Managing care is familiar turf, but substance use disorder is looms as a a major challenge, says CareOregon president and CEO Eric C. Hunter, MBA

Providers may not always like the amounts, but when it comes to standard medical care, CareOregon is on familiar turf.

“The core benefits, doctors and hospitals, and all that — that tends to work on its own. That's a system. It’s defined. We understand it better. We know how to fund it, even if the providers don't always love the number,” says Eric C. Hunter, president and CEO of the Portland-headquartered CareOregon, the largest Medicaid managed care plan in the state with approximately 600,000 members.

But figuring out the cost and delivery of care for people with substance abuse disorder is one of the biggest challenges that he and CareOregon are facing, Hunter said in an extensive interview with Managed Healthcare Executive (MHE). This is the first segment of the video of that interview. Hunter is a member of the MHE editorial advisory board.

Substance use disorder, said Hunter, “is still just out of control — understanding the utilization, the different levels of care needed and trying to serve people in a system that has been historically underfunded and not necessarily designed to move people through a system and series of recovery. It's meant for episodic care. We get them off the streets and get them to [the emergency room]. But then what happens? We get them into the state hospital, but what about the step-down?”

Hunter also mentioned funding and the “systematic erosion of scientifically defined needs in the system” as the challenges. That erosion, he said, included removing Planned Parenthood from the CareOregon network and the dismantling of DEI [diversity, equity and inclusion] programs “so that we can target populations who have been traditionally left behind.”

Hunter continued, “Social determinants of health work that we try to do — the housing pilot, the climate change pilot, nutrition — those kinds of benefits, the work we've done to build up structures to try to head off long-term spend — are being dismantled. It's penny-wise and pound-foolish.”