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Entries in Bruce Goldberg (3)


Kitzhaber Brings Home Bacon

The big news last week revolved around Governor Kitzhaber's successful, last-minute trip to Washington, D.C. where he negotiated final terms of a deal that will bring Oregon almost $2 billion in federal money over the next four years to finance health care reform. The first installment — $620 million — is expected to arrive in Oregon by July 1.

As The Oregonian put it in its lead story on the successful trip: "Kitzhaber saves Oregon budget and his reputation in health care deal with Obama Administration." Both points are true. Oregon needs the money to fund reform. And, Kitzhaber, a former emergency room doctor who thinks, lives and breaths health care policy, had almost no choice but to succeed in D.C.

What remains is a question about whether the new federal money can be used to fill budget holes or must be devoted to new health care reforms. But that question, as important as it may be to budget analysts, ignores the basic policy point — the money will go to reform and that will mean that the reforms have a better chance for success here.

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Promise of Cash Makes Reform Vote Likely

Governor Kitzhaber and one of his health care gurus — Dr. Bruce Goldberg, head of the Oregon Health Authority — returned from Washington, D.C. a couple weeks ago with a load of cash. They reported the Obama Administration promised to help Oregon continue reforming its health care system with $2.5 billion over five years.

As always with such pledges, some observers will say "show me the money."  But the Kitzhaber/Goldberg report made headlines just as legislative committees met at the Capitol to prepare in earnest for the February legislative session, at which health care reform will be one of the big topics.

Embodied in Legislative Counsel bill draft #97, the details of a key reform — Coordinated Care Organizations (CCOs) — made its debut. The idea is to focus care, especially for low-income Medicaid recipients, closer to where they live around the state.

News of the prospective $2.5 billion to finance reform probably came close to assuring that the legislature will pass reform legislation in February. It will be almost impossible to say no.

Here are other developments from last week's legislative committee meeting days:

       *  Three officials — Goldberg; Eric Parsons, chair of the Oregon Health Policy Board; and Mike Bonetto, the governor's health care policy assistant — gave House and Senate committees a report on reform progress and received a respectful reception.

       *  A group of health care policy leaders from the Portland metropolitan area, led by Greg Van Pelt, CEO of Providence Health & Services, and George Brown, CEO of Legacy Health System, updated lawmakers on progress to form a CCO that would organize care for citizens in the tri-county area.  The group, which has been meeting for three weeks and intends to keep working, calls itself the "Tri-County Medicaid Collaborative." It was viewed as a significant development because so many organizations – about 30, including health systems, insurers, counties and MCOs – have taken the initiative to follow-up on the governor's health care transformation vision. Similar, though smaller efforts are under way in other parts of the state.

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Major Health Care Issues Remain Behind the Scenes

Reports persist the Oregon legislature is on the verge of appointing a major joint committee to pursue agreement on at least two major health care policy issues that have remained in the shadows for weeks.

One is the so-called "health care transformation" led by Oregon Health Authority Director Dr. Bruce Goldberg and Governor John Kitzhaber's health care policy assistant Mike Bonetto. Each Wednesday, they have led the "group of 43" in a review of how to achieve the governor's objective to control health care costs and avoid eating a larger chunk of the state budget.

The second is a sales tax for health care, proposed several months ago by Portland attorney John DiLorenzo, but so far not aired in any public forum this session.

Both issues are fraught with political peril. 

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