Health policy experts discuss necessary improvements to Oregon health care system

The Oregon Health Forum held the event “Healthcare Transformation in Oregon: What’s Happening Now?” Tuesday which brought health policy experts together to discuss next steps in Oregon health care policy. Panelists discussed the importance of lowering costs through Value-Based Payment (VBP) methods, creating a public health insurance option to cover all Oregonians and making health care more accessible and equitable for all. 




Panelists included Kevin Ewanchyna, president of the Oregon Medical Association, Jeremy Vandehey, director of the Health Policy and Analytics Division of the Oregon Health Authority(OHA), Becky Hultberg, president and chief executive of the Oregon Association of Hospitals & Health systems, and Felisa Hagins, political director of SEIU Local 49. 

The panelists highlighted the large cost increase throughout the last few years. According to Hagins, Oregon is a high cost state. Ewanchyna showed a graph stating that since 2013 Oregon percentage of total health payments per person are at 29%, while the national increase lies at 12%. Ewanchyna said:

“We only have to look at our own pocketbooks to really see that we are paying more for services, whether it be copays or deductibles. These cost increases have not necessarily improved our health as a population.”

To improve these rates, Vandehey endorses House Bill 2081, which will hold health systems and insurers accountable in the implementation of an improvement plan and to report cost growth data. This will allow for the OHA, health systems and insurers to be more transparent with each other to steer the cost increase in a more manageable direction. 

On a more personal level, VBPs will help keep cost down for consumers, according to the panel. The VBPs pay providers for keeping patients healthy instead of fee-for-service, which incentivizes volume instead of holistic care, according to Hultberg. 

To help insure all Oregonians, it is important that people who are already on the Oregon Health Plan do not lose and regain their eligibility to the Oregon Health Plan consistently. This intersection of people is referred to as the “exchange”, according to Hagins. Examples include minimum wage workers that go from part-time to full-time and employees who are able to get overtime pay throughout the year. Creating a public option under Cover All People, HB 2164, would fill these cracks as well as expand eligibility for underprivileged communities like those from COFA countries, according to Vandehey. Hagins said:

“Without the COVID protections that the federal government has put in place, what we are seeing is that populations go in and out of the exchange. And then we know that, the prices and cost and coverage on the exchange could be improved.”

Outreach, expanded eligibility and lowering of costs are steps to make Oregon’s health system more equitable. Inequity is still very prevalent in Oregon’s health system and focused steps need to be taken to combat it, according to Vandehey. 

“Despite all of our efforts on quality, we’ve learned that unless the system is centered in equity, disparities and inequities really persist.”

Hultberg exercised caution in passing a lot of new legislation. 

“Before we pass policy this legislative session, I think we should understand if the health care system has the capacity to absorb that change at this moment in time and if that change is aligned with our long-term vision.”

View the whole event here