SALEM, Ore.– La Oregon Health Authority (Autoridad de la Salud de Oregon) afirma que las Coordinated Care Organizations CCOs, organizaciones de cuidado coordinado) que atienden a los pacientes de Medicaid a través del Oregon Health Plan (Plan de Salud de Oregon), están trabajando bien para recibir bonos por los avances que han logrado en cuidados preventivos y en el menor uso de salas de emergencia. Esta información se esboza en un reporte anual que comenzó a circular el martes.

Más de 340 mil nuevas personas se han afiliado desde enero al Plan de Salud de Oregon (OHP), y un reporte reciente afirma que este sistema mostró una enorme mejoría durante el año pasado.

El estado vigila lo que las Coordinated Care Organizations CCOs están haciendo por los pacientes del Plan de Salud de Oregon o de Medicaid. Encontró que el número de consultas de pacientes externos en cuidados primarios aumentó un 11 por ciento, y los servicios preventivos subieron 20 por ciento durante 2013.

Ambos indicadores revelan que más personas están recibiendo atención más oportunamente, en vez de llegar a Emergencias. Mimi Haley, quien encabeza el CCO de Columbia Pacific, afirma que a largo plazo eso significa que es muy posible ahorrarle dinero al estado.

“Se puede reducir el uso inadecuado de la sala de emergencias si te aseguras de que la gente acuda a los servicios de atención primaria, que quienes ofrecen esa atención la promuevan, por ejemplo ‘Hey, hace mucho que no la vemos, ya necesita venir para hacerle una mastografía.’”

Haley agrega que el reto actual de los CCOs es mantener sus estándares altos y a la vez servir a muchos más pacientes este año. Su CCO creció de 15 mil miembros a los actuales 24 mil, a partir de que la Ley de Cuidado Accesible (ACA) permitió que más personas pudieran entrar al Plan de Salud de Oregon.

El reporte estatal establece que se está monitoreando a más bebés para detectar a tiempo cualquier problema, y ya hay menos internamientos causados por condiciones crónicas entre los miembros del Plan de Salud de Oregon que en años anteriores. El Dr. Jim Rickards, oficial de estrategia sanitaria de la Yamhill Community Care Organization (Organización Yamhill de Cuidados Comunitarios), dice que esto es en parte el resultado de la colaboración entre los diversos tipos de proveedores de atención, y también de que los pacientes participan en los comités y grupos de trabajo de CCOs.

“Ya sabes, antes de que los CCOs despegaran realmente no había mucho diálogo entre ambas partes, ni siquiera con los miembros que recibían atención; realmente no teníamos esa retroalimentación. Pero ahora, con estos CCOs, como que tenemos una plataforma para que todos se comuniquen, se relacionen y empiecen a trabajar juntos.”

La Autoridad de la Salud de Oregon (OHA) comparó las mejoras en 17 áreas para recibir bonos por el desempeño de sus CCOs. Se trata de dinero de Medicaid originalmente destinado a los presupuestos de los CCOs, pero había sido retenido como incentivo para que éstos superaran sus parámetros.

El reporte (en inglés) puede ser consultado en oregon.gov.


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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.