Over the past four years, almost 400,000 Oregonians gained health insurance coverage through the Oregon Health Plan, paid for by the federal government under the Affordable Care Act (Obamacare). Using an innovative delivery model in CCOs, Oregon has kept per enrollee cost growth to just 3.4% per year, much slower than the growth of overall healthcare costs. As a result, Oregon’s Medicaid funding challenge is primarily driven by a reduction in federal support for the state’s program. Oregon has several available options to fund Medicaid that does not include taking coverage away from people: reducing administrative costs and improving program efficiency while embracing options to maximize federal dollars to help pay for the program.
8 year total: -$365 million
Supported by information provided by the Oregon Health Authority, we believe a savings of $90 million could be achieved without impacting the quality of health care provided through the program. Components include: admin reductions; holding hospital and physician fee for service rates flat; additional drug rebate money; initiatives to improve program integrity; small reductions in other OHA programs; enforcement of mental health preferred drug list.
8 year total: -$1,062 million
Oregon’s hospitals pay a unique assessment on their revenues called the “hospital assessment” that is an effective avenue to raise funds to support Medicaid without shifting costs to the state’s commercial insurers. We can maximize the impact of this assessment by dedicating any available carry-over balance from the 2015-17 biennium, as well as broadening the base of this innovative tax to include all hospitals in the state. Lastly, we can offset about $150 million by enabling OHSU to receive an intergovernmental transfer with the state government.