Legacy CEO, Health Share Board Chair Emphasizes Access to Care, Controlling Health Share Budget

Health Share loses 18,000 enrollees in state redetermination process, but they can reapply when their income changes.

Access to care and controlling the budget are the top two priorities of Health Share, according to its board chair, Dr. George C. Brown, CEO of Legacy Health.

“Good access to care is the biggest challenge for all of us,” Brown told the Community Advisory Council last week. “It’s also important to be good stewards of the dollars we receive.”

The U.S. spends $9,000 per person on healthcare  – about twice what the next highest, Canada, spends -- yet Americans are not as healthy as people in other countries.  “An unhealthy population ultimately costs us all,” Brown said. “If you want to be healthy, you need to change your ways. That message is “far more powerful from this body than from Health Share or Legacy.”

Brown’s experience with “lean management” has shown that leaders of organizations often have different perspectives from those on the front line of giving or receiving care. 

Council members told Brown they specifically want to see Health Share step up efforts to improve nutrition, including asking about programs that provide prescriptions for produce. Council member Amy Anderson said her own diabetes is the best it’s been in seven years due to access to dieticians and cooking classes.

Other council members asked Brown about integrating physical and mental health.  How’s it going?  What’s on the horizon?

When he plays with a community band at Cleveland High School, Brown sees men sleeping under the overhangs of the doors. “We see people struggling everyday and we’ve become blind to them. As a nation, we need to spend less on healthcare and more on education and infrastructure of decent public housing, roads and bridges.”  

He also mentioned the possibility of a new emergency room specifically for mental health and addictions.

But Brown cautioned the council that “the political forces that exercised their will Tuesday [on election day] want to rein this program in,” referring to the Affordable Care Act that expanded Medicaid, required Americans to purchase health insurance and provided tax credits to help pay premiums.

“Yes, we’ve reduced the uninsured population (in Oregon) to just five percent, but that’s still 200,000 people without health insurance,” Brown said. 

On October 31, some 77,000 Oregon Health Plan members across the state got a trick not a treat when they lost their benefits after they earned too much to be eligible for Medicaid.

“There will be another big wave on [of member redeterminations] on December 31” when another five months of delayed or “pent-up” redeterminations are processed, Janet Meyer, Health Share’s CEO, told the council.

Meyer said approximately 18,000 Health Share enrollees, about 7 percent of its current enrollment of 227,166, lost their benefits during the state’s redetermination process. However they can apply to be reinstated, and thus far 850 have done so.

“It’s a big disruption to our members.  Our phones are busy,” Meyer said, adding that Health Share customer service took 500 calls just on Thursday. Most will need to reapply through the Oregon Health Authority, which took some 9,000 calls, with wait times of an hour as members sought to reapply.

“People come on and off Medicaid based on seasonal employment and job hours,” Meyer told the council.  “Income varies.” 

Jan can be reached at [email protected].

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Comments

No reliable information for these figures! Gallup surveys say that Oregon has 14% uninsured. http://www.gallup.com/poll/174290/arkansas-kentucky-report-sharpest-drop... In late 2010, Oregon used Gruber econometric modeling. The charts projected 320,000 (slightly <10%) Oregonians would be uninsured in 2015. And that would improve to 290, 000 by 2019 http://www.oregon.gov/OHA/OHPB/meetings/2010/100810-est-cov-exp-fed.pdf?... Of course, Gruber also just said, "Lack of transparency is a huge political advantage. Call it the ‘stupidity of the American voter’ or what ever." http://fdlaction.firedoglake.com/2014/11/11/jonathan-gruber-admits-the-p...