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 September Bend doctors revolt against Regence BlueCross BlueShield A heated dispute encompassing everything from delayed payments to a disdain for each other’s public relations strategies has led Bend physicians to cut ties with Regence BlueCross BlueShield. A war of words has replaced the more than 45-year relationship between Regence and Bend Anesthesia Group and The Orthopaedic and Neurosurgical Center of the Cascades. The communication breakdown is so bad, the sides can’t even agree upon what they disagree about. RWJ plays Robin Hood The organization run by consumer activist Ellen Pinney is primed to receive a $1.2 million grant from the Robert Wood Johnson Foundation. The final word hasn’t come down yet, but all indications are positive. The Oregon Health Access Project, the research and education arm of the Oregon Health Action Campaign, has been recommended to receive the grant following a site visit by RWJ officials. “We’re the lead coalition; this is the biggest project we’ve ever been engaged in,” Pinney said. However, the money won’t be landing in her agency’s hands. Half the dollars will reach uninsured families and homeless youth, making them aware of publicly-funded programs such as the Oregon Health Plan and FHIAP, which offers insurance subsidies. Several counties, including Lincoln, Wallowsa, Baker and Union will benefit along with Portland-based Outside In. The perks of volunteer work Traditionally, non-profit hospitals aren’t supposed to take risky walks on the wild side when it comes to playing the stock market. But during 2000 and 2001, the investment committee at Merle West Medical Center’s Foundation threw caution to the wind and made large stock purchases: 96,490 shares of Trendwest Resorts, Inc. common stock for $2,778,224. The move raised the eyebrows of independent auditors, and prompted them to issue a warning. “Medical Center has 36% of its investment. . . in Trendwest Resorts, Inc. As such, the medical center is at a higher risk of loss than if the medical center’s investment portfolio was more diversified.” Can you here me now? Even a wireless phone with cellular static would improve the communication between Klamath Falls’ Open Door Clinic and Merle West Medical Center. The lines of communication between the two facilities seem as effective as tin can phones connected by a withered shoestring. In an Aug. 2 letter to the clinic, Merle West asked each of the clinic’s five physicians to pay an annual $50,000 fee for obstetric privileges. The hospital said the clinic’s immunity from liability under the Federal Tort Claims Act was the primary reason. “(Open Door’s) physicians cannot be sued because they’re protected by the federal tort law and the hospital is not,” Tom Hottman, the hospital’s spokesperson, told Oregon Health Forum in July. What can go wrong. . . Ask Pacific Crest Construction about Murphy’s Law. The Troutdale company failed to submit a health insurance application to HealthNet for one of its employees, Ronald Boatright, within a required 31-day filing period, and he suffered a heart attack 28 days later. “Somebody forgot to do the paperwork,” said Katherine Somervell an attorney representing HealthNet in a subsequent lawsuit. No longer a bridesmaid Premera Blue Cross hopes not to be left at the altar in its attempt to divorce its non-profit status and marry a for-profit bank account. Before the wedding bells toll, consumer groups, insurance companies and providers will get a chance to speak now or forever hold their peace. Washington’s insurance commissioner scheduled an initial series of public forums in September and October to allow opponents to protest the conversion (visit www.insurance.wa.gov for dates and locations). The Holding Company Act, which governs the conversion process in Washington, doesn’t mandate public forums, but both Premera and the insurance commissioner agreed they’re appropriate. Malpractice debated The opening salvo quickly flew across the decks at the first meeting of Governor Kitzhaber’s task force on medical liability on Aug. 20. Consumer advocates quickly took to the offensive when Mic Alexander, representing the Oregon Trial Lawyers Association, distributed a three-page letter that asked for 10 years of financial data from all of the malpractice insurers doing business in Oregon. No end in sight for HMOs The legislature’s in shambles and the state’s unemployment rate leads the country, but Oregon’s HMOs may as well be operating in paradise. Despite losing 1 percent (10,261) of their members in the second quarter due to layoffs, HMOs added a utopian 4 percent ($19,574,580) to their collective net worth. The six companies also banked an impressive 2 percent ($13,620,989) increase in their collective net admitted assets. Super-sized The pioneering spirit of Oregon put another notch in its belt this spring. Unfortunately, the notch comes as a result of a Department of Human Services study that shows Oregon’s belts are bigger than any state west of the Rockies. Obesity is now 22 percent statewide. A buffet of statistics justifies the urgency of the non-profits, physicians, legislators, human service workers and providers addressing the issue. The recent bestseller Fast Food Nation estimated health care costs in the United States resulting from obesity at nearly $240 billion annually. The book linked excessive pounds to heart disease, colon cancer, stomach cancer, breast cancer, diabetes, arthritis, high blood pressure, infertility and stroke. It said obesity is second only to smoking as a cause of mortality in the United States. Brain drain Hopefully ambulance drivers in Lane County read the newspaper. Adding to the confusion of trauma services in the area, McKenzie-Willamette Hospital recently downgraded its trauma level from two to three after announcing the county’s neurosurgery facilities will be consolidated at PeaceHealth’s 432-bed Sacred Heart Medical Center. The announcement comes after PeaceHealth’s decision to build a new 480-bed hospital in Springfield by 2007, and its decision to leave a 24-hour urgent care facility at Sacred Heart when it moves to its new digs. Previously, PeaceHealth announced the urgent care facility at Sacred Heart would only operate with limited hours. Also in this issue...
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