Health Reform in Oregon Bruce Goldberg, MD Rural Health Conference

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1 Health Reform in Oregon Bruce Goldberg, MD Rural Health Conference November 6, 2009

4 Opportunity To work together to create a HEALTHY OREGON where all Oregonians have access to quality affordable health care.

5 State ranking on access and quality dimensions State ranking on quality State ranking on access Source: Commonwealth fund state scorecard on health system performance, 2007

6 Health reform in Oregon A healthy population; Extraordinary care for everyone; and Reasonable costs shared equitably.

7 Health reform in Oregon A plan; A set of tools; and Implementing and leading change NOW!

8 Health reform in Oregon HB 2009 creates the Oregon Health Authority and Oregon Health Policy Board to improve the HEALTH of all Oregonians. Mandates three goals: Access: Expanding access to health care to every Oregonian; Quality: Transforming delivery of health care to make sure everyone receives quality care; and Affordability: Containing costs to make health coverage affordable for all.

9 Strategic building blocks Bring everyone under the tent ; Set high standards measure and report; Unify purchasing power; Stimulate system innovation and improvement; Ensure health equality for all; A new and revitalized health care workforce; Federal changes.

10 Coordinating health reform in Oregon Keystone of HB 2009: Oregon Health Policy Board (OHPB) and the Oregon Health Authority (OHA). Citizen-led board provides direction and accountability. Single state agency that consolidates and coordinates state health purchasing and aligns programs to maximize efficiencies.

11 Oregon Health Policy Board Eric Parsons, Chair Recently retired CEO of Standard Insurance Lillian Shirley, Vice-Chair Administrator of Multnomah County Public Health Department Mike Bonetto, Vice-President of Community Benefit and Government Affairs, Cascade Health Systems Eileen Brady, Co-owner of New Seasons Market and board chair, Celilo Group Media

12 Oregon Health Policy Board (cont d) Carlos Crespo, Professor of Community Health at PSU Felisa Hagins, Political Director at SEIU Local 49 Chuck Hofmann, MD Internal Medicine in Baker City Joe Robertson, MD President, OHSU Juanita Werner, President, Ornelas Electronics, Small electronics manufacturing company in Hillsboro

13 Implementing reform Begin and lead changes now! Build on continued state and federal reforms.

14 Bringing more people into health care Implement Healthy Kids and bring all children into health care coverage; Expand OHP initially adding 35,000 low-income adults; Develop affordable small business health insurance products; Provide guidance and support for three share agreements; and Assure quality health care workforce.

15 Reduce costs and improve quality Use the power of the market to lower costs by coordinating and aligning all of the state s health purchasing: 850,000 people-more than 25% of the market. Provide leadership to create a simpler system for all: Accountable, coordinated, integrated, community health care systems; Uniform quality standards; and Reduced administrative overhead.

16 Reduce costs and improve quality (cont d) Changing the way we deliver care; Creating new organizations with new accountabilities; Focusing on quality and value; Use data establish all-payer, all-claims database, publicly report performance and costs; Develop standards for and implement patient-centered primary care health homes; Develop payment reform models that reward comprehensive management of chronic diseases, quality outcomes, efficient use of resources, and end cost shift; Liability reform;

17 Reduce costs and improve quality (cont d) Support statewide adoption of health information technology; Establish a statewide registry of Physician Orders for Life Sustaining Treatment (POLST); and Eliminate disparities.

18 Improving health Connecting public health to health care; linking prevention and treatment. Expand tobacco and obesity prevention and education; Create a coordinated, supportive infrastructure; Continue statewide health care acquired infection prevention program; and Develop statewide health improvement plan.

19 Dovetail with Federal Reform Many ideas similar to HB 2009: Bending the cost curve; Expanding coverage through Medicaid expansion, insurance exchanges and reform; Emphasizing shared responsibility; Strengthening primary care; Preventing disease and wellness; Implementing administrative simplification; and Increasing cost and quality reporting.

20 What about Federal Reform? Focus of proposals on financing and insurance reform. Medicaid expansion likely not until Affordable insurance state or federal exchange(?), public option (?). Less emphasis on delivery of care. Likely to present many opportunities for state innovation and leadership. Oregon well positioned to take advantage of federal changes

Aim High: Building a Healthy Oregon

Oregon Health Fund Board Aim High: Building a Healthy Oregon Final Report November 2008 [This page intentionally left blank] Oregon Health Fund Board 2 TABLE OF CONTENTS Executive Summary Introduction