Kitzhaber Keeps Pressing Health Care Reforms

Health care reform is still needed to reshape a system based on volume and fee-for-service and that fails to integrate physical and mental care.Governor Kitzhaber and Kaiser CEO Bernard Tyson agree the health care business model is broken and one major reason why is the separation of care for physical and mental illnesses.

Appearing together at the Portland Business Alliance's annual breakfast, Kitzhaber and Tyson stressed the need to move from a "volume-driven" approach to a model that offers better care at more affordable prices.

The Portland Business Journal quoted Tyson as saying, "There is a mental health challenge we're working on, how to reattach the head to the body." Tyson said physical and mental illness is treated in separate locations, using separate records, even though 45 percent of physical health visits indicate a need for mental health services.

Tyson also said fee-for-service medicine needs to be "thrown out the window."

Kitzhaber touted the benefits being achieved through coordinated care organizations, which he credited for shrinking annual cost increases in care from 5.4 percent to 3.4 percent. The governor noted the 16 current CCOs care for 900,000 lower income Oregonians and are engaged in integrating physical, mental and dental care. He said he next wants to expand CCO cover to public employees and teachers and ultimately to the entire health insurance market.

The failure of the Cover Oregon website, a source of embarrassment to the Kitzhaber administration, wasn't viewed as an obstacle to continued efforts to transform health care and health insurance. Its failure was cast as a blip on the radar screen in the face of more fundamental systemic problems that need to be corrected.

The presentation didn't have a particularly political air, despite Kitzhaber facing re-election this year. His comments and perspective signaled no retreat from his often trailblazing efforts to reshape health care delivery and bend the health care cost curve.