Health: Reforming Care and Cost, Promoting Well Being
OBC has had a leading role in supporting health care reform and better health outcomes since early in 2004 when we formed a Health Care Task Force to look at health care costs and related issues. Recommendations of the task force white paper, “A New Vision for Healthcare,” were incorporated in the 2005 Oregon Business Plan and in much of SB 329, which emerged from the 2005 Legislature. That legislation created the Oregon Health Fund Board, which was charged to develop the blueprint for state health care reform. In 2009, that board’s blueprint led to HB 2009, which formed the Oregon Health Authority and directed it to overhaul state health policies, governance, and services.
OBC and its members have continued to work with the state, supporting it’s reformed Medicaid service delivery under the Oregon Health Plan. Primary features of the reform, adopted in 2011, include coordinated care, better communications between providers, and a capitated payment system. Coordinated care for 90 percent of the Oregon Health Plan’s 971,000 members is carried out through 15 Coordinated Care Organizations (COOs) around the state. A number of health care providers and insurers in OBC have been key players in the development of Health Share of Oregon, a CCO serving Clackamas, Multnomah, and Washington counties.
In 2013 the Oregon Business Plan Health Care Roundtable, successor to the OBC Health Care Task Force, updated the Business Plan’s Vision for Health Care, building on the foundation set in 2005. The updated vision provides greater emphasis for employers to move toward defined contributions to fund health benefits and offer choice of plans. It favors greater movement toward integrated delivery systems that better align quality, lower costs, and yield higher satisfaction. And it urges action to increase health among Oregonians.
OBC hosts two business community initiatives to improve health care performance and the health of Oregonians. Respectively, these are Oregon Healthiest State and the Oregon Health Leadership Council.
Oregon Healthiest State
The Oregon Healthiest State (OHS) engages and inspires Oregonians to create and sustain healthy systems and environments to support healthy lifestyles.
Indicators underscore the scale of this challenge. In the Gallup Healthways Wellbeing Index, Oregon has fallen in ranking for five years straight and now sits at No. 31 with consistently poor scores in stress and depression. Oregon has one of the country’s highest rates of childhood dental disease. Less than 50 percent of employees are satisfied with their work environment. Nearly one quarter of children are overweight or obese. Of Oregon’s approximately 3.8 million residents, close to 137,000 adults and 39,000 children live with a serious mental illness. Some 270,000 people per month eat meals from emergency food boxes in Oregon.
OHS has met with hundreds of stakeholders to get their input and buy-in on strategies to improve the health and well-being of all Oregonians. Two strategies have emerged to help make Oregon the Healthiest State:
- Statewide Collective Impact. Partners will learn together, identify key indicators, and align their efforts to deliver solutions where Oregon has critical needs to improve health outcomes.
- Local Community Transformation. Engage and support communities to make health easier to achieve for all Oregonians.
In order to identify the efforts with the greatest potential impact, Oregon Healthiest State prepared the State of Health in Oregon Report and presented it at the 2015 Oregon Healthiest State Summit. This report identified several areas of potential focus, and the initiative formed work groups charged to create an action framework to address each one. They are:
- Financial Peace of Mind Team. Make it easier for Oregonians to achieve financial peace of mind.
- Health and Outdoors Team: Make it easier for Oregonians experiencing the greatest well being disparities to access the outdoors.
- Employer Team: Engage employers to make it easier in the workplace for employees to experience health.
Additionally, Cambia Health Foundation brought the Blue Zones Project to Oregon. Blue Zones Project is a community-wide initiative to help make healthy choices easier for Oregonians. Sky Lakes Medical Center in Klamath Falls and Cambia Health Foundation are co-sponsoring Klamath Falls as a demonstration community. One other demonstration community will be selected in 2016. Blue Zones Project tools are also being made available to organizations and communities throughout the state with the support and training of a state Blue Zones Project team.
Cambia Health Foundation provides lead funding for Oregon Healthiest State. Additional funders include Oregon Health and Science University, Nike, The Standard, PacificSource Foundation, Dicks Sporting Goods, and Oregon AARP.
Oregon Health Leadership Council
The Oregon Health Leadership Council, a collaboration of health care organizations across Oregon, works to reduce the rising curve of health care costs and premiums in order to make both health care and health insurance more affordable to employers and individuals.
Since it was chartered in 2010, the Council has completed nearly a dozen initiatives to control or reduce costs and improve patient care, including design of a new Medicaid care delivery system, support for Oregon’s 2011 coordinated care legislation, and development of Health Share of Oregon.
It is focused at present on four initiatives with significant potential to contain costs and improve care:
- Emergency Department Information Exchange (EDIE). EDIE is a data exchange that enables emergency departments to identify and divert heavy and inappropriate users of emergency rooms to better, less expensive care management. More and more providers are participating in this exchange.
- Advanced Care Planning. A Council work group is developing a health plan payment strategy for assisting patients who have life-threatening conditions with advanced care planning.
- Medicaid Revenue Strategy. A Council work group is conferring with the state and key stakeholders on the 2015-17 budget and beyond to shape a strategy to sufficiently fund Medicaid and minimize cost shifting to providers.
- Administrative Simplification. The Council continues to look for ways to streamline the business side of health care to achieve system cost savings. Examples include exploring greater use of websites for eligibility and claims information and recommending common credentialing of practitioners to avoid costly inefficiency and duplication.
Organizations represented among the Council’s 30 members include eight major medical groups and the Portland Coordinated Care Association; eight major hospitals/health systems and the Oregon Association of Hospitals and Health Systems; twelve local and national health plans; and the Oregon Health Authority.