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 April Finances may drive physicians from QualMed More than 600 angry physicians could abandon QualMed of Oregon because the corporation refuses to return $4 million of risk-withhold money collected in 1997 from doctors who were formerly in PACC Health Plans. If the doctors follow through on their threat, it could put the health care of 200,000 Oregonians at risk -- creating a chink in the mortar that holds together Oregon's health care system. SUMMARY: QualMed notified the doctors that the $4 million was needed to help the insurer meet budget targets. The physicians are furious that they spent years building up PACC as a doctor-led cooperative, only to see a giant health company swoop in and wreak such havoc with their expected income. The OMA has gone to bat for the doctors, but they can't expect any help from state insurance regulators. This story includes a revealing interview with QualMed CEO Martin A. Preizler, by OHF writer Linda Roach Monroe. Roseburg docs give up $1.2 million to save SureCare SureCare has endured the toughest financial maelstrom in its five-year history. After the physician-owned insurance company in Roseburg dipped below the minimum reserve required by Oregon's Insurance Division, its 120 doctors agreed to forego $1.2 million in outstanding charges. SureCare's woes resulted in the departure of Susan Scheufele, CEO and founder, plus steep staff cuts. The insurer relied heavily on income from the Oregon Health Plan, but it began losing money on Medicaid because of higher than expected reimbursements due to hospitals. The state plans to address the cost-based reimbursement guaranteed to rural hospitals in the next session of the legislature, if not sooner. Oregon's HMOs retrench in 1997 Taking a look at the 1997 financials for the state's six largest HMOs, the losses are the first thing that jump out. Four of the health plans lost money, and one of the two that didn't, Kaiser Permanente, saw its net income plunge 92.9%. The best improvements were shown by Providence Health Plan, where the income went up by a factor of seven to $5.7 million, and by Regence HMO Oregon, which lost $6.5 million but made a $19.2 million improvement over last year's losses. Each year, OHF prints the annual financial statements of the state's biggest HMOs, as well as the financial data and salaries of a host of other health insurance companies. The losses were big, but the HMOs appear to be cutting back and hunkering down as they prepare to raise premiums and start bringing in more revenue. Total medical/hospital expenses dropped 3% from 1996, but net assets surged 21%. Southern Oregon bursts with competition The dust won't settle for some time in the Rogue Valley, as the two largest competing health systems -- Providence Medford Medical Center and Asante Health System -- grow even bigger. Providence and Asante are both going ahead with multi-million dollar construction projects. The health systems are in an all-out race to secure market share in this growing part of the state. Other headlines
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