December 2006

Revenue, taxes up in Governor’s proposed budget

Champagne corks popped for the first time in several biennia over a governor’s proposed budget that suggests restoring cutbacks to human services rather than announcing new ones.

The Department of Human Services could receive $12 billion in total funds, which represents a 20.8 percent increase from the 2005-07 legislatively approved budget. In terms of the general fund, the governor wants to allocate $3.3 billion, up 27.3 percent. Last biennium’s DHS budget rose just 3.7 percent from 2003-05.

Among the proposed expansions, the Oregon Health Plan Standard would add roughly 10,000 new members; the Healthy Start Program, which provides prenatal and early childhood care, would get a $6 million boost; more than 100,000 uninsured children would receive health coverage; thirteen new school based health centers are expected to open; the mental health system would get revamped; and more than 600 new jobs at DHS would open up.

Regence discontinues top Medicare plan

Regence BlueCross BlueShield of Oregon will discontinue in the Portland area an HMO-style Medicare plan it has offered for 20 years, according to a letter to physicians from Managed Healthcare Northwest, an IPA that works closely with the insurer. By 2008, First Choice Sixty-Five will likely be replaced with Medicare Advantage plans known as MedAdvantage, which offer a preferred provider network, based on a fee-for-service payment model.

Patients may pay less in premiums and have more freedom to choose a provider. But physicians who accept the deal will likely see their overall payments decline by about 12 percent, according to an analysis by the InterHospital Physicians Association (also known as the Portland IPA), which generally contracts with Providence Health Plan.

ODS tapped to run prescription drug pool

Just as Oregonians fill out forms for the state’s newly expanded drug-purchasing pool, a new company is preparing to take over administration of the program.

ODS Companies signed a contract with the state in November that will make it responsible for the expanding Oregon Prescription Drug Program. The new contract takes effect Feb. 1, at the same time Washington joins Oregon in a new Northwest Prescription Drug Consortium.

In November, voters approved Measure 44, which opens up Oregon’s prescription drug buying pool to anyone in the state who doesn’t have prescription drug coverage.

On the record with J.D. Kleinke

When five powerful executives get together, something big is bound to happen. Such was the case when the leaders of Applied Materials, BP America, Intel, Pitney Bowes and Wal-Mart announced earlier this month they were funding a web-based database called Dossia, where employees, dependents and retirees could maintain lifelong personal health records.
Oregon health care ears were especially attuned because the non-profit picked to develop this lucrative web-based framework is a local one: Portland-based Omnimedix.
In fact this national movement, which is expected to roll out in mid-2007, has Oregon roots. It was first brainstormed by J.D. Kleinke, CEO and chairman of Omnimedix, and high-level employees at Hillsboro-based Intel. Kleinke recently sat down with Oregon Health News acting editor Tim Stumm to talk about what implications Dossia will have on the health care sector, corporate stewardship and what he’s doing to stay out of jail.

OHN: Personal health records aren’t anything new to the health care world, what makes Dossia different?

JK: Dossia isn’t a PHR. Dossia is a way of serving data. We are an infrastructure that supports personal health records. Dossia is like the Internet — gathering, authenticating, and making data available securely for other people’s applications. We are not Match.com, or eBay or Amazon. We are the Internet.

Douma, Goldberg nix triage fee

Emergency rooms may save lives, but they won’t necessarily save the Oregon Department of Human Services any money any time soon. In a decision that surprised even opponents of the idea, DHS decided not to go forward with an emergency department triage fee for fee-for-service Oregon Health Plan members.

“After a thorough analysis of the total administration costs for all parties, it was determined that the general fund net savings would be minimal and much of the cost savings would be shifted to non-OHP clients,” said Dr. Alan Douma, administrator of the Division of Medical Assistance Programs. He said the decision was made jointly with Dr. Bruce Goldberg, DHS’s director.

Also in this issue...

• MHOs wrestle with "intense" contract issues
  
• Small group squabble
  
• Budget restores vision, dental to OHP
  
• National work group set to report back
  

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