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Some Good News for Oregon's Health System

PHOTO: Fewer Oregon Health Plan members are seeing this sign. Emergency room visits by Medicaid recipients are down by 21 percent, according to a new state report. Photo credit: Chris Bradshaw/FeaturePics.com.
PHOTO: Fewer Oregon Health Plan members are seeing this sign. Emergency room visits by Medicaid recipients are down by 21 percent, according to a new state report. Photo credit: Chris Bradshaw/FeaturePics.com.
January 16, 2015

PORTLAND, Ore. - Medicaid expansion in Oregon last year didn't mean a spike in costs or emergency-room use, according to a report released this week by the Oregon Health Authority.

The state said Medicaid costs for inpatient hospital services have decreased about 5.5 percent since 2011, despite adding 380,000 new Medicaid enrollees to the system.

Martin Taylor, CareOregon's director of public policy, said it hasn't been easy, but the state spent time developing Coordinated Care Organizations (CCOs) to get more local, preventive care to more people.

"I think there has been stress on the system in the last year," he said. "The reason we were able to make a successful transition of that large a new population was because we'd spent several years putting together CCOs, improving the navigation system, and having a more efficient system."

Taylor said these improvements predate the Affordable Care Act. Oregon's goal is to reduce Medicaid spending by 2 percent per patient per year. The report said emergency room visits by Oregon Health Plan members are down 21 percent since 2011.

Fewer adults with diabetes required hospitalization for complications, according to the state report, and fewer people with asthma or chronic obstructive pulmonary disease ended up in hospitals. Taylor said both are indications that people are getting used to having a "Primary Care Home" - where they can go with any health concern, before it ends up being an emergency.

"The health system has been able to keep visits in primary care settings consistent, so that people have more preventive health," he said. "It has also done a better job of helping patients navigate to their primary-care setting, or urgent-care setting."

The state report said Primary Care Home enrollment is up 55 percent since 2011, and that more people also are getting drug and alcohol treatment - and for children, more developmental screenings.

The report is online at oregon.gov.

Chris Thomas, Public News Service - OR