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Oregon Medicaid Expansion

Oregon Medicaid Expansion Update

 

Oregon Medicaid Expansion Update: As part of the Medicaid provision of the Affordable Care Act, also known as Obamacare all state Governors had the option of expanding their states Medicaid program to the newer inclusive and broader terms as outline by the Patient Protection and Affordable Care Act (Obamacare). Oregon and its governor was one of the twenty five state that chose this path, however as more low income Oregon residents rush to use their new Health Care plans, the new enrollees are proving to be a challenge to the new revamp health network and are straining the system.

Under the Affordable Health Care Act, the Oregon Medicaid Expansion program added nearly 360,000 people to the Oregon Health Plan, its version of Medicaid. This value is more than twice the number original projected prior to the roll out. This has also ballooned the state Medicaid program to nearly 1 million Oregon residents, about a quarter of the state’s population.

The Oregon Medicaid Expansion rollout was the centerpiece of Gov. John Kitzhaber’s plan to help reduce costs and improve health care by primarily focusing on primary care and reducing the number of patients in state Emergency rooms. The revamped health care network was to be the backbone of this system, and had even been endorsed as the potential system that would support a national Medicaid model when the system was rolled out, however as the system begins to face the overwhelming demand of Oregon residents, its locking out some patients, forcing others to wait months for medical appointments and prompting a spike in emergency room visits, which state officials had been actively seeking to avoid.

While the coordinated care model has been championed by the state’s Democratic governor, an early supporter of President Barack Obama’s Affordable Care Act, and is unique to Oregon it has been facing a series of issues of late

— Two regions have stopped accepting new patients, locking out more than 16,000 new enrollees in western and southern Oregon, state data shows. The new patients are still insured, but without a coordinated care network, they’re on their own to find a doctor.

— Eight regions saw some practices, clinics and individual doctors close to new Medicaid enrollees.

— In five regions, thousands of enrollees haven’t been assigned to a doctor or been in for their first medical appointment.

— Seven regions report that new patients are facing long waits for primary care visits, delays that can last months.

— Seven regions report an increase in ER visits, up to 30 percent, in a statistic that has been particularly troubling for supporters of Oregon’s efforts.

According to the article written by the Associated Press, “the problems comes amid nationwide growing pains associated with the unprecedented restructuring of the U.S. health care system, and they show the effects of a widespread physician shortage on a state that has embraced Medicaid expansion.”

Most proponents of the system see this as growing pains very early in a complicated process, and it’s a natural part of rolling out a new system supporters say they anticipated the need for more doctors and are already implementing solutions to improve access to care. They also point to the crush of new Medicaid enrollees as proof that their efforts are necessary and working.

For critics, these problems just adds fuel to the growing series of Oregon Medicaid Expansion woes that include the state’s decision to spend a quarter of a billion dollars on an online marketplace that failed under a litany of embarrassing problems and prompted a switch to a federal site.

However there are efforts being put in place by the state to help the system recover. These efforts include coordinated care organizations opening new clinics and offering grants to physicians who’ll accept more Oregon Health Plan members, offsetting low federal reimbursements that had prompted many doctors to turn Medicaid patients away. Two coordinated care regions have even increased Medicaid reimbursement rates for doctors to run even with commercial rates.

One example includes Virginia Garcia Memorial Health Center, which comprises nine clinics in northwestern Oregon, and serves 36,000 patients in Washington and Yamhill counties. The center has been working through a backlog to link thousands of people to doctors, using innovations such as group visits and telemedicine.

The state continues to enroll new Medicaid recipients unfortunately; the number of physician and health care providers are not increasing at the same rate.

 

chris_jones
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