On June 26th, I attended an OHP CCO 2.0 Road Show event held in Springfield. The gathering was sponsored by the Oregon Health Authority and served as an opportunity for the Oregon Health Plan to present its proposed roadmap to developing requirements for the next Coordinated Care Organization contracts.
Coordinated Care Organizations (CCO), such as Trillium Community Health Plan in Lane County and Umpqua Health Alliance in Douglas County, are tasked with providing a wide range of health care and related services to enrolled members of OHP. The services offered are wide ranging, but the focus is on health care. The purpose of this meeting was to have discussions about how OHP should require and measure CCOs to provide care in five areas. The discussion points are available through OHA by emailing [email protected].
There are two items that stood out to me after attending the meeting. First, the direction of the CCO proposal process is being driven by survey results that ranked children’s health tenth on the list of ten priorities. First was improving behavioral health care. From my perspective, failing to address children’s health as a priority will result in forever chasing improvement in overall mental health. So many of the children we have referred to us with sensory processing issues, developmental delays, and similar conditions would benefit tremendously from Occupational or Sensory Integration Therapy. The approach illustrated in the presentation ignores the research and documentation available that ties addressing these issues in early intervention to improved behavioral health outcomes. Thus, reducing the need for more expensive treatment in adolescence or adulthood. In general, I find the state’s willingness to kick our children’s health care to the bottom of the list is short sighted and contrary to evidence-based paths to improving behavioral health.
Secondly, the emphasis on reducing health care costs, as a member of my discussion group pointed out, is likely going to have unintended consequences. From Primary Care Physicians to Specialists to Therapists, there is a financial breaking point for every organization. At some point, when payments from CCOs drop below the cost of providing services, providers of all types will be faced with a hard decision on whether or not to continue to provide care for our children. I would argue again that by making sure children have access to proper care and services at an early age, the long-term cost savings would be realized.
In summary, the meeting was an enlightening trip through the OHP’s CCO 2.0 plans. There are not a lot of easy answers, and the issues become more difficult to resolve when trying to make decisions affecting 15 separate organizations with vastly different populations, geographic obstacles and available health care options.
However, I would encourage any parent who has a child with insurance through a CCO to make their concerns known by emailing, calling or writing to OHP if they feel their children’s health should be higher than 10th on the list of priorities. Taking care of our kids now will make it easier to achieve future goals of reduced health care costs and improved behavioral health.