July 2007

Lawmakers make healthy inroads

Oregon’s 74th legislative session began with a bang. Cannons and F-15 fighter jets ushered in the second term of Gov. Ted Kulongoski, and several weeks later he made a rare hearing room appearance in support of the Healthy Kids Plan.

Now, as the dust settles, lawmakers, advocates, insurers and providers are split on how health care fared in 2007.

“There was a lot of optimism at the start of the session that there would be radical reform,” said Rep. Ron Maurer (R–Grants Pass). “We have yet to see that tsunami crest.”

Medicare Advantage soars out of control in Oregon

Medicare Advantage, once touted as a way to save Medicare through contracting with private plans, turns out to cost more and provide less. And the situation is particularly bad in the Beaver state.

Reports swirled around Washington, DC in recent months that Medicare Advantage insurance plans were being over-funded to the tune of $54 billion over five years, according to the Congressional Budget Office.

A study by the Commonwealth Fund showed that private Medicare plans are paid 13 percent more for the same services as traditional Medicare managed by the federal government.

State falls short of Harmon settlement benchmarks

The state has fallen short on an agreement it forged more than a year ago to improve staffing ratios at the Oregon State Hospital and increase community placements for people found guilty of a crime by reason of insanity.

The agreement, known as the Harmon settlement, resulted from a class-action lawsuit on behalf of state hospital patients. Since the settlement expired in June, the door has reopened for a new round of legal maneuvering if conditions worsen.

“We were overly ambitious in setting numerical targets,” said Bob Nikkel, the state’s assistant director for addictions and mental health. “Reasons had to do with the caution and care this state takes in discharging people who have been civilly committed.”

On the Record with Joel Ario

Health care insiders were shocked last month when Joel Ario announced he was leaving his post as administrator of the Oregon Insurance Division to accept a similar position in Pennsylvania. Ario has been with the Department of Consumer and Business Services since 1994, when he was hired as its legislative director, and has led the insurance division since 2000. Deputy director Carl Lumbard is stepping in during a national search for Ario’s replacement.

During his tenure, Ario spearheaded several reform movements, including a pair of transparency initiatives, which are just gaining traction. Oregon Health News editor-in-chief Tim Stumm recently talked with Ario about the OID’s achievements as well as his thoughts on Michael Moore’s new movie Sicko, which paints a less-than-flattering picture of the insurance industry.

OHN: Why Pennsylvania?

JA: It’s a new professional challenge, a bigger insurance market. There’s a major consolidation of the two largest Blues plans that’s pending there, which would create a $16 to $18 billion health insurer. And Governor Rendell has an aggressive health reform agenda, which I am interested in as well.

Private groups calm Mercy plea for mental health funding

Mercy Medical Center in Roseburg may have found a way out of the weeds in terms of the $1.8 million it lost in 2006 at its behavioral health unit.

In June, the hospital announced it was beginning the first phase of negotiations with two companies to run the unit and purchase the building. The transition, if agreed to, is expected to be finished in September.

Based on initial discussions, ChristieCare, a nonprofit that serves children with mental health needs, would purchase the building – while possibly leasing the land – and provide services to children within the unit. Telecare, a for-profit provider of mental health services for adults, would operate adult services.

Also in this issue...

• Speight returns to Oregon to head Trust Board
  
• Seven new mandates on the books
  
• Two Oregon hospitals utilize offshore bank accounts
  
• OHSU’s bottom line slips in 2007, but legislature increases funding
  

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