Community Governed Healthcare...
A Solution to a National Epidemic
Many countries, especially the United States are facing an epidemic. It’s not a disease, a parasite, a drug problem, or any number of issues that come to mind when we think of the word epidemic. What nations are afflicted with is the lack of organized systems of healthcare.
For the most part, countries collections of hospitals, providers, commercial payers and government insurance programs have been cobbled together over time. No intentional design of an actual system with the end user in mind(the patient) with clear goals and measurable performance indicators was undertaken.
As a result, most communities don’t have a single mission, vision, global budget or standard set of metrics with which to manage their healthcare resources. Additionally, there is not usually a platform to allow for governance of healthcare resources that allows for provider and patient input. The state of Oregon realized this gap as an opportunity. In response to this problem, it created a policy and legal framework for communities to build community-governed healthcare plans called Coordinated Care Organizations. There are now 16 of these entities in the state which provide medical benefits to over 1.1 million individuals. Over the five years, they have been in existence, medical costs have been held to under a 3.4% annual cost trend increase. Clinical quality metrics have also been achieved such as a statewide decrease in hospital readmissions by over 30% since 2011. CCO’s work for Oregon’s communities and can probably work just about anywhere.