Salem Health position on health care transformation

We were pleased to have the opportunity to meet with the Statesman Journal editorial board today to discuss the challenges of health care transformation and what is needed for it to succeed.

Here’s what we presented:

Salem Health supports Governor Kitzhaber’s vision to transform health care leading to improved community health.

• More than $200 million in taxpayer dollars goes to the Coordinated Care Organization in Marion and Polk Counties for physical and mental health services for Medicaid recipients. We will all be expected to do more with less. We accept that larger hospitals will not get paid the full cost of care. Last year Salem Health lost $14.2 million on the services provided to our Medicaid population. Coordination of care across the delivery system should help keep people out of the hospital. That is a good thing.
• Health care transformation means that we are all focused on the health needs of the individual. It requires that all providers change the way we do business. The status quo is not acceptable or sustainable.
• Health care transformation involves a high degree of clinical integration and financial alignment. Shared risk and aligned incentives among all providers is a fundamental requirement to improve quality and reduce cost.

Salem Health is demonstrating its commitment to health care transformation that is in the best interests of the community.

• Salem Health is working with other members of Willamette Valley Community Health (the coordinated-care organization) to prevent unnecessary emergency room visits and readmissions. Salem Hospital and West Valley Hospital are part of a WVCH pilot project to facilitate timely primary care physician follow-up after emergency visits.
• Salem Health is working with WVCH members to develop a tool to identify network patients in need of additional health care resources after discharge from the hospital. The goal is to provide the most appropriate and cost-effective care for high-risk patients.
• Salem Health has partnered with WVP Health Authority to reduce the readmission rate of Medicaid heart failure patients. Our case management team ensures follow-up appointments are scheduled after discharge and care is coordinated.
• We believe all providers should equitably share both risk and reward for changing the current system rather than supporting the status quo.
• Recently, Salem Health proposed a risk model to the CCO built on the key principle of aligned incentives for all providers as a motivator for tighter clinical integration and seamless care coordination.

Transparency to the CCO owners is critical to the success of the CCO

• Since the CCO legislation was in development, we have been publicly vocal about the need for transparency. This is not a new issue for us.
• CCO board members need to have access to the necessary information to fulfill their legal and fiduciary responsibilities. Transparency is key to equity, fairness and trust for all members.
• We should ensure that its primary loyalty is to the community as a whole, rather than to any particular provider or group of providers.

We know that serving Medicaid patients is only the beginning, and that this program will be expanded to other consumers covered by the state. We need this transformation to be successful right from the start. We are committed to that.