HEALTH INSURANCE INITIATIVE
Insurance costs are rising and more and more people are incapable of carrying insurance. Dr. Kauvar felt strongly about economically driven health care inequities and devoted a good deal of time to his innovative health care initiative. "We've got a situation that is so urgent with healthcare coverage,"he said, "that we've really got to be able to try some new approaches." For Kauvar, one important new approach came from an experiment undertaken a decade ago in Oregon.
In the early 1990s, the state of Oregon was working to implement the Oregon Health Plan, a then-controversial approach to providing healthcare to Medicaid recipients that relied on a "prioritized list" of medical procedures. The list was created through an extensive process of medical outcomes evaluation and town meetings to gauge what Oregonians valued in the healthcare system.
The result was a list that had more than 700 items on it. The idea was to allow the state legislature to strike a balance between the number of people that the state could afford to cover with Medicaid and the services that it would offer. The goal was to cover more people for the most beneficial healthcare services, realizing that some of the less efficacious procedures may no longer be covered.
As with anything having to do with healthcare coverage, the evaluation of the Oregon plan has been mixed. But it has shown enough promise that Kauvar enlisted a small group (including Former Governor Richard Lamm, Jim Hertel, President of Healthcare Computer Corporation of America and Chris Adams to see how this approach could help with Colorado's uninsured problem.
Currently, this group has been working with private and public entities to see if it would be possible to make commercially available a health plan based on the prioritized list. The idea would be that residents could purchase a plan for a lower premium that may not cover everything, but because the prioritized list ranks procedures by how beneficial they are, they would get "the most healthcare for the buck." Although this proposal uses a list of health services similar to the Oregon Health Plan, it is fundamentally different because its goal is to provide a more affordable and medically effective choice in the private sector, not as a basis for limiting Medicaid services.
"This approach to healthcare holds a great deal of promise," says Chris Adams "Rather than providing some people-either those who can afford private insurance or those who are very poor and qualify for Medicaid-with very rich benefit plans, this approach strikes a middle ground. It provides the most beneficial treatments at an affordable price."