Emergency Medicine News

Center for Health Systems Effectiveness
hosts forum for OHSU faculty, staff and community

Health Share of Oregon - Oregon's largest coordinated care organization (CCO) - continues to move forward in its plan to transform health care for Oregon Health Plan (Medicaid) patients in the tri-county area. OHSU is one of 11 partner organizations in Health Share of Oregon (formerly known as Tri-County Medicaid Collaborative).

The Center for Health Systems Effectiveness (CHSE) hosted a "Mitch dinner" Oct. 16 to discuss just how - and how quickly - Health Share will answer the fundamental question which originally united the group of private and public organizations: Can we together improve the quality of care and the care experience of Oregon Health Plan members, and do it for less money?

John McConnell, Ph.D., director of CHSE and associate professor of emergency medicine, introduced the panel members at the Mitch dinner - a series of events which are held periodically and named after State Representative Mitch Greenlick (D-Portland), who was in attendance. The panelists included Honora Englander, M.D., assistant professor of medicine; David Labby, M.D., CMO of Health Share, Jacqueline Mercer, CEO, Native American Rehabilitation Association of the Northwest, Inc.; and Ed Blackburn, executive director, Central City Concern. Mercer and Blackburn are Health Share board members.

The conversation was wide-ranging, reflecting issues commonly considered in health care reform - payment structure, care coordination and an emphasis on prevention - but also broad, systemic components of a truly transformed delivery system, including housing, nutrition and health professions education.

"This is huge transformation really compressed into a tight timeline," said Dr. Labby. "[The partner organizations of Health Share] are people with intense market competition, so to be able to sit at the table and learn to talk to each other is…a test to their fortitude."

A $17.3 million Health Commons Grant from the CMS Innovation Center awarded to Health Share is a springboard for broad delivery system changes in the region. Through five integrated care model interventions, the project's three-year savings are estimated at $32.5 million, with a population impact of 19,000 patients. In addition to clinical transformation, the plan is to adjust risk and payment incentives to achieve the Triple Aim, and to simplify administrative services for providers and members (see chart at left). The Triple Aim improves the patient experience, improves outcomes and lowers costs.

Dr. Englander is the co-principal investigator and medical director of the Care Transitions Innovation (C-TraIn), a transitional care quality improvement program. As part of the Health Commons grant, she will work with Legacy Emanuel, Legacy Good Samaritan and Legacy Mt. Hood to launch the intervention, which was developed and studied in a randomized controlled trial at OHSU, in each of those hospitals.

"It's hard to change health care," said Rep. Greenlick at the conclusion of the event, a simple statement that evoked appreciative laughter from the attendees. In closing, he thanked the panelists and said: "You're our current health care heroes."