Program aims to cut Medicaid costs in Jackson County

Taking a bite out of soaring Medicaid costs is one of the goals of a coordinated care organization that should start up Sept. 1 in Jackson County.

"We want to get control of 20 percent of the population that requires 80 percent of the dollars," said Sen. Alan Bates, a Medford Democrat and doctor who has been working on the state plan.

The idea is to better shepherd some Medicaid patients who suffer a multitude of maladies and have difficulty negotiating a maze of doctors, clinics and hospitals. In some case, one patient might be diagnosed with schizophrenia, diabetes, obesity and other disorders.

The Jackson County Coordinated Care Organization received provisional approval from the Oregon Health Authority as part of a statewide goal to improve the Medicaid/Oregon Health Care program.

If successful, the new approach could cut Medicaid's rising costs by $10 billion statewide over a 10-year period, Bates said.

In Jackson County, 38,077 people are eligible for Medicaid coverage, according to CareOregon.

Because this is a pilot project for this state only, the federal government has awarded $1.9 billion in grants over five years to get the program up and running.

Medicaid costs still are expected to rise, but not as steeply if these organizations prove successful, Bates said.

"We're trying to bend the curve," he said.

Jackson County could actually get two separate community care organizations under the plan.

AllCare Health Plan Inc. is a physicians group that would serve Jackson and Josephine counties and is scheduled to start Aug. 1.

The Jackson County Coordinated Care Organization could begin Sept. 1, and is a partnership with CareOregon, and providers and organizations in the county, including Addictions Recovery Center, Asante Rogue Valley Medical Center, Community Health Center, Jackson County Health and Human Services, Jefferson Behavioral Health, Jefferson Regional Health Alliance, La Clinica, OnTrack, PrimeCare and Providence Medical Center and Medical Group.

Jeanie Lunsford, spokeswoman for CareOregon, said some areas in the state have chosen to have multiple care organizations while others only have one.

The organizations will assess the needs of the patients and determine who would benefit from managed care.

A "navigator" would be assigned to patients seeking more intensive care, with the hope of lessening the number of emergency room or hospital visits.

She said the program could offer something as simple as buying a scale for a congestive heart patient to determine whether water is building up around the lungs.

In other cases, the program could provide some means of going to the grocery store to find more healthful food alternatives, Lunsford said. Other times, the navigators would make sure patients get to medical appointments.

The caseload could vary for navigators, who would text and talk on the phone to patients to make sure they are following through on their treatments, she said.

The goal is to get the patients into a routine where they avail themselves of cheaper medical alternatives rather than going to the emergency room, Lunsford said.

If successful, the program should improve the patient experience, the outcome of their treatment and reduce overall costs to the health system, she said.

"I think Oregon will be the pacesetter for the rest of the country," Lunsford said.

Reach reporter Damian Mann at 541-776-4476 or email

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