A new health care model

Written by Katy Nesbitt, The Observer March 08, 2013 02:51 pm

Wallowa County health providers formulate strategies on how to better serve patients

by KATY NESBITT / The Observer  

WALLOWA — Wallowa County is leading the region in response to Gov. John Kitzhaber’s vision to save 2 percent of Medicaid costs across the state.

In June 2011, Kitzhaber and the Oregon Legislature passed a bi-partisan bill  that proposed a statewide system of Coordinated Care Organizations creating a new model of health care. These organizations will improve health and lower the high cost of care by emphasizing prevention, reducing waste, improving efficiencies and eliminating avoidable differences in quality and outcomes. 

The organizations will be a community-based network of patient-centered care, driven by local need. The legislation provides for flexibility to set up networks in a way that will work best locally because health care the goal needs may be different from community to community.

To prepare for the 12 Eastern Oregon county organization headed by Greater Oregon Better Health Initiative and ODS Community Health Inc., Wallowa County health care providers began meeting last May. In so doing, they now have the jump on paving the way how Medicaid reimbursements will better serve patients.

Dr. Renee Grandi serves on the Eastern Oregon region’s Coordinated Care Organization board and the clinic she helps run in Enterprise, Winding Waters, has its own patient advisory committee so she is already familiar with working with patient feedback with the intent to improve care. This coordination has carried out among health care providers in the community.

“We’d already been doing this work, forming care teams with doctors, nurses and pharmacies. Now we are broadening out to care more holistically,” she said. “The Coordinated Care model will get us off the hamster wheel of seeing patients — this way we can refer them to a physical therapist, provide child care so they have time to exercise or learn how to better shop and cook,” said Grandi. “Until now, we’ve been putting Band-Aids on things.”

Due to the development of the Organizations, the providers in Wallowa County felt that they were being given a tremendous opportunity to reform health services in accordance with the specific needs in their own community. After a state-sponsored informational session in April 2012, providers started gathering for monthly meetings. These providers represented primary care, hospital care, behavioral health, holistic care and community service organizations. They met to discuss questions, concerns and ideas about how to become leaders in the health care reform movement.

The Wallowa County Network of Care is being developed in order to promote the formalization of an integrated health care network that will seek to achieve efficiencies; expand access to and improve the quality of essential health care services; and strengthen the rural health care system.

A county commissioner and the chair of the local advisory committee from each of the 12 Eastern Oregon counties will join the regional committee, which will guide the processes to best fulfill the needs of the counties’ Medicaid patients. County Commissioner Susan Roberts will serve as one of Wallowa County’s representatives on the regional council.

“The end game is all about money and the advisory committee is there to shepherd the region through the process,” Roberts said.

Roberts said the county doesn’t provide health care services, but is coordinating the health care, public safety, and education needs. 

The state wants physical and mental health as well as alcohol and drug addiction to be addressed through the Coordinated Care Organizations providing all-encompassing care, said Roberts. She is spearheading a group of consumers to provide feedback and said the theory of gathering all of these different needs together is to provide the best wrap-around services including organizations like the county health department, Building Healthy Families, and Community Connection.

Bridget Brown of the Center for Wellness which provides the county’s mental health services said the vision of the network is for 100 percent access with no disparity amount patients.

“The mission of the network is better health and better living through community collaboration and education,” Brown said. “Wallowa County is now seen as a model of ideas of reform. We put them into practice so fast the state doesn’t know what to do with us.”