Policy Analysis: State Health Policy Reform Innovation

State Health Policy Reform Innovation
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Abstract
The US healthcare policy is undergoing changes aimed at instilling proper cost management and efficiency. Part of the development is evident at the state levels. Different states have taken the initiative to steer their healthcare through the necessary quality and cost management practices. In 2012, Oregon became one of the states that fuel healthcare reform innovations. The Oregon policy is known as the coordinated care model and was sponsored by the state legislator. The policy intends to integrate Medicare utilization in the state. The coordinated care model was based on the state's modification of its Section 1115 Medicaid waiver. The terms of the waiver indicate that Oregon would receive $1.9 billion federal funds over five years to fuel the implementation of CCOs. Within that period, the state needed to reduce its Medicaid-per beneficiary spending growth by at least two percentage points two years after the implementation. Oregon renewed its federal government waiver in 2017. So far, the results are positive, with Oregon leading in various state-based comparative analyses of healthcare innovations.
Keywords: coordinated care, waiver, and Medicaid
State Health Policy Reform Innovation
The US healthcare system is currently undergoing an extensive change poised to make it better. Partly, the present changes are focused on some of the problems that healthcare faces presently, including high costs and lack of efficiency. Various state governments have implemented healthcare policies that will lead to lower costs for the patients and hospital management, better outcomes, and enhanced quality. Governors understand that improving health to their citizens is essential in balancing budgets and controlling healthcare costs as much as it is important in ensuring that citizens live productively. There is a wide range of state health reform innovations poised to change healthcare structures in different states in the future. Oregon is one of the states that have designed platforms to instill futuristic healthcare plans in the state. This policy analysis explores Oregon's coordinated care model policy through its different prospects, including its rationale, adoption, funding structure, impacts, and ethical considerations. The coordinated care model is a vital innovation that could be mirrored in other states in instituting improvements in the coordination of care in Medicaid.
Coordinated Care Model
Oregon introduced a policy to improve its coordination of care in Medicaid in 2012. The new policy would be referred to as the coordinated care model, and it revolved around the inputs of coordinated care organizations (CCO) (Kowalski, 2018). CCOs are state-created community–based and integrated care organizations. The organizations are majorly developed to help integrate healthcare activities through segments of the state's population included in the Oregon Health Plan. CCOs are a form of accountable organizations whose members are part of the Medicaid segment of the population. The Oregon Health Authority describes CCOs as a network of stakeholders in healthcare, including members of the general population and patients and local ...