to do,” he said.
Allen said there are three main areas of concern that OHA will be addressing in the new CCO contracts.
The first, Allen said, is that people are having a hard time getting access to care. The system is complicated and it’s not well coordinated with physical health care, he said.
Second, people need help with issues not directly associated with health care, like transportation, food security and housing, “Housing just came up consistently,” said Allen, “from the very largest communities in Northeast Portland to the very smallest communities ... there’s just a real crisis about housing.”
Allen said even if the entire medical budget was spent on housing, it would hardly make a difference. But he said CCOs can make a difference by brokering access to rental housing, “Those are the sorts of things we want to explore, having CCOs do more to support those social elements that are such an important part of people’s actual health,” said Allen.
The third area Allen heard people talk about was the coordination of care. He said health care is complex, especially when a patient is suffering from both physical and mental problems. He said those people need help managing their health, “We’ve done some good work to try to do a better job of coordinating that either through the CCO or at the primary care level. But what we heard consistently is that we’ve got a long way to go.”
The health authority now has to draft contracts with the CCOs.
“Now we need to have harder conversations about what those contract terms look like and what the expectations of the system are,” said Allen. “What’s reasonable and what’s not reasonable. We probably need to push fairly hard on CCOs, they’re probably going to push back fairly hard.”