oregon health authority

Health Plans Show That Drug Costs Continue Escalating for PEBB

Nine complex biological drugs, all of which lack competition or price controls in the United States, accounted for 19 percent of all spending by Kaiser on PEBB members in 2015. The cost of speciality drugs is increasing 27 percent a year. Meanwhile, the board appointed Mark Fairbanks, chief financial officer of the Oregon Health Authority, its new vice-chairman.

The Public Employee Benefit Board vendors continued to show extreme inflation in the cost of pharmaceutical drugs in reports released Tuesday, a development that could stymie efforts to make healthcare costs sustainable.

OHA Prepares Statewide RFP to Implement Tele-mentoring and Reduce Specialty Referrals

The Oregon Healthcare Workforce Committee probed Oregon’s foray into “tele-mentoring” through Project ECHO, developed at the University of New Mexico Health Sciences Center to increase access to specialty treatment in rural and underserved areas by giving front-line clinicians support to manage patients with complex conditions such as hepatitis C, rheumatoid arthritis, chronic pain and behavioral health disorders.

In 2013, HealthShare used some of its transformation dollars to launch a Project ECHO pilot on psychiatric medication management with Oregon Health & Science University.

Now a second “cohort on Oregon’s North Coast has launched with Columbia Pacific CCO taking the lead.

FamilyCare, OHA in Mediation Over 2015 Contract

The legal opinion from the Legislative Counsel sided with FamilyCare.

FamilyCare still has not signed the 2015 contract amendment with the Oregon Health Authority and has refused to return the $55 million in supposed overpayments. But the CCO may have the law on its side.

FamilyCare and Health Authority Plan More Mediation over 2015 Rate Dispute

Mediation talks on Tuesday did not reach a conclusive outcome, requiring the Health Authority and the Portland-based CCO to call for a second round of discussion. The outcome of the mediation may determine whether FamilyCare will be able to continue as a CCO.

The feud between the Oregon Health Authority and FamilyCare will continue for another week after binding mediation talks over its 2015 reimbursement rates failed to produce a resolution on Tuesday.

Stakeholders Want Basic Health Option on Exchange for 2018

A legislature-commissioned workgroup has found a compromise solution that insurers, brokers and providers will be more likely to support, setting a highly-regulated and standardized basic health insurance plan on the exchange, provided by multiple companies and paying providers rates similar to Medicare, while still offering lower premiums and eliminating deductibles and coinsurance for consumers under 200 percent of poverty.

The Oregon Health Authority is putting the finishing touches on the state’s revised designs for a  Basic Health Plan, breaking considerably from earlier proposals that would have simply expanded the coordinated care organizations to cover more working-class adults.


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