Winter Spring 2018

13 Winter/Spring 2018 In Astoria, says Thorsen, the push for change is motivated by the freshmemory of a time before Medicaid expansion, when an underinsured communitymeant an overtaxed emergency department. “We don’t want to return to an environ- ment like that,” he says. “The expansion and having people covered has certainly improved our profitability, which we have in turn invested into improvements in the community deliver system.” Collaborations with the city, county, and other Oregon hospitals including OHSU have enabled CMH to expand its primary and specialty care options and open a 16-bed crisis respite center to better address behavioral health needs. Such successes prove the value of a little vision and a lot of teamwork, saysThorsen. “It took collaboration and a little bit of risk. People had to put some money in, and we were uncertain what the outcomes might be. But it’s proving to really pay off in terms of getting care delivered in the right place at the right times.” ‘Better off together’ Soundermodels and smarter partnerships will be key to keeping Oregon’s health care system steady and solvent going for- ward, says Davidson. Hospital leaders, for their part, must embrace their roles as consensus builders, he adds, nurturing stronger relationships with hospital gov- erning bodies and boards, plus reaching beyond the confines of their own insti- tutions to collaborate and brainstorm. And they must manage it all without losing sight of the end users: those com- munity members who will walk through the hospital doors seeking reliable, afford- able care today, tonight, and tomorrow. “The need to find commonality is more important today than it’s ever been,” he says. “At the end of the day, the secret sauce to all of it is the acknowledgment by hospital leaders that we’re way better off together than we are on our own.”  H