Oregon Business Association

Banking on Health Care Coordination

A lot rides on the success of health reform ventures such as coordinated care organizations (CCOs), but not everybody knows what they are, including some of the people responsible for making them happen.

The Oregon Business Association honored 11 Oregonians this year for their contributions to CCOs, which are just being formed after winning legislative approval in 2011. One of the honorees said the task of CCOs is to fill in the white spaces between existing parts of the health care delivery system.

Senator Alan Bates, D-Ashland, talked about filling in the white spaces to ensure greater coordination in delivering health care services to improve patient outcomes and save money. He gave an example of a man who underwent extensive medical treatment for physical ailments, while his underlying psychological issues weren't diagnosed or addressed.

CCOs call for unprecedented levels of coordination between health care providers that are competitors. People seem to be playing well in the sandbox together now, but how it ultimately works out remains unknown.

Just as important is whether CCOs can help stem the tide of rising medical costs for low-income Oregonians as budget pressures build at the state and federal levels to find cuts in Medicaid and Medicare.

The predecessor term to CCOs — accountable care organizations — was first used in 2006 by Elliott Fisher, Director of the Center for Health Policy Research at Dartmouth Medical School, during a discussion at a public meeting of the Medicare Payment Advisory Commission. The term quickly gained credibility, reaching its pinnacle in 2009 when it was included in the federal Patient Protection and Affordable Care Act.  

The Public Policy Cauldron: What's Intractable and What's not


No less an important public figure than former State Senator Ryan Deckert, now president of the Oregon Business Association (OBA), used that term last week as he introduced Governor John Kitzhaber at the annual OBA Statesman dinner.

He said Kitzhaber, now in his third term as governor, has defied conventional political wisdom by taking on seemingly "intractable" problems such as education and health care reform.

Deckert's words contained a bit of irony because, at approximately the same time, police forces in Portland and Salem were removing so-called "Occupy Wall Street" demonstrators from overstaying their welcome in public parks and roads in the two cities. That group, like the right wing Tea Party, does not appear to be interested in solving intractable problems; they appear to want "their way or the highway."

Speaking of the Tea Party movement, in a column last week in the Oregonian, columnist George Will contended that, "in scale, Occupy Wall Street demonstrations-cum-encapments are to Tea Party event as Pittsburg, KA is to Pittsburgh, PA. So far, probably fewer people have participated in all of them combined than attended just one Tea Party rally, than of September 12, 2009, on the Washington Mall. In comportment, OWS is to the Tea Party as Lady Gaga is to Lord Chesterfield: Blocking the Brooklyn Bridge (or streets in Portland) was not persuasion modeled on Tea Party tactics."