Health Care Cabinet considers Oregon and Maryland’s reforms

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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.