Oregon's innovative way to do more with less Medicaid funding

The Affordable Care Act (ACA) is changing how Medicaid funding works--money is increasingly tied to outcomes, rather than pegged to tests and procedures, according to a story published in the Milwaukee-Wisconsin Journal Sentinel.

Armed with a new flexibility, Portland health systems have found an innovative way to cut costs by treating root causes of problems that cycle patients through their doors, the article said.

In light of this, can an air conditioner (AC) be considered medicine? Janet Meyer, CEO of Health Share Oregon, says it can, according to the article.

"There is the case of a guy with a heart problem," Meyer told the publication, describing a patient who goes to the emergency department, where doctors stabilize him and send him home, only to see him return days later.

"Come to find out, he's in a walk-up with no AC--he has trouble managing his fluids," Meyer said. "We say, 'Maybe what he needs is an air conditioner.' Instead of going back and back to the ER, we buy him an air conditioner and help him manage his fluids."

The end result is less money spent and the patient's health improved.

The relentless economics of the U.S. healthcare system have sapped resources in poor areas for decades as hospitals and doctors follow the money in the form of well-insured patients, according to the Journal Sentinel.

Doctors and medical care facilities serving large numbers of poor patients have trouble staying afloat because the care necessary to treat uninsured patients and those on Medicaid is expensive.

While most systems tried to skirt financial losses by avoiding those patients, a handful--from hospitals in Camden, New Jersey to Philadelphia to those involved in the Oregon effort--have decided to focus on the poor, making them the centerpiece of efforts to spend less and give better care, according to the Journal Sentinel.

Oregon's effort is centered on the high users--patients who show up frequently for emergency care and readmissions after hospitalization--among the approximately 971,000 people enrolled in its Medicaid program, the article said.

Some of the most successful strategies to improve care and lower costs include encouraging providers and patients to make good healthcare choices, expanding access to medical homes and primary care, and promoting an increased use of technology, as was previously reported by FierceHealthPayer.

To learn more:
- see the article

 

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