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Policy Summit at 2015 CFHA Conference

Posted By Matthew P. Martin, Friday, October 16, 2015


According to Senator Elizabeth Hayward, the process of health care change is "messy and organic”. And so agrees the rest of the expert panel at the 2015 CFHA Policy Summit in Portland, Oregon which included wonks from both the public and private sectors in Oregon and Colorado. This first-of-its-kind meeting covered current initiatives and barriers, stories of success, and future challenges. Robin Henderson and John Muench opened the summit and Deborah Cohen moderated the discussion among panel members who represent two states leading the health care transformation charge.

The expert panel included the following:


Janet Meyer, MHA

CEO, Health Share of Oregon 

Ron Stock, MD, MA

Director of Clinical Innovation, Oregon Health Authority 

Sean Kolmer, MPH

Principal, Health Management Associates 

Lynne Saxton      

Director, Oregon Health Authority 

Robin Henderson, PsyD

Chief Behavioral Health Officer and Vice President of Strategic Integration

St. Charles Health System 

Patrick Fox, MD

Chief Medical Officer

Colorado Department of Human Services 

Patrick Gordon, MPA

Associate Vice President

Rocky Mountain Health Plans 

Judy Zerzan, MD, MPH

Chief medical Officer/Director of Client & Clinical Care Office

Colorado Department of Health Care Policy and Financing 

Vatsala Pathy      

Director, State Innovation Model 


The format for the summit meeting was conversational and off-the-record. Panel members enjoyed a sense of safety in the intimate setting as they discussed mutual challenges with only a small sympathetic audience within earshot. According to one audience member, meetings between policy experts from different states rarely happen but they need to in order to push change farther. Two factors were clear at the onset of the meeting: 1) both Oregon and Colorado have had tumultuous histories with health care reform and 2) both states have taken advantage of recent crises to try new and bold initiatives.

For example, in 2010 Oregon faced huge financial problems in supporting state health services. In response, the state legislature approved (57 to 3) plans to create Coordinated Care Organizations (CCO) to "treat the whole person” and organize previously fragmented services for the Medicaid population. In Colorado, several factors lead to innovation including fallout from years of managed care, state fiscal issues, and the indomitable Colorado spirit of independence. State leaders began to invest in a new multi-payer system and integrated behavioral health services. Today, both states are finding success with their recent investments in groundbreaking policies strategies as well as facing ongoing, inherent challenges.

Some of those challenges include:

-          Working with federal, state, and local stakeholders: allowing for flexibility while striving for standardization in policies and protocols

-          Creating a clearinghouse for data management and sharing

-          Federal administrators have short tenures which disrupts momentum and working relationships

-          States are not collaborating enough to share successes and brainstorm new strategies

-          Fear and misconceptions of change and the health care industry prevent stakeholders from making progress

-          Moving customers from Medicaid to private insurance


Despite these challenges, both states have made remarkable progress. Colorado boasts one of the lowest uninsured rates in the country, has multiple integrated care clinics across the state, and utilizes an effective multi-payer model. Oregon has 16 CCOs across all parts of the state to cover over 2 million Medicaid recipients, is moving away from volume-based to outcome-based productivity models, and is working closely with counties across the state toward a global budget.


All panel members agree that there is much more to be done. Ron Stock believes that states should be as transparent as possible when reporting outcomes of various quality metrics. He also notes that a more cohesive and comprehensive advocacy plan will carry the message of reform farther. Patrick Gordon reminded the audience that hospital systems need reform as well to completely move away from the fee-for-service model of yesteryear. Robin Henderson predicts that success with reforming the Medicaid systems will lead to future success in improving state employee health systems. Finally, Sean Kolmer believes that state governments can drive the conversation on integrated health care services and that state budget crises are real opportunities for designing innovative policies that take health care systems in new directions.

What does the policy summit mean for you? The takeaway messages seem to be, yes, change is messy AND stakeholders can have honest conversations about the barriers and challenges facing health care reform. Senator Hayward concludes that moving to new care systems is really hard for most people but that we can change our frame of reference from fear-based to what works. 

  Matt Martin, PhD, LMFT, is director of behavioral science education at the Duke/SR-AHEC Family Medicine Residency Program in North Carolina. He is the current CFHA blog editor. Interested in writing? Send a message at


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