Health Reform Policy to Practice: Oregon as a Case Study for a Path to a Comprehensive and Sustainable Health Delivery Model offers a real world example of an innovative, successful and comprehensive program conducted by the U.S. State of Oregon.
In 1991, Oregon embarked on a journey to improve health for all its citizens by radically re-thinking how to approach health care for long-term benefits. Over more than two decades, Oregonians have participated in a dialogue to create a new approach to solve the dilemma of providing high quality health care that is affordable and effective. Traditionally, health care reform looked at cutting people from care, cutting provider rates or cutting services. Oregon’s approach is unique in that it built a new system of delivery from the ground (community) up.
The Oregon model took a “Fourth Path to health care by redesigning the clinical delivery system through reducing waste, improving individual health and prevention, and therefore reducing utilization of services, creating local accountability, aligning financial incentives and creating fiscal accountability. This is not only an Oregon story, but a national one as other states, payers and purchasers implement health care reform.
- Written by content experts who have been actively involved in health care reform efforts
- Provides clear translation of current information and experience to implementation
- Explores the potential impact of the Oregon experience on national and international health care reform efforts
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About the Author
Dr. Stock is a geriatrician, family physician, clinical health services researcher, and the former Director of Clinical Innovation at the Oregon Health Authority Transformation Center. With past funding from the John A Hartford Foundation, Robert Wood Johnson Foundation, and AHRQ, he has dedicated his professional career spanning thirty years to improving the quality of health care for vulnerable populations, with a focus on redesigning the primary care delivery system in the community for older adults through an interdisciplinary team model. Before joining Oregon Health&Science University in 2012 as an Associate Professor of Family Medicine, he served as Executive Medical Director of Geriatrics and Care Coordination services, and Medical Director of Education&Research at PeaceHealth Oregon Region. In 2012, he was appointed The Foundation for Medical Excellence John Kitzhaber MD Fellow in Health Policy with special emphasis on studying the impact of medical home and coordinated care organization health care delivery reform on physicians and medical practices in Oregon.
A graduate of the University of Nebraska College of Medicine, Dr. Stock completed his residency and faculty development fellowship in Family Medicine at the Medical University of South Carolina and University of North Carolina-Chapel Hill and has a Certificate of Added Qualifications in Geriatric Medicine. He has been an invited member of numerous technical expert panels that include AHRQ panels on team-based care design and measurement in primary care, the Institute of Medicine (IOM) Best Practices Innovation Collaborative on Team-Based Care, an IOM Task Force exploring the role of “Patients on Teams, and a former invited member of the National Quality Forum Measurement Applications Partnership Clinicians Workgroup advising HHS on quality measures for public reporting and pay-for-performance.
Dr. Goldberg served two Oregon Governors as the Director of the Oregon Office for Health Policy and Research, the Director of the Oregon Department of Human Services from November 2005 through February 2011, and then led the formation of the Oregon Health Authority from February 2011 through 2013. He led Oregon's nationally recognized health reforms transforming Oregon’s Medicaid system to one based on a model of coordinated care. In addition, he led efforts to establish Oregon’s Healthy Kids program providing health coverage for all children, improve Oregon’s mental health system and transform the delivery of public human services to enhance efficiency and effectiveness.
Dr. Goldberg's experiences span time as an administrator of large complex organizations, a practicing clinician, teacher/academician, a county health officer, medical director for a Medicaid managed care organization, and Director of Community Health Services for the US Public Health Services in Zuni, New Mexico. He has been a faculty member at Oregon Health and Science University for more than 15 years. He is a graduate of the Mount Sinai School of Medicine in New York City and completed his family medicine training at Duke University School of Medicine in Durham, North Carolina.
Table of Contents1. Foreword: Leveraging State and Federal Health Reform Efforts to Improve Care
2. The Oregon Narrative: How did we get here
3. State-level Design: The Coordinated Care Model
4. The Coordinated Care Organization: Organizing Care to Improve Health
5. Developing a primary care infrastructure
6. Implementation Strategies and Support: The Transformation Center
7. Measuring Success
8. Integration of Care
9. Community Engagement
10. Aligning financial models with healthcare delivery
11. Expanding the Coordinated Care Model beyond Medicaid
12. Creating a future state