Oregon Health Care Reform

[Cinquefoil]

Hi y'all.

I'm a student nurse right now, but am really interested to hear your ideas about how you think House Bill 3650 and the creation of CCO's may affect nursing practice in Oregon?

Here are a couple of links on the bill: http://gov.oregonlive.com/bill/2011/HB3650/

http://www.wecandobetter.org/2011/07/live-webcast-taking-the-pulse-of-health-system-transformation-in-oregon/

The second link is clearly slanted in favor of the bill: I'm not intending this post to be for or against.

I am really interested in what you think may change in daily practice if this bill passes!

Thoughts?

[Cinquefoil]

To get the ball rolling, here are some thoughts I've heard from nurses so far:

Cons:

1. Clinics scrambling to form CCO's (coordinated care orgnizations = legally mandated combination of medical, behavioral, dental, mental health services), this added to their usual workload.

2. Larger health care providers taking over creation of CCO's, leaving holes in service provision due to lack of continuity of care in populations.

3. Social determinants of health largely determine health; this program only covers health care, which has been estimated to only influence 10% of individual health

Pros:

1. Nurses' strengths (holistic view, patient teaching, tailoring the care to the person) are backed by organizational mandate, enabling more nurses to more powerfully shape patient care

2. CCO's finally help low-income patients get holistic care more easily and make it easier for nurses to get this for their patients (more direct referrals, less "hurry up and wait" or workarounds)

Pro or con?

Nurses have less bedside presence, more case management and community health worker supervision.

Thoughts?