Health Reform in Oregon: Coordinated Care Could Improve Conditions For All

By Mary Monnat, Guest Columnist for The Oregonian, Saturday, February 18, 2012

Mary Monnat

Mary Monnat

An orthopedic surgeon, a consumer of mental health services, a dentist and an addiction counselor are sitting at a table … talking. No, this is not the windup to a joke. Far from it. This is a serious conversation and one of hundreds like it happening all over Oregon in preparation for health care reform that promises to radically improve the health of all our communities. Radical? Yes, Oregon is on the brink of something bold. The passage of Senate Bill 1580, and its call for the creation of Coordinated Care Organizations, represents an incredible opportunity that will benefit all Oregonians.

How so? While the bill targets the most vulnerable members of our community, those on Medicaid — many of whom struggle with poverty and chronic health conditions, including serious mental illness, addiction and multiple traumas — it also paves the way for improved care for all of us. Coordinated care will result in fewer public dollars spent on expensive hospitalizations and emergency room visits, allowing us to invest these savings in prevention and early intervention. For example, Bill Graves’ compelling Sunday Oregonian article on cutting costs for the Oregon Health Plan, “Emergency savings” (Feb. 5), makes clear how potent the savings can be: hundreds of thousands of dollars.

Since the launch of health care reform last year, the conversations have been lively as all stakeholders grapple with the reality that we must do better at far less cost. Fortunately, the individual patient has been at the center of all this talk. By keeping the focus on who matters most, barriers come down, possibilities emerge and amazing things happen. We can do better.

As behavioral health care providers, we need to do better at screening our consumers for chronic health conditions and linking them to primary care. It’s not enough to prevent psychiatric hospitalizations. We also have to keep our consumers from using the emergency room over and over to treat their chronic health conditions. It’s a wasteful use of resources, especially when primary care is the best prevention for keeping people with serious mental illness from dying 25 years earlier because of chronic health conditions.

Similarly, primary care needs to routinely screen patients for addiction and mental health issues. Not surprisingly, as individuals and families experience the first signs of mental illness, they often turn to their doctor for help. Unfortunately, doctors are not always trained to deal with such needs. By partnering with behavioral health, medical staff can intervene earlier and disrupt the costly downward spiral of addiction and mental illness. Now that is real hope. Even better, such ready access and routine screening also shatters the stigma associated with these illnesses. More will get help sooner, saving lives and preserving families.

We have an amazing opportunity to do well by all Oregonians. The conversations have been critical, important and will continue, but it’s time to act. Now is the chance for us to be bold and really pull together across the legislative aisle and across the sectors of business, health care and human services to make a lasting difference for a healthier Oregon.

Let’s work together. Let’s do this now.

Mary Monnat is President and CEO of LifeWorks Northwest, which provides mental health and addiction services.

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