Q & A with Jeff Heatherington | CCOs straining from Medicaid surge | Who’s driving the bus at Cover Oregon?

The downside of this time of transition in health care is that sometimes the margin for error is painfully small.  Sometimes, getting to success is an iterative – and ugly – process.    

Like politics and sausage making, watching how successful health care delivery and financing comes together can sometimes be tough.  We have a few of those things on our list this month:  the painful parts of an iterative process of transition.

1. Q & A with FamilyCare CEO Jeff Heatherington

If you’re wondering how Medicaid expansion looks from the front lines, there is no one better to ask than Portland-based FamilyCare’s president and CEO Jeff Heatherington.

In this exclusive interview with State of Reform, Heatherington offers some interesting insights on the challenges of running a CCO.  He also reflects on the recent “ruckus” in the Oregon legislature regarding a dispute between OHSU and his organization.   The interview is a good read from one of Oregon’s longtime – and more colorful – health care leaders.

2. CCOs straining from Medicaid enrollment surge

Cover Oregon has had its problems, but signing up new Medicaid enrollees hasn’t been one of them.  After only a few months, nearly 280,000 newly eligible Oregonians have signed up for Medicaid, more than twice the number the OHA had projected would enroll by the end of 2014.

If anything, Oregon may prove the wisdom of the old adage “be careful what you wish for,” because some CCOs are clearly feeling the strain.  Two of the 16 recently closed their doors to new enrollees, which has fueled new concern about long-term viability even with the transformation project well underway.

3. Who’s driving the bus at Cover Oregon?

In a surprising move, the Cover Oregon board recently hired turn-around expert Clyde Hamstreet to serve as interim executive director following Bruce Goldberg’s resignation.  The search for a new permanent hire begun in February continues.

The real question, we think, is increasingly this:  who is in charge there?  If it’s the board chair, Liz Baxter, why didn’t she testify to Congress?  If it’s former Providence CEO Greg Van Pelt, who did go before Congress, why wasn’t he named the new interim executive director?  If it’s Hamstreet, who is the new interim exec, why wasn’t he named to the permanent position?

4. HHS goes public with Medicare payment data

There was a big splash last week when HHS released to the public an enormous database of payments to doctors and other health-care providers.  The release came thanks to the persistence of the Wall Street Journal.  Additional news organizations from the New York Times to the Seattle Times rushed to report on the doctors and specialties receiving some of the biggest payments.

It will take a while to sift through the information to reach any solid conclusions about what can be found in the data. The question will be what consumers and businesses do with the data and how it will get used in months and years to come.

5. VA wrongful deaths in Oregon and Washington revealed

There was stunning news this month that the U.S. Department of Veterans Affairs paid out more than $200 million in wrongful death payments to veterans’ survivors during the decade following 9/11. The payments were made for more than 1,000 wrongful deaths in VA medical centers, including 22 deaths in Oregon and 14 at the VA in Seattle.  The Center for Investigative Reporting, based in California, obtained the VA data.  The frustration that members of Congress expressed at a recent hearing suggests this issue is likely to get a lot more attention.

The sad reality is this:  generally speaking, the U.S. long-term care system works great if you’re rich.  It works pretty well if you’re poor.  But, it’s not so hot for folks in the middle.  This story seemed a painful reminder of that fact.