 |
 |
 |
 |
 |
 |
|
|
 November CareOregon takes over the Oregon Health Plan in Portland CareOregon has made it official. It's planning to take over the majority of Oregon Health Plan members in Portland -- with the imminent departure of Regence HMO Oregon, Providence Health Plan and Kaiser Permanente. By next September, when the transition is completed, CareOregon will double its membership and have 98,000 clients. Only FamilyCare, with 4,000 members in Portland, will remain. In January, Regence members begin rolling over to CareOregon as physician groups climb aboard, said Mary Lou Hennrich, CEO. " Everyone's working together to convince everyone to stay in the game with us. Whichever physicians have contracts, we'll take their members. " By next April, CareOregon will have Regence's 25,000 members in Portland -- while the 7,100 in Washington County are expected to join Tuality Health Alliance. Another 20,000 members are coming from Providence, while Kaiser has 12,000 lives. " Providence is helping plan the transition and is willing to stay until the end of September if that works best, " Hennrich said. Kaiser, meanwhile, has said it will remain for an unspecified time. Rural health clinics get the spotlight Over the past year, Diane Redd has visited each of Oregon's 27 rural health clinics, asking their boards and staff about basic business practices. She wanted to know everything about their internal office operations from staffing to marketing strategies. Redd, a rural health clinic consultant, was hired by the Oregon Primary Care Association to survey clinics in small, remote communities to assess their health and well being. Her results and recommendations will be included in a report issued by the OPCA in December. The project, now in its second year, is funded by a $70,000 grant from the federal Bureau of Primary Health Care. The survey's purpose " is to learn about rural health clinics and then provide the technical assistance to strengthen their business practices and keep them from going out of business, " said Redd. Historically, about 20 percent of rural health clinics have closed their doors each year, leaving many small towns without primary care. The reasons are varied and have as much to do with their geographic isolation and small populations as with patients' lack of health insurance or adequate incomes. Kitzhaber has big plans Watch out Congress. Gov. Kitzhaber is heading your way with some radical proposals. " I plan to aggressively challenge Medicare and Medicaid policies in the form of waivers, " he told the Oregon Medical Association's House of Delegates in November. " I intend to beat down the doors of Congress over the next 18 months. I can't think of a better way to spend my time. " He leaves office in January 2002. Kitzhaber can count on plenty of help. Recently Oregon received a $1.25 million grant from the Health Resources and Services Administration to identify strategies to cover Oregon's uninsured population. Kitzhaber is focusing on four areas -- eligibility, benefits, co-payments and the CHIP program that covers low-income children. He wants to use CHIP dollars to help pay their parents' insurance premiums and for safety net and school-based clinics. Developing a basic benefit plan that's not as rich as the priority list for non-categorical eligibles -- single adults and married couples without children -- is also on his radar screen as well as imposing co-payments to encourage more responsibility by consumers. PacifiCare assumes the risk from physicians After crafting a deal with Legacy hospitals and 453 physicians, PacifiCare is gearing up to change its contracting arrangements. Until now, PacifiCare gave physicians the responsibility to manage their own risk, make referrals and handle prior authorizations. However, after an outcry by physicians, PacifiCare decided to launch PacifiCare Direct. It's intended to rescue physicians from their financial losses. OSU scores victory over Plan B Because of religious convictions, most pharmacists at Oregon State University's student health center refuse to dispense Plan B, an emergency contraceptive approved by the FDA. That's made it extremely difficult for students to gain access to the pill. Until now, nurse practitioners could only dispense the pill when the pharmacy was closed. However, the Board of Pharmacy decided to change that rule, giving nurse practitioners that right, regardless of the time of day. But not before a prolonged discussion. Bill Boyce, RPh, pharmacy director at OSU, said the student health center didn't have a private area to counsel patients and felt it was far better for nurse practitioners to give the pill after counseling students. " We want to provide emergency contraception in the most expedient manner with the least amount of embarrassment, " Wayne Kradjan, dean of the College of Pharmacy at OSU, told the board. Multnomah County revamps mental health system After agonizing over the mental health system for nearly a year, Multnomah County Commissioners are determined to make drastic changes. When they meet Dec. 7, the scenarios facing them share one component Ñ they each call for a single entity to oversee mental health. Currently, CAAPCare and Ceres Behavioral Health share responsibility for the 87,000 Oregon Health Plan clients in Multnomah County. The commissioners could restructure the system by contracting with CareOregon or create a non-profit entity as the overseer. Commission Chair Bev Stein leans toward CareOregon. She wants to create an integrated delivery system for physical and mental health and reduce the fragmentation, which has haunted the system. " CareOregon is committed to delivering services to ethnic minorities and the low income, " she said. However, CareOregon's CEO, Mary Lou Hennrich, isn't anxious to take over mental health. " We have to be reasonable. It's very flattering for everyone to say let CareOregon do this, but hang on a minute. Let's not throw the baby out with the bath water. Right now we're kind of busy. We don't want to say absolutely not, but the timing is not good. " Coalition attempts to resolve tobacco dispute The defeat of two ballot measures earmarking the tobacco settlement is being turned into a victory by its opponents. A coalition led by tobacco prevention advocates representing the heart, lung and cancer societies fought both measures. Now that same coalition is seeking endorsements from all the health care players. Next session, lawmakers decide the fate of the tobacco settlement, which will bring between $280-360 million into state coffers. The coalition wants 20 percent devoted to tobacco education, 20 percent for long-term care and 60 percent for the Oregon Health Plan. Unless the health care community unites, the coalition worries that the tobacco settlement will be spent on other pressing needs such as K-12 education. " We hope we can put together a coalition and will reach out to the hospital association, " said Tom Novick, of M and R Strategic Services whose coalition spent $280,000 to defeat both ballot measures. However, the Oregon Association of Hospitals and Health Systems isn't hopping on the bandwagon. Also in this issue...
|
|
 |
