Are surgical centers getting the shaft from Oregon's new coordinated care organizations (CCOs)? Rob Schwartz, director of the Oregon Ambulatory Surgery Center Association, thinks so. "CCOs around the state have not invited ambulatory surgery centers to the table," Mr. Schwartz recently told The Lund Report. "Surgery centers have called [CCOs] and not received a meaningful response."

CCOs are community-based organizations that use patient-centered primary care homes and fixed global budgets. They're designed to reduce costs by improving efficiency and quality; by emphasizing preventive, integrated and coordinated care; and by focusing on managing chronic conditions. In Oregon, they combine physical, mental and dental healthcare providers under one umbrella and serve the state's Medicaid program.

They're guaranteed a 3.4% increase in payments every year, regardless of whether their costs go up or down, which might be expected to incentivize them to seek out and use the less-expensive ASCs, which they're prohibited by law from excluding. But Mr. Schwartz and others say that hasn't happened.

"We've tried, but we've not gotten a lot of attention from them," Jim Sergeant, administrator of the East Portland Surgery Center, told The Report. "They seem mainly to concentrate on hospitals. They might not want hospital services going out the door."

Others strongly rejected the assertion that ASCs are being treated unfairly. "We have quite a bit of usage of ambulatory surgery centers. It sounds like horse puckey to me," Jeff Heatherington, the CEO of a Portland-area CCO, told the Report. "They're far cheaper than going to hospitals. I think they're great."

"We use ambulatory surgery centers now," said Debi Farr, spokeswoman for a Eugene CCO. "We're looking to utilize those services more."

Greg Miller, a lobbyist for the surgery center group, was taking a wait-and-see approach. "CCOs are young," he said. "I don't want to jump the gun about how they're utilizing different providers just yet." He added that he's gathering information about the extent to which CCOs are using ASCs, and plans to make the data available to the Oregon Legislature in February.

Jim Burger