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Cost of Coverage – The Real Measure of Health Reform Impact

The author who runs an insurance agency in Roseburg, contends that only low-income Oregonians and people on Medicaid will benefit from the insurance reforms under the Affordable Care Act
OPINION – May 20, 2013 -- Prior to actual plan pricing being available, everyone, including me, tried to predict how much the Affordable Care Act (ACA) would increase premiums. Estimates generally ranged from 25 percent to 38 percent, and I was on the high end. So we all knew premiums were most likely going to increase, we just weren’t sure how much. All these efforts to predict were generally done on a false assumption that similar plans to the new Platinum, Gold, Silver and Bronze plans were available already, and all we had to do was predict the added cost of the new 2014 ACA requirements. These included a change in rating methods, added preventive benefits and guaranteed issue with no health restrictions, in addition to added fees and taxes. None of these plans actually existed. We knew prices were going up but not actually how this would impact the people who buy health insurance and those who haven’t, but are now required to or pay a fine. Read More >>

Hospitals Accused of Putting Their Own Self-Interest Above Patients

The problem has become particularly acute for physical therapists and radiologists. Senate Bill 683 would require physicians employed by hospitals to disclose their organization’s financial interest in referrals and allow patients to seek care with an independent practitioner.
May 20, 2013 — As major hospital systems like Providence and Legacy have bought up ancillary medical centers, added more physical therapists to their payroll and expanded their own supply of medical imaging equipment, independent physical therapists and radiologists say they have seen their referrals dry up and their businesses decline. Read More >>

Greenlick and Monnes Anderson Differ Over Health Insurance Rate Review Changes

The House Health Committee Chairman wants to give DCBS new powers in the annual health insurance rate review approval, while the Senate Health Committee Chairwoman continues to support Regence’s efforts to limit notice of rate hikes.
May 17, 2013 — Rep. Mitch Greenlick, D-Portland, is moving to bolster Oregon’s rate review process, even as Sen. Laurie Monnes Anderson, D-Gresham, continues to support a Regence BlueCross BlueShield provision that removed requirements from Senate Bill 413 that insurers notify consumers when they request steep rate increases from the state's Insurance Division. Read More >>

New Primary Care Option in Salem

The owner of Salem Women's Clinic expands into primary care.
May 16, 2013 – Dr. Elizebeth Harmon understands that patients want more time with their doctors because it’s how she’s run her gynecological practice, Salem Women’s Clinic, for the past 20 years; giving the women who visit the clinic time to be heard, understood, and receive meaningful and appropriate care. Being able to offer more quality time to patients in a primary care setting is what led her to open the Salem Wellness Clinic in early May. Read More >>

Single-Payer Activists Keep Dream of Universal Healthcare Alive

A separate measure, giving state sponsorship of a comprehensive study on universal healthcare financing, makes its way through the Committee on Ways & Means.
May 15, 2013 — Wes Brain was uninsured last winter when a tonsillectomy showed signs of throat cancer. He qualified for the high-risk Oregon Medical Insurance Pool, which the state has administered through Regence BlueCross BlueShield. Read More >>

House Passes Assessments for Hospitals and Nursing Facilities

Many hospitals will receive much more than they pay in after the state dollars are used to leverage federal money, helping to implement both the Affordable Care Act and the CCO transformation.
May 15, 2013 — The House passed assessment taxes on hospitals and long-term care facilities by a wide 54-5 margin Tuesday, ensuring Oregon’s health and human service budgets will raise over a billion dollars from providers in coming years and leverage $1.4 billion from the federal government next biennium for Medicaid. Read More >>

FamilyCare Executive Forges Bad Actor Compromise Over Salem Health Lawsuit

Rep. Brian Clem said Jeff Heatherington’s proposal to scale back the punitive repercussions of a CCO dispute makes it more likely the Legislature will be able to move the bill along.
May 14, 2013 — The chief executive officer of the Family Care coordinated care organization has stepped into the growing turmoil over healthcare delivery in the Salem area with a compromise to the so-called “Bad Actor Bill,” which was drafted to put pressure on Salem Health to end its lawsuit against Willamette Valley Community Health. Read More >>

What is the Successful Path to Healthcare Cost Containment?

The author not only shares his preferences for a health plan but encourages readers to come up with their own alternatives.
OPINION – May 13, 2013 -- The rise in healthcare costs has inflamed our public policy debate for decades, leaving a trash heap of unsuccessful pursuits and discredited experts. The cost of a robust health insurance policy, left unsubsidized is hard to justify for most sensible individuals. And subsidies in all forms are inflationary. Isn't it essential that we break this behavior of pursuing unproven policies merely because we believe in their likely merit? We do not even have consensus that the cost of healthcare should have influence on our personal demand for services. How do we possibly control costs when so many believe costs to be an offensive consideration? So what is the right path forward? What health plan constraints would you accept? Read More >>

Repeal of Insurers’ Unlawful Trade Practices Act Exemption Moves into Senate

An economic analyst from Washington tells the Senate Consumer Protection Committee that insurance premiums fell after the state strengthened the private right of action against insurers, countering a national trend of rising premiums.
May 13, 2013 — The bill to repeal the insurance industry’s one-of-a-kind exception to Oregon’s chief fraud law has moved to the Senate Consumer Protection Committee, where it faces a less certain outcome than in the House. Read More >>

Treatment Facility Lets Women Parent While Kicking Their Habit

Letty Owings Center was one of the first residential drug and alcohol treatment facilities in the nation to provide on site childcare
May 10, 2013 – Ten years ago, Leah Hall was using intravenous drugs every day, and turned to crime to support herself and her daughter, who was then just one year old. Eventually, Hall went to jail and her daughter went into foster care, and she called her daughter's paternal grandmother and said she wanted to go into treatment. Read More >>
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