Christopher David Gray

Southern Oregon CCOs Provide Unique Perspectives to Health Policy Board

The four counties along the California border going east from the Pacific Ocean have 10 percent of the population, but four CCOs are experimenting with the delivery of healthcare.

Southern Oregon has the state’s most concentrated presence of coordinated care organizations, with four organizations serving four counties with less than 10 percent of the state’s population.

Bates Wants Remaining Cover Oregon Functions Moved to Insurance Division

Bates Wants to Move Cover Oregon to Insurance Divison
Sen. Alan Bates, D-Medford, said a bill ending Cover Oregon and moving its remaining functions and work with the insurance marketplace into the Oregon Insurance Division, will likely be the first law enacted by the 2015 session.

Even as the Cover Oregon board dawdled last week on a decision on where to operate the remaining functions of the state insurance exchange, another leading Democratic senator is saying p

Oregon Counties Hope to Reduce Public Safety Costs with Better Mental Health

An improving state budget combined with the new wellspring of Medicaid dollars for low-income healthcare has Multnomah County Commissioner Judy Shiprack and the Association of Oregon Counties feeling like the time is right to make considerable investments in community mental health that will reap great savings by reducing police and jail costs.

The Oregon counties are rolling out a lobbying campaign to improve services for people with severe mental illness, particularly those who burden the public safety system.

Medicaid Home Births Coming in December, but Not for CCOs

The state plans to adopt an uneasy compromise that will carve out the pregnancy benefit package for women that will be delivered outside of the coordinated care organization program. Finding a permanent fix for such care by CCOs may take further legislation and will likely be an issue in the 2015 session.

Oregon women who receive care through the Oregon Health Plan should get the chance to receive the services of a midwife for normal childbirths starting this winter, but their care will take place outside the coordinated care organizations for the foreseeable future.

Cover Oregon to Decide Whether to Scrap Independent Agency

The remaining state functions of the insurance exchange, much of which has already been handed off to the federal government for 2015, could be housed in the insurance division or the health authority for plan year 2016. The board voted Thursday to retain a limited role for Oregon as a state-based marketplace beyond next year.

The Cover Oregon board should decide as early as next Thursday whether to keep its public corporation alive or if its work will be folded into a state agency such as the Oregon Insurance Division or the Oregon Health Authority.

Providence Employees Unsure if Judge’s Autism Ruling Applies to Their Kids

Earlier this month, federal district Judge Michael H. Simon ordered Providence Health Plan to cover applied behavior analysis on plans it sells in the Oregon insurance market, but Providence may not be bound to his ruling for its own employees, who are covered by a self-insured plan exempt from state laws. At least one mother wonders if her daughter will get the treatment she’s been prescribed.

A federal judge’s ruling earlier this month paved the way for autistic children who are covered by Providence Health Plan’s fully insured plan to receive needed treatment, but that ruling didn’t automatically open the door for the children of Providence Health & Services’ own employ

Feds Back Down from Drastic Changes to CCO Formula

Coordinated care officials expressed confusion at the different instructions they were being given by federal health directors. Rep. Greenlick reiterated that he doesn’t believe the CCOs have reformed enough.

The feds backed down from their criticism of Oregon’s handling of the state Medicaid system, stepping away from a position that could have upended the whole transformation of the Oregon Health Plan into coordinated care organizations.

Clark County Expansion Provides Contrast to Oregon Medicaid System

Oregon had an incentive to get as many new Oregon Health Plan enrollees it could handle -- every new member increases revenue for the CCOs, increases the risk pool, and helps bolster finances needed to make the Medicaid system transformation work.

With 425,000 people, Clark County is the third-largest county in the Portland metro area and has more than 20 percent of the metro area’s 2.1 million residents, but the Columbia River cuts a wide gulf when it comes to healthcare access for the Northwest’s most vulnerable citizens.

Providence Loses Autism Case in Federal District Court

But a separate lawsuit, brought against the Public Employees Benefit Board, burns on, as the state of Oregon argues that the mental health parity law doesn’t apply to it. Meanwhile, the Health Evidence Review Commission is expected to approve applied behavior analysis for the Oregon Health Plan at its meeting later this week.

Providence Health Plan has lost the federal class-action lawsuit brought by the parents of preschool-age autistic children after the insurer denied their physician-prescribed treatment, applied behavior analysis.

Cover Oregon Might Still Resurrect State-Run SHOP Exchange for Small Employers

Even as new Cover Oregon director Aaron Patnode unequivocally ruled out putting the state back in charge of the enrollment website for the individual market, he said the state could still opt for a partnership exchange like Illinois, where Oregon would be responsible for the small group portal.

Even as Cover Oregon appears to have closed the door on bringing back the full state-run health exchange website for the individual insurance market, director Aaron Patnode indicated Friday that the Cover Oregon board is still considering an online exchange portal for the small business market.


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