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Looking the future straight in the eye Share This OHSU Content

The tri-county CCO could be a model for the rest of the country as states grapple with developing systems of care that are coordinated, effective and less expensive.

OHSU has signed on to what’s being called by many an unprecedented collaboration between Portland-area health care entities, symbolized with a letter of intent filed April 2 to form a Coordinated Care Organization (CCO) for Oregon Health Plan (Medicaid) members. The letter was submitted to the Oregon Health Authority, which is poised to begin certifying CCOs after July 1, thanks to the passage of Senate Bill 1580 A, Governor Kitzhaber’s Health Care Transformation legislation.

The letter of intent was signed on behalf of the Tri-County Medicaid Collaborative (TCMC) – a group of 14 health care organizations in Clackamas, Multnomah and Washington counties who have been meeting for months to address “a single, complicated question: Can we together improve the quality of care and the care experience of Oregon Health Plan (OHP) members, and do it for less money?”

OHSU executives Joe Robertson, Peter Rapp, Lawrence Furnstahl and Connie Seeley have been active in various workgroups for the TCMC, and President Robertson will remain a member of the new CCO’s steering committee as work begins focusing on the technical application due April 30, and implementation following.

Executive Vice President Peter Rapp briefed Faculty Practice Plan Board members a day after the letter was submitted during the Board’s regularly scheduled meeting, and called the filing “remarkable in many ways.”

Dr. RobertsonTwo central components of the discussion are the anticipated increase in Medicaid patients as a result of federal reform, and the nation’s aging population. While there are many details to be worked out, Mr. Rapp noted the unusual engagement of all the large stakeholders – including Legacy, Providence and Kaiser – and described the developing payment model as “pay or play.”

The tri-county CCO could be a model for the rest of the country as states grapple with developing systems of care that are coordinated, effective and less expensive. “[The plan] has a good start. It’s very, very unique in the country, and it’s got a whole lot of questions,” said Mr. Rapp.

OHSU President Joe Robertson addressed health care reform during the April 5 Town Hall (OHSU login required to watch video) and referred to the graph below, which projects Medicare and Medicaid to be the largest source of noninterest federal spending as a percentage of GDP in the years ahead. When talking about changes coming due to the federal budget challenges — half of OHSU revenues are from public sources — he said. "We’ve had our best financial performance ever over the last five years. …Now, that’s the past, it’s great, it’s why we’ll succeed in the future, but now let’s look the future straight in the eye.”

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More than 50 letters of intent from organizations around the state had been filed with the Oregon Health Authority by the April deadline; see the full list on their website.