At this month’s Health Care Cabinet meeting, we heard about
health
reforms in Oregon and Maryland with a focus on how/if their successful
strategies could be applied in Connecticut. Oregon consolidated state health
purchasing under one new state agency, implemented an ambitious Medicaid waiver
with a total annual cap on cost increases, assistance for PCMH transformation
(similar to CT Medicaid’s glide path), and a commission that reviews medical
evidence of effectiveness and makes coverage recommendations. Oregon relies
heavily on data analysis and evidence-based medicine to address both over- and
under-use of care. Several Cabinet members supported expanding this capacity in
Connecticut. Oregon Medicaid has created 16 capitated Coordinated Care
Organizations (CCOs), similar to ACOs, that have responsibility to care for all
Medicaid members in a specific region. CCOs have improved quality and access
measures and have exceeded savings targets. Maryland’s reforms have focused on
reducing hospital and total costs and expanding PCMHs. Consumer satisfaction
rates have improved, racial disparities are down, and achieved savings across
measures. Next month we will hear from our last state and begin deliberations
on recommendations for Connecticut.
