Oregon gives coordinated care organizations millions to provide health care to Medicaid patients. It’s an experiment to change the incentives in health care so that there’s a drive to control costs and improve quality.
We hope it works, but one aspect of the experiment needs a change proposed by Senate Bill 415, which would require CCOs to operate under Oregon’s public meetings law. CCOs are currently exempt.
CCOs work with public money to provide a public health care program. One hundred percent public money.
CCOs also have virtual monopolies and enjoy an anti-trust exemption under Oregon law.
They shouldn’t then get to make their important decisions about how they spend the money and provide care behind closed doors.
During recent testimony on the bill, CCOs argued against the change. They pointed out all the ways in which they listen to public input.
“There’s every attempt to be transparent, but when we go into our board meetings we do have work to do,” said Janet Meyer, the CEO for Health Share of Oregon, the largest CCO in the state.
That’s an interesting view of openness. It would be like the Bend City Council or the Oregon Legislature having an opportunity for public comment but then going behind closed doors to make decisions.
CCOs made the point that they sometimes have sensitive contract negotiations to discuss.
But there are exemptions under Oregon’s public meetings law for discussions about contract negotiations. The bill is not asking that identifiable patient information be made public.
It’s also true that CCOs are held accountable by the state for performance. They must also explain to the state how they spent the money.
But if they are making those decisions about care behind closed doors, the public is shut out from the most important matters that the CCO takes care of.
We should say that PacificSource, the CCO in Central Oregon, has been open with us about its plans. When the state of Oregon declined to provide a document to us about what it wanted PacificSource to do, PacificSource provided it. PacificSource and the health care providers in the region are also trying to come up with innovative ways to control costs.
The proposed change in the law is not an attack on PacificSource or any other CCO. They are, though, doing the public’s business with public money. Their meetings should be required to be open to the public.