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 December E-Board victory by hospitals could be short-lived After weathering the November Emergency Board without a scratch, hospitals are hoping their good fortune will continue when the legislators return on January 9. But since the fast and furious decision making in November, some lawmakers are reconsidering their vote to beef up hospital reimbursement at the expense of mental health, chemical dependency and adult dental benefits for 110,000 Oregon Health Plan members. Public outcry over the decision is finding its way into the ears of legislators, who refused to hear public testimony prior to the November vote. Breathing life back into the Oregon Health Plan Saving the Oregon Health Plan is Jeff Heatherington’s top priority. “Our intent is to come up with a way to address the current budget issues to preserve the foundation of the Oregon Health Plan,” said Heatherington, CEO of FamilyCare, who was chosen by the health plan contractors to lead a newly formed work group. But from the onset, it doesn’t appear as if everyone is on the same page. Take Rep. Jeff Kruse (R-Roseburg) for example. He’s not certain the prioritized list is still relevant. During the group’s first meeting, “we got into a discussion that the list should disappear,” he said. Earlier, at an Oregon Health Forum breakfast, Kruse said: “We can no longer afford the Oregon Health Plan. There’s a better way. A single payer system will be a disaster. But the Oregon Health Plan needs to go away, and we need to get to some real health care.” Mission impossible For rural obstetricians and physicians in high-risk specialties such as neurosurgery, finding the cash to pay for increased medical malpractice insurance may seem impossible. For administrators of assisted living facilities who take care of mentally ill seniors, just finding the coverage is impossible. Gary Lane, who runs Fillmore Lane Foster Home in Eugene, is going bare. “There are no laws against not having insurance.” Anti-trust exemption challenged The era of West Coast monopolies didn’t end when California’s railroad powerhouses dismantled, according to Congressman Peter DeFazio. “This is an issue that DeFazio hopes to bring attention to,” said Kristie Greco, his spokesperson. In the most recent Congress, DeFazio introduced a bill to deal with the insurance crisis by eliminating the antitrust exemption guaranteed to the insurance industry under the McCarran-Ferguson Act of 1945. A new sheriff in town A new voice will join the choir singing for tort reform on Jan. 13. “We need to find a solution,” said Senator-elect Frank Morse (R-Albany), because what we have right now is unacceptable.” The Grinch is back Put the Santa Claus costumes aside, Multnomah County Commissioners get to wear Grinch outfits again this December. For the third year in a row, the county has to implement significant midyear cuts because of declining revenue and state aid. Commissioners need to hack $20.5 million from the county’s 2002-03 general fund budget of $274 million. At a work session on Dec. 5, the Department of County Human Services suggested cuts of slightly over $1 million (5.8 percent) from its $17.9 million county general fund. The reductions include a $208,434 reduction for aging and disability services, a $76,679 reduction for developmental disabilities and a $554,255 reduction in mental health and addiction services. The capitol's top doc With Governor Kitzhaber emptying his desk, now Rep. Alan Bates, MD will be answering House calls from fellow legislators seeking a prescription to heal Oregon’s rapidly shrinking health care budget. He talked to Oregon Health Forum Associate Editor Rory Carroll by cell phone on his drive back from the Democratic caucus, just a day after he appeared on an OHF breakfast forum panel. OHF: Did hospitals get special treatment at the November E-Board? AB: Did anyone have a discussion with the hospitals and the pharmacists about the cuts they were expected to take? Did anyone sit down with the hospital association and say we’re cutting your DRGs? I don’t think so. They were just told that’s the way it’s going to be. The push back was if you’re going to treat us this way, then we’re going to get this reversed. So they went to Jackie Winters and her group, and it got taken from the other side. There’s plenty of blame on both sides, but we need to sit down and make this thing work, not poke each other in the eye over it. The hospitals and pharmacists were not treated in an open straightforward fashion, so they came back and treated someone else the same way. Chugging along The Bush Administration may want to consider some Oregon HMO executives for its economic team. Despite a flailing national economy, Oregon’s HMOs garnered a walloping 23 percent ($5,870,054) increase in its collective net worth in addition to an astounding 26 percent ($101,050,260) gain in net worth in the last year. Medical and hospital expenses were only up one percent ($3,406,958). The battle for PEBB A recent Public Employees’ Benefit Board hearing in Eugene became the soapbox on which McKenzie-Willamette Hospital and its supporters aired their grievances against its nemesis Sacred Heart Medical Center. The Springfield-based hospital recently announced it was headed down bankruptcy lane thanks to its Eugene counterpart, and backed it up with a lawsuit against PeaceHealth — Sacred Heart’s owner — alleging illegal market practices intent on driving McKenzie-Willamette out of business. CareOregon check-up Rumors about the future of CareOregon are swarming around the health care industry. A closed door negotiation followed by an out of court settlement with Legacy Health Systems over a multi-million dollar lawsuit did nothing to quell uncertainty about the viability of the state’s largest OHP managed care plan. Concerns were again stoked by Peter Davidson, Multnomah County mental health director, who said publically that CareOregon’s condition was critical. “(CareOregon) is about out of business, and they need a cash infusion to survive,” he said. Ruby Haughton, director of legislative and public affairs for CareOregon, said that times are tough for all state sponsored health plans, and CareOregon is no exception. Increased medical costs and utilization have contributed to the pressure. Haughton couldn’t give too much reassurance, however, about the future.”We’re not going out of business tomorrow,” she said. “But you’re asking me to factor in the crystal ball dynamics of health care, and national economists haven’t been able to do that.” Escalating utilization has only compounded the organization’s woes. Also in this issue...
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