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 September Regence to eliminate HMO line of business Monumental changes are coming to Regence BlueCross BlueShield of Oregon. After years of scaling back its HMO, Regence is terminating its managed care business. And that’s only the beginning of the company’s makeover. Most of its business will be phased out during 2004 and replaced by BlueChoices, a PPO product similar to those offered by PacifiCare and LifeWise, according to insurance agents. Although company officials are keeping quiet about the costs and benefits of the new product, this is what Oregon Health Forum has learned about changes coming to the state’s largest insurer. Legacy docs eye options Following a series of town hall forums and interviews with physicians, the Legacy Board of Directors will hold a retreat on Sept. 19-20 to discuss the future of Legacy CEO Robert Pallari. In early May, Legacy physicians circulated a no confidence letter expressing their dissatisfaction with Pallari’s management style. Although that letter was addressed to the Legacy Board of Directors, it was never sent because physicians were able to discuss their concerns with Board Chair Jack Winter. Since then, physicians have been meeting with Eric Allenbaugh, a facilitator hired by Legacy’s Board, and have identified issues of trust, management style and negotiation style in dealing with Pallari. OHSU satellite clinics in financial trouble For years, Oregon Health & Science University’s six primary care satellite clinics have been losing money at a steady clip, and now administrators are mulling changes. Direct operating expenses for the six clinics during fiscal year 2003 were roughly $14 million (or about 1 percent of OHSU’s $1 billion operating budget), while the programs have operated at a loss of between $8-10 million annually. Safety net clinics may close Not a dime. That’s how much money was set aside for safety clinics by the 2003 legislature. Several bills would have provided money for the shoestring clinics, which provide access to the poorest citizens in some of the state’s most remote areas, but none passed. As a result, two clinics may go by the wayside: Jordan Valley Clinic in Malheur County and Asher Clinic in Wheeler County. Asher Clinic has had 1,200 patient visits a year — 22 percent of whom live in poverty — on a $400,000 annual budget. The 20-year-old Jordan Valley Clinic had an equal amount of encounters last year on a budget of $109,000, and fell $23,000 short of breaking even. “That’s a pretty common scenario for our low volume providers,” said Troy Soenen, field specialist for the Office of Rural Health. “And that’s with them being studious — getting grants — so it’s really more like they’re $50,000 short.” With 65-70 clinics around the state, safety nets sought $1 million from the legislature. Providence pushes onward The battle between Providence Health System and Tuality Healthcare over whether Providence can build a new hospital in Hillsboro has been thrown into the lap of Hillsboro’s City Council. On Oct. 21, the council expects to hear an appeal by Tuality on the zone change, contending the business park zone doesn’t comply with the city’s comprehensive plan. Mental health mystery Fear kept lawmakers from plunging into unknown waters. They dared not broach the unknown, leaving 34 counties standing in the wings who wanted to come up with a better formula to distribute public mental health dollars, according to Gina Firman, executive director of the Association of Oregon Community Mental Health Programs. “Clackamas and Multnomah counties didn’t want it,” she said, in reference to Senate Bill 925 which, despite two public hearings, never left the Rules Committee. “They felt, since there was no new money on the table, any formula we came up, they’d end up being the losers.” Discussions about the best way to fund mental health will continue over the interim. Dentists get the short end of provider tax deal Pulling teeth to grab onto more of the provider tax, the dental plans only walked away with a package that covers extractions for the OHP Standard population plus another $1 million for other emergencies. If the economy turns around and lawmakers wind up with a surplus next fall, the Legislative Emergency Board could restore full funding. For now, however, the dental plans are counting on the extraction package, expected to start Jan. 1. “It’s enough to keep people out of pain, but we would have liked them to receive the same benefit as the Plus population,” said Cedric Hayden, who founded Hayden Family Dentistry and spent endless hours at the Capitol lobbying for a dental benefit. A new Health Council For years, members of the Oregon Health Council have felt like they’ve been toiling in the dark. Their astute health policy minds have never had the ear of lawmakers. That will change with the passage of House Bill 3653, which will reconfigure the council’s membership, alter its duties and change its name to the Oregon Health Policy Commission. The most significant change is that four legislators will participate as advisory, nonvoting members. Also in this issue...
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