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.