Kaiser charity care in question

Kaiser Permanente is playing a waiting game in an impasse that has dragged on since December 2005. The health care giant intends to build a hospital on property it owns in western Washington County.
But before the process can move forward, Kaiser needs to submit more information about its charity care numbers to state officials. They hold the bargaining chip: the certificate of need that is required for any new hospital construction.

Kaiser intended to open its new hospital in 2009, but that timeline has been pulled back. “We won’t set a date for ground breaking until it [the new hospital] has received all state and local approvals,” said Gail Mathabane, Kaiser’s spokeswoman.

Nurses at Legacy get organized

What’s in a name? To nurses at Legacy Health System, just about everything.

For the past four years, more than 3,000 registered nurses have been meeting and organizing under the title United Nurses of Legacy. Although the group is affiliated with the American Federation of Teachers Healthcare — a national union that represents more than 2,500 local nurses and health care professionals at Kaiser Permanente and Providence Milwaukie Hospital — it has never been officially recognized by Legacy.

“They are not a recognized representative of any Legacy employee,” according to Lise Harwin, spokeswoman.

That, however, could soon change. “The single goal is to organize all nurses in Legacy into an active collective bargaining union that is recognized by Legacy,” said Leanne Park, a nurse at Legacy Emanuel Medical Center and a member of United Nurses of Legacy. A union election is 12 to 18 months away, she predicted.

Residents to take hit

Despite the impending physician shortage and attempts to expand residencies to rural hospitals, the Office of Medical Assistance Programs intends to eliminate graduate medical education funding to six hospitals.

Those Medicaid funds have helped hospitals pay for the direct costs of training medical school graduates, such as salaries for residents — typically about $65,000 — and for teaching physicians. Indirect costs have also been covered, such as the additional time to treat a patient while instructing a resident.

“It seems ironic that, at the very time we are trying to expand the number of medical students, we would risk restricting the pipeline at the next phase,” said Dr. Joseph Robertson Jr., who was just named president of Oregon Health & Science University.

Water hazard

Rural Oregonians face a hazard. The water they drink every day could be full of contaminants; unless legislators take action next session by opening their wallets, there could be serious consequences. Oregon could lose $24 million in federal grants that fund the water systems in rural communities.

“That’s reason enough to improve the system,” said Sen. Bill Morrisette (D—Springfield), who chairs the Senate Interim Committee on Public Health.

Currently 140 federally regulated water systems in Oregon are “significantly non-compliant,” meaning they have had numerous violations of the federal Safe Drinking Water Act. Water systems that serve more than 25 people are federally regulated. Oregon has 2,700 such systems.

Golden Gate reform

San Francisco, well known for its hills and trolley cars, soon may be a model for health care reform as well.

A group known as the Universal Health Council has spent the last four months combing through actuarial data and consumer advocate testimony. The round-the-clock discussions included testimony from nearly every major health sector, including hospital CEOs, labor representatives and business owners.

What they came up with was the San Francisco Health Access Plan, which gives 82,000 uninsured an array of health care services comparable to those offered by Medi-Cal. “It was both exhaustive and exhausting,” said Dr. Sandra Hernandez, CEO of the San Francisco Foundation and co-chair of the council. Hernandez will appear at Oregon Health Forum’s annual conference on Sept. 12.

PEBB releases 2007 renewal rates

The days of double-digit increases may be drawing to a close for the Public Employees’ Benefit Board. When its four health insurance carriers presented their renewal rates for next year, those rates reflected a 9.8 percent hike, on average.

Kaiser Permanente took the biggest leap, raising its HMO and Added Choice (Point of Service) products by 10.5 percent. Monthly premiums will reach $670.05 and $703.17 respectively for full-time workers. On June 21, Kaiser had captured 7,168 of the state’s 49,426 employees.

Regence BlueCross BlueShield, the most dominant player in this market, raised its PPO rates by 8.56 percent. Its new rates will be $720.56. At last count, Regence insured 37,652 state employees.

Court holds up title

The last time a review board heard public testimony about health insurance rates, Gov. Ted Kulongoski was the administrator of Oregon’s Insurance Division. If the past is any indicator of what’s in store for the future, it might be another two decades until that feat is repeated.

In May, Tom Chamberlain, president of the Oregon AFL-CIO, pulled the plug on an initiative that would have picked up where Kulongoski left off by requiring insurance companies to gain approval from a review board before raising their rates. A similar effort led by Kulongoski failed because he overstepped his boundaries.

“The problem was there was all this powerful testimony, but in the end Ted was bounded from what he could actually do with it by statute,” said Joel Ario, the division’s current administrator.

OHSU wants check book to stay open
August 1 is the deadline for public agencies to submit their budgets for the 2007-09 biennium. Oregon Health & Science University is prepared, focusing on work-force initiatives to deal with the state’s impending shortage of physicians, dentists and nurses.

“There’s a need for the state to look at the larger menu,” said Lesley Hallick, OHSU’s provost. She feels confident the governor is on board, having met with his staff over the past few months. “I feel like it’s a healthier place than two years ago when no one was writing any checks.”

No savings for OHP

When lawmakers introduced co-pays and premiums to the Oregon Health Plan Standard population in 2003, they hoped to reduce state spending by curbing utilization.

But in reality, the policy never worked, according to a study by the Oregon Health Research and Evaluation Collaborative.

The OHP Standard Plan hasn’t “seen much in the way of savings” for the cost of covered services, said John McConnell, PhD, an economist with Oregon Health & Science University.

Safety nets get technical

As the value of electronic medical records becomes an established fact, Medicaid officials should promote computer record systems at safety net clinics throughout Oregon, said Michael Leahy, executive director of the Oregon Community Health Information Network.

To accomplish that feat, he suggested health plans and other stakeholders pay a higher reimbursement rate to clinics that use EMRs. Medicaid could lead the way by giving clinics another $4 for every office visit. Such a move would cost the state $4 million next biennium, based on 500,000 visits each year.

Also in this issue...

• Biopharm in the field
  
• PDX docs influence AMA
  
• OHP: Oregon Health Prevention
  
• Oregon uninsurance rate climbs higher
  
• California dreaming
  

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