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Oregon Agency Proposes Behavioral Health Changes

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Oregon’s health reform agency wants to create a system of regional entities that would coordinate mental health care and behavioral health care in each region in the state.

The Oregon Health Authority included that idea in a list of four recommendations released March 24.

A regional entity would oversee the region’s behavioral health care providers. The entity also would oversee the behavioral health efforts of organizations not typically seen as behavioral health services providers, such as schools and law enforcement agencies, according to the authority.

The authority also recommended that the state adopt statewide behavioral health care competence standards, come up with a plan for improving behavioral health care worker training, and make more use of information technology tools, such as mapping systems, to understand where it needs to increase the supply of providers.

The authority based the recommendations on work done by a commission that the authority created last summer.

Oregon has been active at developing and implementing health system change programs.

The state used Affordable Care Act Medicaid expansion money to expand Medicaid enrollment.

The state tried to set up a state-based ACA public exchange but had trouble getting its exchange enrollment systems to work. Oregon ended up using, the exchange enrollment and account administration system developed by the U.S. Department of Health and Human Services.

Oregon has been trying to improve the quality and efficiency of its Medicaid program by setting up coordinated care organizations. A CCO is a group of hospitals, physicians, clinics and other providers that agree to works as a team to care for a region’s Medicaid enrollees. A care coordinator is supposed to help each enrollee get care.

CCO supporters say the programs improve care and hold down costs. Oregon CCOs succeeded at holding the state’s increase in Medicaid spending per enrollee to just 3.2% this year, according to the Oregon Health Authority.

In some regions, patients say CCOs make care too hard to get.

In September, The Register-Guard, a newspaper based in Eugene, Oregon, quoted consumers who complained about difficulties with getting behavioral health care and other types of care from their region’s CCO.

The success or failure of care coordination efforts in Oregon could influence similar efforts elsewhere. Employers and commercial insurers throughout the country are testing whether accountable care organizations, or entities similar to CCOs, can improve the quality and efficiency of care in the commercial health coverage market.

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