COHO Helps Managed Care Actually Manage Care
Going into the 2011 session, Oregon was facing a major budget deficit which was felt especially harsh in the Human Services Budget. The original proposed cuts to providers were a devastating 39%. The Legislature was able to band-aid those cuts down to 11.2%. While these cuts are still too high, COHO led the effort to give Managed Care Plans the ability and flexibility to manage those cuts effectively by closing loopholes some providers were using to avoid cuts.
COHO championed legislation closing the loophole that would have allowed hospitals to arbitrarily raise their revenues. Senate Bill 204 required the Oregon Health Authority to prescribe one payment methodology for hospitals and ambulatory surgical centers for both inpatient and outpatient rates. By linking inpatient and outpatient rates, it is expected that tens of millions of dollars will be saved in outpatient costs, and great incentives created to use more cost effective forms of care.
COHO also led the effort to pass Senate Bill 101. SB 101 lowers the non-participation rate for non-contracted hospitals from 2% to 4% below the base Medicare cost for non-contracted hospitals. This bill gives hospitals more incentive to contract with Managed Care and allow more flexibility to evenly dispersing the cuts throughout the entire health care system.
Senate Bills 101 and 204 will be vital tools for Managed Care Organizations to bridge the Oregon Health Plan to the next biennium. They bring fairness to the systems and will ensure that critical health care access is maintained for the most vulnerable and sick Oregonians.