Transforming health care

July 12, 2011
Message from Greg Van Pelt
Senior vice president/chief executive, Oregon Region
As published in The Oregonian, July 12, 2011
With the passage of landmark health care legislation in Salem this year, the time has come to improve some of the most fundamental elements of our health care system.  Although much of that work has already begun in Oregon, it is clear that we must take the next step forward to improve the health of our communities.
House Bill 3650 will set the stage to transform the way people are cared for under the Oregon Health Plan. We know we can improve the way we deliver services. Health care costs are threatening every sector of our economy and the Oregon Health Plan is facing serious budget reductions and a large influx of people coming into the system. We must use this opportunity to redesign the system and make health care more affordable.
One thing must stay the same:  Our collective commitment to care for those in need and improve the lives of all Oregonians.
Here are some areas where our system has great opportunity for change:

• We know we need to reduce inefficiencies and ineffective care. The Institute of Medicine says 20 to 30 percent of what Americans spend on health care goes for treatments and technologies that are not effective for the patient. That's a national study, and though we believe we have a better track record in Oregon –all of us in health care recognize the need to improve.

• The cost of prescribed medications is one of the single largest contributors to increased health care expense. We need to find better ways to use the right drug at the right time for the best outcome.

We need to better connect care for clients of the Oregon Health Plan, who have to negotiate a sometimes dizzying array of disconnected services for physical, mental, and dental health care.
We need to provide more coordinated care to reduce duplicate tests,  lower use of expensive emergency rooms for non-emergency conditions, and prevent avoidable hospitalizations.
We need to provide better preventive care services to keep people healthier and reduce costly treatments for people who could have been helped earlier. An estimated 80 percent of health care costs come from 20 percent of the population. This is particularly true for patients with chronic conditions.
We need to remove incentives in federal programs that pay for more care but not necessarily better care.
To meet the budget and human challenges ahead, we have to change the way we do business. House Bill 3650 provides a starting place, setting up Coordinated Care Organizations, which will allow Oregon to begin taking on the challenge of improving care and reducing costs.
These organizations or networks would bring together local care providers under a team-based approach with one singular focus: keep people healthy and provide high-quality, affordable services. They would operate under a fixed budget and be responsible for performance standards and benchmarks. They would also have flexibility from state officials to invest in preventive care and disease management. This will help reduce costs later and keep people healthier.
We know nothing will happen immediately. Oregon legislators will be looking at plans for Coordinated Care Organizations when they next meet in February, with a goal of launching in July 2012.
Between now and then there is a lot of work to do. Providence and other health care organizations are exploring ways to improve access to primary care across our communities. We continue to look for ways to expand coverage for all Oregonians as part of health care reform. By working together, I believe that we can seize the opportunities before us and find new and different ways to truly transform health care in our state.