Restoring Leadership, Accountability & Innovation For a Healthier Oregon
Oregon was once known as a leader in health care policy innovation and delivery. Unfortunately, today we’re known for scandals, lawsuits, mismanagement and waste. In recent years, despite significant increases in health care spending, the Oregon Health Authority has been defined by excessive management turnover, massive technology failures, a lack of accountability and tens of millions wasted that should have been spent providing care for those in need. And the next stage of Medicaid reform, aka “CCO 2.0,” has stalled out for lack of gubernatorial leadership.
Health care is a fundamental need, not a luxury. Given the ongoing changes and uncertainty surrounding federal health care policy and funding, it’s never been more important for Oregon policy makers, providers and insurers to recapture a sense of shared purpose, innovation and collaboration for a healthier Oregon.
1. Reclaim Oregon’s National Leadership in Delivery of Medicaid Services
1. Continue to oppose drastic federal cuts in State Medicaid funding. Provide State funding for Medicaid that is stable, long-term and broad-based – not a collection of hidden fees, taxes and budgeting gimmicks.
2. Make State Medicaid hospital assessments permanent.
3. Coordinate investments, set financial expectations and determine specific metrics in social determinants of health – such as workforce training, employment, community engagement and housing.
4. Hold Coordinated Care Organizations’ (CCOs) rate increases to 3.4% annually, as promised in the original CCO reform waiver.
5. Prepare for third-generation CCOs through mission and geographic alignment of Early Learning Hubs, Regional Solutions, and related social and health services.
2. Every Oregonian Who Needs Mental Health Care Gets It
For years, Oregon policymakers have talked about integrating mental health and physical health, but little progress has been made. We must expand access to mental health services and hold payors accountable for delivering on the promise of mental health integration.
1. Reorganize the payment and delivery of Medicaid mental health services to fully integrate mental and physical health through CCOs, with counties continuing to serve as providers, and tie CCO funding to outcomes. Today, these programs are administered through both CCOs and counties, which unintentionally perpetuates misalignment of funding and service delivery.
2. In cooperation with non-profits, county mental health and health systems, expand access to walk-in and community based mental health facilities throughout the state.
3. Reverse the trend: Be the only state in the nation that significantly reduces its suicide rate.
4. Create evidence-based standards for licensed substance abuse treatment facilities, to help make sure that people are successful in recovery.
5. Stop the criminalization of the mentally ill, and develop robust court-designated conservators for assistance with care and treatment.
3. Cut Opioid Abuse-related Deaths by 50%
1. Two-pronged approach to combat the abuse of methamphetamine, opioids and other dangerous drugs:
-Bolster medical treatment and peer-to-peer counseling and set evidence-based outcomes standards for licensed treatment centers.
-Prevention: Focused, public health prevention carefully designed to reach and teach kids before they use dangerous drugs.
-Educate prescribers during academic training and in continuing education.
2. Tighten controls on legal distribution and return of prescribed controlled substances.
4. Support Reproductive Rights & Women’s Health Care
1. Regardless of changes in federal law, ensure that Oregon remains a pro-choice state and that all Oregonians maintain full access to reproductive rights and health care.
2. Continue to make improvements to Oregon’s pioneering over-the-counter birth control law, speeding payments from insurers to pharmacies, and promoting greater awareness and convenience of the new, landmark law.
3. Decrease the unintended pregnancy rate by another 25% over the next five years.
5. Ensure Every Oregon Child is Healthy & Ready to Learn
Rep. Buehler has released a detailed plan to improve education in Oregon. A key component to enhanced learning, especially in early grades, is children’s health. Today, nearly half of all children in Oregon are enrolled in Medicaid yet Oregon is ranked 46th for child wellness checkups and 42nd for child dental checkups. Given the availability of funding (76% federal), Oregon must improve its targeting of these critical resources to improve children’s health.
1. Raise Oregon Medicaid to the Top 5 among States for child wellness checkups and child dental checkups – and hold CCOs accountable for outcomes.
2. Provide on-site behavioral specialists and peer support hotlines in all public schools, managed by CCOs. (About half – 48% – of Oregon children are enrolled in Medicaid.)
3. Invest in drug abuse prevention and education designed to reach adolescents.
6. Drive Down Drug & State Employee Health Care Costs
1. Prosecute the leaders of price-gouging pharmaceutical companies.
2. Adopt a single formulary for all state taxpayer-funded drug purchasing – PEBB, OEBB, Department of Corrections and Medicaid – to drive down drug benefit costs.
3. Order PEBB to enter into direct, lower-cost “accountable care” contracts with hospital and clinic systems where PEBB has sufficient population, such as the Portland and Salem areas, and pay based on measurable outcomes.
Independent leadership and bipartisan solutions to reach Oregon’s potential