Polk, Marion join provider network

SALEM -- Polk and Marion counties and 11 health care organizations throughout the Willamette Valley entered into an agreement June 19 to form a Coordinated Care Organization (CCO) to better serve regi



SALEM -- Polk and Marion counties and 11 health care organizations throughout the Willamette Valley entered into an agreement June 19 to form a Coordinated Care Organization (CCO) to better serve regional Medicaid patients.

A CCO is a network of all types of health-care providers -- physical, mental health and dental -- that agree to work together in their local communities for people who receive health care coverage under the Oregon Health Plan (Medicaid).

CCOs are intended to focus on prevention and helping people manage chronic conditions, like diabetes. This helps reduce unnecessary emergency room visits and gives people support to stay healthy. A goal is to reduce the per capita cost of health care.

If the state gives approval the Marion-Polk CCO, named Willamette Valley Health, LLC, will be up and running by Aug. 1.

"I think this is an exciting time," said Geoff Heatherington, Polk County Mental Health administrator. "We really have an opportunity to transform how health care is delivered to people on the Oregon Health Plan."

Heatherington, as well as Bob Brannigan, West Valley Hospital administrator, and Polk County Commissioner Craig Pope, has been part of planning for the CCO, a process that began more than a year ago.

The agreement is between 13 entities, including Polk and Marion counties, Northwest Human Services, Salem Health/Salem Hospital and West Valley Hospital.

"While everyone in this group provides some form of health care, our organizations are all set up differently," said Cheryl Nester-Wolfe, R.N., chief operating officer for Salem Health.

"We spent a lot of time learning how one another's businesses work and finding a way to mesh the requirements of not-for-profit entities with for-profit entities to come up with a new model," Nester-Wolfe said.

Pope added the agreement is unique among the plans emerging across the state in that both counties' governments are involved.

"This is the only one that has a provision that county commissioners' votes are relevant," Pope said, adding the goal with county involvement was to assure county services, such as public health, mental health and addiction treatment, are funded adequately.

Heatherington said there is still plenty of work remaining. An implementation committee is meeting weekly to plan for the transition before the CCO is set to begin operation in August.

He said the goal is for patients not to notice a difference in service at first. Gradually, services will become more integrated until the CCO achieves its objective of having patients work with a team of providers encompassing all of their needs.

Pope said the coordination is needed to reduce the cost of providing care by concentrating on prevention and helping patients avoid visiting emergency rooms.

"I think the key thing for people to understand is this is about Medicaid," Pope said, adding Medicaid funding is often in danger of being cut. "I think that CCO operations is the first step in offering better delivery of care for less dollars."



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