Greenlick Opens Controversial Debate on Future of CCO System

Rep. Greenlick

Rep. Greenlick

Rep. Mitch Greenlick seeks major changes that will ensure that the local Medicaid health management companies operate in the public interest, and he wants legislation passed before the new contracts come out. Sen. Bates seeks more transparency from the Oregon Health Authority to avoid another heated battle with CCOs over payment.

The Lund Report, January 15, 2015
by Chris Gray

Rep. Mitch Greenlick, D-Portland, has unveiled some major changes to the structure of the state’s coordinated care organizations that are designed to create more transparent rules for their operation that will ensure they will be run in the public interest and have clearer expectations that might prevent further rows with the Oregon Health Authority.

“It creates a blueprint of what CCOs should look like,” Greenlick said.

All CCOs would become non-profit, community-based organizations by 2023; their board of directors would have meetings open to the public, and 50 percent of their directors would represent the general public. Of the remaining board members, only 25 percent could represent the risk-bearing CCO stakeholders, and 25 percent could be healthcare providers.

Reserve funds, now kept in vaguely defined accounts by the CCOs, would instead be placed in a global escrow account housed in the state treasury starting in 2018. The Oregon Health Policy Board would need to develop new health metrics that CCOs would be required to meet or else forfeit their contracts.

Greenlick’s proposals could put an end to the relentless infighting between the Oregon Health Authority and some of the CCOs, diminishing the opportunity for some stakeholders to get rich from the Medicaid system and reducing the perception that the state might be playing favorites when it sets rates.


Obama loses another round in House Republicans' ACA lawsuit

A White House spokeswoman said the Obama administration is "confident that the courts ultimately will dismiss this taxpayer-funded political stunt, which would make healthcare more expensive for millions of Americans. Getty Images

A White House spokeswoman said the Obama administration is "confident that the courts ultimately will dismiss this taxpayer-funded political stunt, which would make healthcare more expensive for millions of Americans. Getty Images

Modern Healthcare, October 20, 2015 .
by Lisa Schencker 

The Obama administration suffered yet another setback Monday in its attempts to fend off House Republicans' lawsuit alleging it funded part of the Affordable Care Act without permission from Congress.

U.S. District Judge Rosemary Collyer rejected the administration's request to immediately appeal her earlier ruling that House Republicans have standing to sue the administration. Had she agreed to the so-called interlocutory appeal, a federal appeals court could have agreed to hear the matter before the case was resolved in District Court.

House Republicans allege in the lawsuit that the administration is illegally spending money that Congress never appropriated for the ACA's cost-sharing provisions. Those provisions include reduced deductibles, copayments and coinsurance that Americans receive, depending on income, for plans purchased through the ACA's insurance exchanges.


Edward Kleinbard provides a primer on tax and spending that the politicians need to read

We Are Better Than This
How Government Should Spend Our Money

Physicians for a National Health Program: McCanne Quote of the day
Posted on Thursday, December 3, 2015
by Edward D. Kleinbard

This book argues that the strand of contemporary American political thought that defines itself through its hatred of taxation is narcissistic self-pleading wrapped in a flimsy sheath of economic lingo. Personal economic liberty, of course, is one foundational principle of our country and our economy, but it is not the only principle that defines us; and the emaciated government that this philosophy demands is not the way to promote the happiness of society, if by that we actually mean the society composed of all of us who identify ourselves as Americans. Our fixation on taxation means that we have turned our thinking upside down: instead of focusing on what government might usefully do, and whether we can afford it, we obsess over the taxing side of things, and ignore the purposes to which those tax revenues are applied.
We do not pursue the path of of our society’s happiness, including our collective prosperity, by pursuing abstractions like the sanctity of markets if by doing so we waste $1 trillion or so every year in healthcare spending, and further leave tens of millions of Americans without adequate healthcare coverage, thereby condemning them to worse long-term health outcomes and to risks of bankruptcy. To the contrary, the markets here are telling us something quite clearly, which is that healthcare for all members of a society is a load that private markets cannot lift alone. And what is true of healthcare of course is even more apt for broader forms of insurance against the vicissitudes of life.