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 November Physicians, hospitals will learn the truth about the OHP If the Henery report sent shock waves through the medical community, wait until Dec. 14 -- when Milliman & Robertson (M & R) share their findings on the finances of hospitals and physicians Their analysis looks at the Oregon Health Plan as well as the commercial arena. "We're looking at the reasonableness of the overall capitation rates," said Bob Cosway, consulting actuary. The M & R report will determine whether Henery's findings are valid, said D'Anne Gilmore, assistant administrator of the Office of the Oregon Health Plan Policy and Research (OHPPR). Prescription for trouble: MDs rally against PBM tactics As pharmacy costs continue to rocket skyward, Oregon doctors are increasingly concerned that pharmacy benefits management companies (PBMs) -- many of which are owned by pharmaceutical manufacturers -- are using confidential patient information to boost sales of particular drugs Delegates at the Nov. 7-8 meeting of the Oregon Medical Assn. approved a resolution urging the AMA to take steps against "inappropriate and unethical" use of confidential patient information by PBMs in steering patients toward "preferred drugs. Telemedicine: A revolution pending in rural health care? The faceless, impersonal nature of modern medicine is often cited by disillusioned consumers as a symptom of the inadequacy of health care to meet the needs of patients. Telemedicine, or the use of telecommunications to provide medical services to consumers, could be the most radical departure from the traditional patient-physician relationship. Proponents of telemedicine claim it will expand and improve medical services to rural residents. Critics, however, see the practice as an expensive, and not necessarily efficient alternative to traditional medical referral. Telemedicine, they say, is another example of how emerging medical technology is de-humanizing health care by distancing the patient from his/her medical advisors. Long-term care feels Medicare pinch Adult foster care is on the wane and providers claim low Medicaid reimbursement coupled with aggressive marketing by assisted living has crippled their industry. It's difficult to remain operational when Medicaid reimbursement is half what it is for assisted living and we are limited to only five beds by the state mandate," said Roberta Ronning-Fry, owner of Ronning-Fry Homes, Inc. in Eugene. Foster care providers struggling to survive have had to make difficult choices to remain viable. Many can't afford to accept Medicaid patients. But with the exodus of private pay customers to assisted living, foster homes have few options Also in this issue...
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