By DR. ROBIN L. RICHARDSON

FamilyCare Health didn't want any of this. We didn't want to spend the holidays worrying about where our members will receive vital health care services in the new year. Nor did we want to announce layoffs of over 300 employees.

The story of FamilyCare's disagreement with the Oregon Health Authority over the reimbursement rates it pays us to provide care for our Medicaid-dependent members has always been a business story. Our exit from the Oregon Health Plan is a business decision forced on us by the OHA. FamilyCare has been providing excellent health care to Oregon's most vulnerable populations for over three decades, longer than any other coordinated care organization. No one disputes that.

But in 2015, OHA made the decision to reduce its payments to FamilyCare by 20 percent, a reduction that was not forced on any other CCO. These rates were simply insufficient to cover our costs. To this day, FamilyCare, the state's second largest CCO, has the lowest reimbursement rate of any CCO in the state.

We have tried to have OHA show us its rate methodology for three years. They have refused, claiming it is a trade secret. These secret rates have created over $100 million in losses for FamilyCare through 2017, and the 2018 rates offered by the OHA would force us into bankruptcy. The only explanation that the OHA has stated for these low rates is that we paid our primary care providers too much.

In 2013, we made a decision to get our patients off the assembly line. By increasing the amount we paid primary care providers, we increased our members' choice of providers and allowed providers the ability to spend more time with members. The basic idea -- better, more comprehensive care that would curb future costs -- fulfills one of the Oregon Health Plan's original objectives of "emphasizing managed care, preventative care, early intervention, and primary care." In fact, a 2016 Portland State University study found that each extra dollar spent on primary care translated to $13 in savings on other services, including emergency room and specialty visits.

In the often-impersonal health care landscape, FamilyCare has ensured our members know their primary care physician, and that their physician knows them. We've built a holistic approach to care, including the integration of mental health and addiction services. We have also created a nationally recognized integrated customer service model that provides one-call-service to members and providers.

FamilyCare's demise hurts those people the most and will have a domino effect across the system. We will work to ensure our members have a smooth transition, but there's no easy way to change health care providers. Regular appointments may have to change. Doctors, nurse practitioners and counselors may be different. And vital mental health and addiction resources could be lost at a moment when a patient is most at risk.

This was all avoidable. Over the last three years, the state has increased reimbursement rates by 12.7 percent for Health Share of Oregon, the other Portland-area CCO which will be absorbing many of FamilyCare's clients. In that same time period, the state has decreased rates to FamilyCare by 2.4 percent for essentially the same population. Had FamilyCare received reasonably similar rates we would still be in business today.

The state will now pay Health Share's higher rates for FamilyCare's members. There will be no money saved. There's only disruption. The loss of FamilyCare means a loss of certainty for so many. Most importantly, it means a loss of security and comfort for those who have little of it.

Robin L. Richardson, D.O., is chairman of the board of FamilyCare, Inc.