SPIRIT A CareOregon eNewsletter
  March 2012   2012 Vol. 1
CareOregon's Community Care Program's team;
Left to Right: Peggy Parker, David Labby, Lisa Pearlstein, Carrie Covode, Debra Read, Laurie Lockert, Rebecca Ramsay. Front row seated left to right: Amy Vance, Becky Wilkinson and Rachel Hammer

Q. Could you talk about the beginnings of the new community care program at CareOregon?  What was the primary influence in launching the program? How was the idea conceived?

A. The exploration of community care teams began when the funding cuts to Medicaid were announced. The actual idea was ignited by a trip to Boston by David and Rebecca to visit a colleague, Bob Masters, MD, who is the CEO of an organization called the Commonwealth Care Alliance. It is a small health plan that serves high-risk, dually eligible individuals in the greater Boston area. Bob has run a community-based care model for these individuals for about 20 years, and we wanted to see it in action.

"In the clinic setting there is usually an established relationship between the provider and the member. By having the provider perform introductions (we call it doing a “warm handoff”) to the outreach worker, we are establishing faster connections with prospective members than if we make “cold calls” to them."
Laurie Lockert
Community Care Program Manager

We spent two days going on home visits with his teams and were incredibly impressed with the quality of care they were providing and the reductions in expensive avoidable hospital and ER visits that were the result. We came back to Portland, talked it over with the Senior Management team, got approval from Dave and the board to start a pilot, and then began engaging our primary care partners in the development of the program.
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Neighborhood Health Center's Midwife Program

Michele Megregian, NMNP
Michele Megregian, NMNP examines CareOregon member and expectant mother April White at the Neighborhood Health Center Beaverton clinic.

Midwives have been around since… well, since the first woman helped another through childbirth. And certainly since before doctors existed.

Now there is a resurgence in this time-honored tradition, and Neighborhood Health Center–Beaverton is a part of it.

Michele Megregian, NMNP, and Sally Hersh, CNM, MSN, are midwives practicing at Oregon Health & Science University. Since early November 2011, they’ve also been seeing patients at the Beaverton clinic.

Like all Neighborhood Health Center clinics, the Beaverton office is located where a need was identified for more primary care for low-income, uninsured and Oregon Health Plan members. The Beaverton clinic also has more demand for prenatal care than there are practitioners.
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Have you ever had a vendor or business colleague complain about having to go through  Customer Service before reaching you or a department you asked them to call?

503-488-2255* * * * * * * * * * * * * * * *

Provider Video Campaign
is Launched

As we mentioned recently, Communications, Provider Services and the web team created videos and brochures to highlight the ease of working with CareOregon and the values we share with our providers. We’ve got the latest provider video on the website, linking from a banner on the home page.

See our provider videos.

Check it out and share it with your provider contacts. We have invited providers and others to share their recommendations for other providers who share our values and make a difference in their communities.

If you want to nominate a provider,
check out our survey.

Emily Katz, MPH

Emily Katz, MPH
Federal Policy Manager

CO-OP Update from Washington, DC

You have probably heard the term CO-OP used more and more throughout CareOregon over the past several months.  From All Staff meetings to the Business Plan, the term CO-OP may come up often in your conversations (or not!).  In my last staff newsletter article, I covered much of the CO-OP basics. To save time, I’ll spare you most of the repetition from that article. That article can be found by clicking .

CO-OP stands for Consumer Operated and Oriented Plan.  The Affordable Care Act called for the establishment of the CO-OP Program in order to foster the creation of member-governed qualified nonprofit health plans in each state’s Health Insurance Exchange.  Oregon is on track to have their Health Insurance Exchange fully operational and excepting enrollment by October 2013, in time to provide coverage in the small group and individual market beginning January 1, 2014. There will be at least one CO-OP offered on Oregon’s Insurance Exchange.
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Coordinated Care Organizations: The future of Medicaid in Oregon

Erin Fair, MPH, JD

Erin Fair, MPH, JD
Sr. Manager of State &
Federal Regulatory Policy

Like much of the rest of the U.S., Oregon has been in the grips of a crippling recession that has been devastating to the state budget, and the programs that it funds.  The Oregon Health Plan (OHP, Oregon's Medicaid program) is one of the largest pieces of the state budget, and it is the state's fastest-growing cost.

Unlike most of the rest of the U.S., Oregon's legislature and Governor Kitzhaber decided to balance the state's budget and (hopefully) curb the cost of medical care in OHP by taking bold steps toward transforming the way care is paid for and delivered.  Most states, on the other hand, have simply cut reimbursement, cut benefits, or cut Medicaid enrollment - all of which simply shift costs elsewhere in the system.

Oregon's plan to transform OHP, Senate Bill 1580, was signed into law last Friday, March 2, 2012.  This plan depends on a new kind of entity called a Coordinated Care Organization (CCO), which will be responsible for managing the cost of integrated physical, behavioral and oral health services for those who are enrolled in OHP.
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