Spending on behavioral health 'blew the doors off' of the funding system. Now the state of Oregon and CareOregon are figuring what to do, says CareOregon president and CEO Eric C.Hunter

The number of people struggling with behavioral health problems soared during the COVID-19 pandemic. The state of Oregon responded, says CareOregon president and CEO Eric C. Hunter. It plowed $1 billion into the behavioral system, raised rates by 30% and “even opened up provider panels to people who were unlicensed to increase access,” says Hunter, who is a member of the Managed Healthcare Executive (MHE) editorial advisory board. CareOregon, the largest Medicaid managed care plan in Oregon, also got involved, investing $200 million into building behavioral health capacity, according to Hunter.

“We really invested in all that stuff. It worked, but it blew the doors off the funding system because so many people came in to take advantage of those systems,” Hunter says.

In this second segment of an extensive interview with MHE, Hunter speaks about the aftermath of the surge in spending on behavioral healthcare. In his view, behavioral health as it currently exists is ill-suited for meeting the long-term needs, often in different settings, that many people with behavioral health issues have. 

“How do we build in an entire sort of continuum of care, and is that the responsibility of managed care companies?” Hunter says, “We don't employ providers, and if they don't exist, who provides the infrastructure to build them up, because we won't start paying them until they're actually there and seeing patients? That's really the biggest challenge.”

Hunter discussed some of CareOregon’s behavioral healthcare efforts, singling out for mention the CHAT [Community Health, Assess and Treat] program that dispatches technicians instead of a firetruck and ambulance to take care of people having an behavioral health emergency.

Hunter says that paying for behavioral health and related services does save money overall but winds up costing CareOregon.

“We're talking now to community partners, to the city and the county, and the metro departments, and the state, about how we define societal advantages of that work. We knew what it meant to healthcare spend. But what does it mean to the jails, to the police departments, to the schools, to say, ‘Hey, if we realize the savings for multiple areas of society, then there is a value add,’ and then it’s easier to pay for expanding that kind of work,” Hunter said.