Health Authority director says reform plan should cut waste

Oregon Health Authority Director Dr. Bruce Goldberg made no guarantees Tuesday as he spoke to a roomful of local heath care professionals about the major overhaul coming to the Oregon Health Plan this summer.

The one point Goldberg tried to hammer home to the hopeful but skeptical doctors, nurses and community activists gathered at the Red Lion Hotel's meeting room was that the path Oregon is on is not sustainable.

"Health care costs have reached crisis levels, and we must do something about it and soon," Goldberg said. "We can't settle for the status quo."

Goldberg's visit was part of a statewide barnstorming effort to explain the changes coming to how Oregon delivers health care to its lowest-income residents.

The recently passed legislation will overhaul the way residents on the Oregon Health Plan receive medical care.

Goldberg said the current system is fraught with waste because of a lack of communication between physical and mental health care providers.

The goal is to combine health care providers under one umbrella, so that when a person enters the health care system he or she is tracked through all types of care.

The major component of the reform effort is the creation of coordinated care organizations that will group mental, physical and dental care providers together to serve low-income patients under the Oregon Health Plan.

"This is really about health care being local," Goldberg said.

Several providers have signed up to become part of Jackson County's CCO, including CareOregon Jackson County, Coordinated Care of Oregon and PrimaryHealth.

The Oregonian reported that some counties are chafing at the idea that out-of-state providers have applied to join the CCOs.

Goldberg said these organizations will have to prove they can meet benchmarks that will improve care in the specific community in which they apply. He said this could prove difficult for these providers.

If approved, all providers will have to closely communicate with each other as a patient moves through the health care system so there isn't a redundancy in treatment, which causes medical costs to skyrocket.

The Oregon Health Authority believes that by not having mental and physical health services interact and coordinate care, jams are created in the system that cause patients sometimes to see multiple doctors to get the same treatments.

Some in the audience said they had doubts about whether the CCO system could work.

When asked how transparent the process would be for adopting a CCO, Goldberg said a provider would have to hold an open meeting with the community and present how it could best serve Jackson County's population.

"The community will have the say in the CCO," Goldberg said.

Some in attendance said the plan is geared toward directing patients to primary care physicians and could drastically cut down on hospital visits throughout the state.

The fear would be that hospitals would have to cut bed space and some smaller hospitals in rural areas might be forced to close.

Dr. Paul Matz, who practices at the Medford Medical Clinic, said he fears the CCOs could add to an already complicated bureaucracy.

"The easiest part of my job is diagnosing and treating," he said. "The hardest part is dealing with the bureaucracy. It's a nightmare."

Oregon lawmakers adopted the legislation last session and plan to begin implementing it by Aug. 1.

Goldberg admitted that the timeline is incredibly tight, considering the massive undertaking of reforming an entire system.

"The timeline is aggressive, but we have an aggressive issue to deal with," he said.

As revenues continue to struggle in the aftermath of the deepest economic downturn since the Great Depression, the state cannot continue drastically increasing medical spending each year, Goldberg said.

"Change is hard and we have to do it with less resources," he said. "But the alternative is not a good one. We can't go back to the way it was."

Reach reporter Chris Conrad at 541-776-4471 or email

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