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Mon Feb 25, 2013, 03:13 PM

Medicaid: Oregon Gov. John Kitzhaber: ‘No one thinks fee for service is working’

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/25/oregon-gov-john-kitzhaber-no-one-thinks-fee-for-service-is-working/
Oregon is at work on an ambitious Medicaid experiment one that, if it works, could save the federal government $10 billion over the course of a decade. The idea — which you can read more about here — is to change the way doctors and hospitals get paid, incentivizing them to provide more cost-efficient care.

--snip--

Kitzhaber got a sense that governors in both political parties were generally frustrated with the Medicaid program. It keeps eating up more of their already-squeezed budgets. “No one thinks fee for service is working,” he said.

The plan Kitzhaber is implementing in Oregon has split the state up into 15 regions, each with a fixed budget. Unlike fee-for-service medicine, where more volume adds up to more profits, the hope here is that a capped budget will put downward pressure on health care spending.

Will Kitzhaber’s plan soon show up in other states? “There was a lot of interest about the waiver,” he said, mentioning that he fielded questions from governors of Arkansas, Montana, Nevada and Washington.

“I’d like to find a few governors, both Democrats and Republicans, who could really collaborate on something like this,” Kitzhaber said.


Thirteen years as a practicing emergency room physician. The architect of the Oregon Healthcare Plan. And now responsible for the 2 billion dollar gamble that Oregon cannot afford to lose- and which could revolutionize Medicaid (and possibly healthcare in America) if we win.

You can look over a very basic outline here.

PB

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Reply Medicaid: Oregon Gov. John Kitzhaber: ‘No one thinks fee for service is working’ (Original post)
Poll_Blind Feb 2013 OP
joeybee12 Feb 2013 #1
Poll_Blind Feb 2013 #3
Mojorabbit Feb 2013 #5
Wounded Bear Feb 2013 #2
Warren DeMontague Feb 2013 #4

Response to Poll_Blind (Original post)

Mon Feb 25, 2013, 03:15 PM

1. I think the big potential problem with this is NOT prescribing necessary tests

In order to stay within budget.

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Response to joeybee12 (Reply #1)

Mon Feb 25, 2013, 03:22 PM

3. Agreed. But, IMO, I think the reason Kitzhaber made this deal is because he has a...

...good idea how Medicaid is both being exploited and where it breaks down and (again, IMO) I believe he thinks he can nail the target with the budget under the new plan.

We get the 2 Billion over five years, but if we miss any of the milestones along the way- bang! It's over. It's quite a gamble and I'd even admit a strange and potentially dangerous one. But with his background and with what he's already accomplished, I am hoping he knows what he's doing. I think he does.

PB

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Response to joeybee12 (Reply #1)

Mon Feb 25, 2013, 05:19 PM

5. That is what happened back in the day

It failed then. I wonder why they think it will work now.

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Response to Poll_Blind (Original post)

Mon Feb 25, 2013, 03:16 PM

2. Actually, there are many who think it is working just fine.....

That would be the folks making money hand over fist on people's misery and pain, headed up by the medical insurance industry.

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Response to Poll_Blind (Original post)

Mon Feb 25, 2013, 03:26 PM

4. I'm gonna listen to what the man has to say, for sure.

the system as it stands now has some deep ingrained structural problems.

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