| August 31, 2010 | For More Information Contact: Denise L. Honzel 503.860.1278 |
OHLC: Program Launched by 19 Oregon Health Organizations to Lower Healthcare Premiums, Increase Quality of Care for Oregonians with Chronic Conditions
Fourteen medical groups, five health plans and four of the State’s purchasing groups in Oregon have launched an unprecedented pilot program designed to improve care and reduce costs for thousands of patients across the state. Facilitated and partially funded by the Oregon Health Leadership Council (OHLC), the High Value Patient Centered Care project will implement a focused, comprehensive primary care-based model in Oregon specifically for those individuals with chronic and complex medical conditions, such as asthma and diabetes. The goal of the program is to find a sustainable method for Oregon’s employers to reduce premiums for employees by providing better care for those with complex medical conditions.
This patient-centered model coordinates all the individuals responsible for treating patients with chronic conditions. Under this pilot project, a specially trained nurse acts as a navigator, developing a personal relationship with a patient to understand exactly how best to care for them. This nurse then coordinates between other members of the team, including the patient’s primary care physician, medical specialists, hospitals and health plans. The Council has identified potential outcomes that could help improve quality while reducing the $20,000 per person in annual health care costs for this segment of the population.
The High Value Patient Centered Care project will begin in October and will track the progress of as many as 4,500 chronically ill patients against a control group for two years.
“We have recognized that current healthcare cost trends are unsustainable, and we must change the way we deliver care in order to pay for it,” said Joan Kapowich, administrator of the Oregon Educators and Public Employees Benefit Boards. “This project is an opportunity for purchasers to support innovation that ultimately provides better care for our employees, while allowing long-term sustainability in healthcare costs. It’s important that the groups who facilitate care every day work together to find a solution.”
Inspired by the success of a similar pilot project run by Boeing last year that saw a 20 percent decrease in costs and a measurable increase in quality of care, the project will place the specially trained nurses within the fourteen medical groups. These nurses will work with 200 patients with chronic conditions and an assigned medical home team.
“This is a very advanced demonstration, and the findings have the potential to significantly inform the national dialogue around high quality, affordable care,” said Dr. Pranav Kothari, principal of Renaissance Health, a national leader in healthcare delivery innovation and a coordinator of the project. “The planning work among the stakeholders in Oregon has been uniquely collaborative. No health plan provider could do this alone; with the volume of organizations involved, the cost and benefits can be shared.”
The participating health plans and payers will provide prospective funding to the medical groups to cover initial costs associated with this model, including the salary for the project’s nurses, who are trained to build a relationship with patients to better understand how their care plan should be structured. Utilization/performance measures will be provided to each medical group on a quarterly basis to help support their work. Those measures are still in development, and will likely include decreased emergency room visits, decreased hospital readmissions, higher level of prescriptions refilled and more indicators that patients are receiving better up-front care.
The 14 medical groups are:
- Adventist (Portland) High Lakes Health Care (Bend)
- Legacy (Portland) Medford Medical Clinic (Medford)
- Northwest Primary Care (Portland) North Bend Medical Center (Coos Bay)
- OHSU (Portland) Oregon Medical Group (Eugene)
- PeaceHealth (Eugene) The Portland Clinic (Portland)
- Portland Family Practice (Portland) Providence (Portland/Newberg)
- Tuality (Hillsboro) Westside Internal Medicine (Beaverton)
The Health Plans and State groups that have agreed to participate are:
- Health Net ODS
- PacificSource Providence
- Regence BlueCross BlueShield Public Employees Benefit Board (PEBB)
- Oregon Medical Insurance Pool (OMIP) Division of Medical Assistance Program (DMAP)
- Oregon Educators Benefit Board (OEBB)
“After seeing the success of Boeing’s pilot program, we’re especially excited to implement a new model of care that can potentially help us increase quality of care and simultaneously lower costs,” said Dr. Laurie Roberts, Medical Director of Portland Family Practice. “We’re hopeful that, with the resources, tools and training provided by the plans and OHLC, we’ll be just as successful and be able to expand the model in the future.”
CareOregon, an OHLC member, will also participate in the learning collaborative and provide training support, along with Renaissance Health.
About The Oregon Health Leadership Council
The Oregon Health Leadership Council was commissioned in the summer of 2008 when Oregon’s major business groups asked the state’s health care industry executives to work together to slow the growth of health care costs and keep health insurance premium increases closer to the growth rate of consumer prices. The Council is made up of physicians, health plans, hospitals and health systems. These industry representatives have been identifying which medical costs are driving premiums higher and what actions the industry itself can take to moderate medical cost increases.
The Council is focusing on four areas that support improved quality and can help lower the cost of healthcare. The four include payment and reimbursement reform, evidence-based best practices, value-based benefits and administrative simplification.
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