Inside the Industry

The Portland-area nonprofit says even with a 9.8 percent rate hike, it faces a $75 million deficit and could go out of business.

Coordinated care organization reimbursement rates that were announced this week included a hike in how much FamilyCare will receive in 2018 – but not enough to appease the leaders of the Portland-area CCO, who say low reimbursements are putting their nonprofit organization at risk.

Nov 8 2017
An examination of records by the new leadership at the Oregon Health Authority discovered that an error in the Cover Oregon process caused the state to categorize older, Medicare-eligible adults in the Medicaid expansion.

The Cover Oregon debacle continues to dog the Oregon Health Authority. Actuaries have newly discovered that more than 41,000 people were miscategorized over three years, which caused the state to draw down $74 million more federal dollars than it was allowed.

Nov 1 2017
Though he intends to begin collecting PERS this fall, Robertson says he will work unpaid for the rest of the academic year, as a search for his successor is launched.

OHSU President Joe Robertson will retire at the end of the month, but plans to continue working in a slightly scaled back capacity, as he begins treatment following a recent diagnosis of multiple sclerosis, he announced this week.

Oct 20 2017
The Oregon Health Insurance Marketplace will run TV ads for the first time since the Cover Oregon days to offset severe cuts from the federal government. A Senate fix is in the offing, but conservatives and the temperamental president may balk.

Where President Trump plans cuts, Oregon plans to fill in the gaps, with $1.8 million in support for the 2018 health insurance open enrollment period, which starts in less than two weeks on Nov. 1, and runs through Dec. 15.

Oct 20 2017
Though FBI officials questioned employees earlier this year, the U.S. Attorney’s Office has told Portland-based Zoom Management Inc. that it is closing its investigation.

The U.S. Attorney’s Office has closed its investigation into Zoom Management Inc.

Oct 19 2017

After nearly two months of negotiations, key senators said Tuesday they have reached a bipartisan deal on a proposal intended to stabilize the Affordable Care Act’s insurance market, which has been rocked by recent actions by President Donald Trump.

Oct 17 2017
President Trump has cut off funding for money that helps lower-income people pay for their healthcare at time of service, calling the payments a bailout to health insurers. However, his move will actually cost the feds nearly $200 billion more than just making the the payments.

Oregon insurance officials announced Friday that they will jack up premiums for silver-rated individual health plans an additional 7.1 percent, roughly doubling the rate increase for these 2018 plans compared to 2017 plans.

Oct 13 2017
A referendum from a group of Oregon House Republicans to repeal the tax funding package for Medicaid has given Rep. Knute Buehler an opening to debate the governing Democrats on healthcare, but it has infuriated the healthcare industry that relies on that funding to do business.

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Oct 12 2017
A federal investigation into the failed health insurance plan continues, but the Oregon Department of Business and Consumer Services has closed its investigation.

The founders of Zoom Health Plan have reached a settlement agreement with state insurance regulators, agreeing to pay fines while avoiding criminal liability after getting into hot water over their failed health plan – though a federal investigation appears to still be ongoing.

Oct 12 2017

Just four hours earlier, Sallie Cutler had been sharing Mother’s Day lunch with her mom, Alyce Cheatham.

Then, that same evening, Cheatham, 96, landed in a Portland, Ore., emergency room, lethargic, unable to speak and paralyzed on her right side by a massive stroke.

Oct 11 2017

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