Two months after the unexpected death of a bill that would restrict corporate influence on medical practices, its sponsor has assembled a broad workgroup to get input in preparation of bringing it back in the 2025 legislative session.
The workgroup, which held its first meeting remotely on Tuesday, included about 85 people representing insurers, health care providers, medical practices, labor unions, lawmakers, state agencies and others.
State Rep. Ben Bowman, D-Tigard, introduced the unsuccessful bill last session to strengthen Oregon’s current laws that prohibit corporations from controlling how medical practices provide care. Bowman, who in March was elected majority leader, introduced the bill in response to Optum, Inc. and other large investors’ growing presence in Oregon’s health care system.
“Oregon has a long tradition of protecting patients from corporate interests not bound to the same ethical standards as licensed providers but the industry has changed faster than we have updated our laws,” Bowman said in a statement. “The core principle of the legislation we are designing here is that we must keep patient care decisions in doctors’ hands–and out of corporate boardrooms.”
After sailing through the House, the bill ran into opposition in the Senate and faced calls by Republicans to replace it with a study group — a move Bowman resisted.
Facing opposition that included out-of-state corporations, the bill died when Democratic leaders called the session to an early halt that left several pieces of health care legislation without a final vote.
Bowman was unavailable for an interview, but a spokesperson told The Lund Report in an email that the workgroup will “continue conversations” from the previous legislative session and will “provide opportunity for perspectives and input on different components of the legislation.”
One topic that’s expected to come up is the balance of power between management services organizations and medical practices, according to the spokesperson. The bill’s opponents included doctors who rely on management services organizations to handle administrative chores. The bill would have restricted these arrangements by mandating that doctors hold a controlling share of their medical practice.
“Why would a doctor need to have control over something like that in advance? Does that create an environment where private equity doesn't want to invest because there’s too much risk for them?”
Other issues that could come up include contractual arrangements between providers and corporations, including non-compete agreements, according to the spokesperson. The issue of non-compete agreements has become a focus in Oregon amid access concerns in the Eugene area as a group of lawmakers are pressing Optum to let doctors formerly employed by the company’s subsidiary, Oregon Medical Group, treat patients.
Optum did not immediately respond to a request for comment from The Lund Report.
“Rep. Bowman and I would really like to iron out any of these potential wrinkles so that we get something that everybody feels good about and get rid of some of the misinformation on what the intent of the bill’s policy is,” state Rep. Cyrus Javadi, a Tillamook Republican who backed the previous bill, told The Lund Report.
Javadi, a practicing dentist, said that a misunderstanding about the bill was that it would have banned private investors entirely from medical practices in Oregon, depriving them of funds. The bill would still allow private investments but kept them from having a controlling stake in medical practices.
He described the workgroup’s initial two-hour meeting as constructive and focused, saying it will also allow for more “in-the-weeds” conversations about how the bill would play out practically, Javadi said. He said there were concerns the bill would restrict corporations or investors from making operational decisions like whether to rent or own a facility.
“Why would a doctor need to have control over something like that in advance?” he said. “Does that create an environment where private equity doesn't want to invest because there’s too much risk for them?”
But he said there are other areas where investors or corporations shouldn’t have control over, such as hiring, firing and wages, because it could impact patient care.
The bill exempts hospitals and health systems, which Javadi said could pave the way for them from expanding control over medical practices.
He said the goal is a bill that keeps health care decisions local while not deterring private investment, while also convincing opponents to at least not lobby against it in the next session.
Glad to hear this is gaining steam again. Oregon's health care system is a mess - partly due to the stress of covid, of course. Most is due to hospitals "boutiquing out" profitable specialities, health care workers understaffed and overworked, and large investors with short term profit goals buying up every game in town.