Oregon Wins, For Once

The Oregon/Washington rivalry extends even to the world of public policy, apparently. Where we have Washington’s somewhat punitive approach towards dealing with Medicaid costs (to say nothing of the cost shifting involved…), Oregon seems to be trying something completely different:

Oregon Gov. John Kitzhaber signed a bill Friday implementing his plan to redesign health care in his state, which the former emergency room doctor said would reduce costs so significantly it could help fix the federal budget.

The new law will allow novel ways of paying for and delivering health care, such as assigning the costliest Medicaid patients caseworkers to manage all aspects of their care, from medical to mental, with the goal of eliminating redundant tests and procedures and reducing expensive hospital stays.

The idea here—extended in Atul Gawande’s New Yorker article “The Hot Spotters”—is that you assign workers to help certain patients to help navigate the obstacles of the health system. It’s something that should absolutely work in theory, which is why it’s nice to put it into practice.

There’s a portion where proponents say the program could—if applied nationwide—save about $1.5 trillion over 10 years, which is quite a bit of money. If it ever materialized I wonder whether we’d be better off just plowing the money right back into Medicaid and raising reimbursement rates (so as to increase access), but that’s a thought for another time. It’s good to see a try. Well done Oregon.