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 December Employers intend to ignite the health care landscape Oregon's major employers are teaming up to get a better deal on health care. Public and private employers want to influence health care decisions. Toward that end, they've created the Oregon Coalition of Health Care Purchasers, which represents more than 75,000 employees and their dependents. The statewide coalition is a merger between the Lane Health Coalition and the Oregon Health Care Purchasers Assn. Members include the Port of Portland, PGE, Northwest Natural, Tektronix, Blount Industries, the Public Employees' Benefit Board, the cities of Eugene and Portland, Lane and Multnomah counties, and Eugene and Springfield school districts. Specialists insist Providence's bonus system is capricious Providence Health Plan's IPA will revamp its reward system for specialists next year following a torrent of criticism that its current set-up is unfair. "It's fair to say this has been a divisive issue at all the institutions dealing with this plan," said Thomas D. Lindell, MD, a surgeon at Providence Portland Medical Center since the early 1970s. "A lot of us feel it is capricious and arbitrary, and not a quality bonus. It has nothing to do with quality; it has to do with volume." Beginning in 1996, Interhospital Physicians Assn., Providence's IPA, has sponsored a specialty quality bonus program, recently called a "participation" bonus. The program pays between $1.5 million to $2 million a year with bonuses up to $20,000 going to individual specialists -- those who receive at leat 40% of Providence Health Plan's patient referrals. Hospitals, MDs agree to discuss Oregon Health Plan disparities Gov. John Kitzhaber has encouraged hospitals and physicians to resolve their differences before the 1999 legislature convenes. Kitzhaber aide Mark Gibson and Barney Speight, administrator of the Office of Oregon Health Plan Policy and Research, have brought together key stakeholders, including Alan Yordy, chairman of the Oregon Health Council, and Michael Bonazzola, MD, access committee chairman, and representatives from the Oregon Medical Assn. and the Oregon Assn. of Hospitals, as well as health insurers. Full steam ahead for "Operation Bad Bundle" Federal attorneys in Texas have dropped out of Operation Bad Bundle, a nationwide Medicare probe into hospital billing practices for outpatient lab tests, but more than 30 Oregon hospitals are still under the gun. Asst. US Attorney Bob Nesler, who heads up the investigation in the Beaver state, said he has no plans to call off the dogs. "We anticipate these cases going forward," he told the Oregon Health Forum. "They will continue to be investigated and hopefully resolved." Launched last year, Operation Bad Bundle has so far recovered $14 million from hospitals nationwide. Hospitals fare better than MDs The Milliman & Robertson report confirms what physicians have been saying for the past few months. -- hospitals earned more money on the Oregon Health Plan than they did. On average, physicians were paid 65% of their commerical rates, while hospitals recovered 80% for inpatient care. However, the report is not conclusive, said M&A actuary Robert Cosway. Findings do not include physician withhold payments or reimbursement to small rural hospitals, known as Type A and B. Also in this issue...
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