The Lund Report

Tribal Health Advocates Worry About New CCO System

Oregon Health Authority, native health experts say specialty access not out of reach to non-enrollees

July 25, 2012 -- Healthcare advocates are concerned that American Indians who choose not to participate in a coordinated care organization (CCO) will have difficulty getting access to specialty care. On August 1, CCOs begin integrating physical, dental and mental healthcare for about 650,000 people who qualify for Medicaid.

Advocates Gain Traction in Insurance Coverage for Autism

Group Health Cooperative has become the first insurer in Washington to pay for such treatment, while legislation is being drafted in Oregon

July 24, 2012 -- Advocates have strengthened their hand in seeking additional insurance coverage for applied behavioral analysis (ABA) treatment. Throughout the West Coast, they’ve achieved victories in the court system and, in Oregon, are focusing their attention on legislative changes.

CDC Grant Program Focuses on Improving the Health of People with Disabilities

Oregon is one of 18 states to be funded for a project emphasizing prevention of secondary disability, including chronic conditions

July 19, 2012 -- One in five adults lives with a disability – and many more are likely to acquire a disability at some point in their lives either through illness, injury or the aging process, according to numbers released by the Centers for Disease Control and Prevention. People with disabilities are two and a half times more likely than non-disabled peers to report unmet health needs, and more than four times as likely to report fair or poor (as opposed to good) health.

Health Insurance Exchange Board Hammers Out Choice, Communication Issues

PacificSource was chosen to become the essential benefit plan because other insurers, such as Regence BlueCross BlueShield’s offerings were more expensive

July 18. 2012 -- The Health Insurance Exchange Board intends to launch an aggressive communication campaign next summer and encourage people to purchase insurance so they can avoid paying a penalty starting in January 2014 when the Affordable Care Act kicks in.

Idaho Woman Takes Battle with Blue Cross Online

Blue Cross Idaho is refusing to pay for part of Danni Cote Gilbert’s cancer treatment

July 12, 2012 -- Until recently, Danni Cote Gilbert kept a pretty low profile. She teaches high school social studies and psychology in Mountain Home, Idaho, a town 40 miles east of Boise with a population of 12,266. Her husband, James, is an administrator in the Mountain Home School District, and they have two daughters, aged five and seven.

Workforce Issues, CCO Progress Take Center Stage at Health Policy Board

The board will begin writing administrative rules to reduce friction and confusion in student clinical placements

July 12, 2012 -- The Oregon Health Policy Board voted unanimously Tuesday to give the Oregon Health Authority the power to develop administrative rules for the student healthcare workforce, after a presentation by Lisa Angus and Terri Johanson who argued that nursing and medical students often face a major bureaucratic scramble when dealing with residencies or clinical placements during their education.

Providence Health Plans Asks for 15.7 Percent Increase

The Oregon Insurance Division will hold a public hearing on the rate request on August 2

July 11, 2012 -- Providence Health Plans is seeking a 15.7 percent average increase for people who purchase their own coverage starting November 1. If approved, 12,162 Oregonians would be impacted. The actual rate increase depends upon a person’s age and whether their family members are on their insurance plan.

A public hearing is scheduled for August 2 starting at 1:30 in the Labor and Industries Bldg. in Salem.

Oregon Health Authority Seeks Transformation Consultants

At a time when budgets are tight, transformation consultants will be hired by the OHQA

July 5, 2012 – The Oregon Health Authority, the governmental agency that oversees the implementation of coordinated care organizations, is seeking proposals for transformation consultants.

These consultants are expected to facilitate the exchange of information between these CCOs and the authority and will each be paid up to $100,000 a year for such services and travel costs. The authority intends to award multiple contracts from August 1 through next July.


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