Provider groups that stepped up to be the cutting edge of Oregon's health reforms say the state is reneging on promises of a financial helping hand. <\/p>\n
Led by Gov. John Kitzhaber, lawmakers earlier this year approved ambitious reforms that would turn over the state's Medicaid-funded Oregon Health Plan to beefed-up managed care groups called coordinated care organizations. <\/p>\n
Now, members of the new groups are crying foul after a directive Thursday that they'll receive no new funds for the additional responsibilities they've agreed to take on -- mental health care, prevention efforts, quality measurements and new patient-care staff, among others. <\/p>\n
They say the success of the reforms is at risk because revamping the care of 600,000 people takes money. <\/p>\n
\"We're stunned,\" said Janet Meyer, interim CEO of a consortium of Portland-area hospitals and other providers called the Tri-County Medicaid Collaborative. \"That wasn't the impression we had been given throughout the process.\" <\/p>\n
But the new groups simply have to be more creative, says Oregon Health Authority Director Bruce Goldberg, who is overseeing the reforms. \"There are no additional dollars,\" he said. <\/p>\n
The state asked the new care groups to submit rate requests based on their projected costs, but on Thursday informed the groups that those requests should be no greater than last year's rate, which itself was an 11-percent cut. <\/p>\n
The message was \"if it's not around this number -- and very close -- you will not be accepted as a CCO,\" said Jeff Heatherington, who heads FamilyCare, a Portland-based physician group that is among the new care groups. <\/p>\n
The state's mandated CCO rates -- about $250 per member per month, in some cases -- are about 20 percent less than what the groups requested based on costs. <\/p>\n
Some managed care groups \"have really been struggling\" and need more money, said pediatrician Bob Dannenhoffer of Douglas County's Umpqua Health Alliance. He said he hopes the state makes allowances on requirements such as quality of care reporting. <\/p>\n<\/p>\n
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New health care groups say Oregon's reforms could sputter without more cash<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Provider groups that stepped up to be the cutting edge of Oregon's health reforms say the state is reneging on promises of a financial helping hand. Led by Gov Continue reading