Oregon Public Broadcasting

Oregon Tries To Improve Access To Dental Care

About a quarter of Oregonians on Medicaid get a dental visit each year. That compares to almost three-quarters of the general population.

Cavities and gingivitis might not sound like a big deal. But over time, poor dental health can lead to inflamed gums. And the bacteria from inflamed gums travel through the bloodstream causing everything from heart disease to cancer.

Rep. Alissa Keny-Guyer, D-Portland, especially wants women who are pregnant to be seen.

“It’s a very short window of opportunity and we know that at least 50 percent of them have dental carriers. And we know that that leads to premature birth," she said. "So how do we get to them really quickly and make sure that they see a dentist?”

The state has launched a work group to improve dental care access for Oregon’s poorest residents. It's expected to have a list of ways to improve access by September.

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Is Oregon's Public Health System Meeting Needs?

Oregon’s public health system is “minimal” in a third of communities, according to a new report commissioned by the Oregon Health Authority.

Public health deals with everything from immunizations to ending tobacco use. It also covers tests for lead and monitors factory emissions, which have been relevant issues in Portland and elsewhere statewide lately.

The state estimates it can conduct about five health assessments a year, but five times as many are needed to address environmental risks.

Lynne Saxton, director of the OHA, said the shortage of health workers is apparent across Oregon.

“In my travels across the state in the last year, many counties have said to me, 'We have one person trying to meet the entire needs of the public health system in our county and it’s simply not sustainable,'” she said

Oregon spends about $25 a person on public health each year. That compares to $40 in Washington and $95 in Idaho.

The state estimates it needs an extra $30 million out of the next legislature to modernize the system.

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Oregonians Spent More Than Needed On Health Prodcedures Last Year

Oregonians could have saved 28 percent on their health procedures last year if they’d shopped for the best price, according to a new study from the Portland cost transparency company HealthSparq.

People with health insurance don’t usually shop the best cost on procedures like an MRI or hip replacement.

But over the last five years, insurance deductions have increased from around $300 a year to $3,000 a year. HealthSparq CEO Scott Decker said that increase is pushing people to shop more.

He estimates 11 percent of unnecessary spending in overall health care costs in Oregon could be eliminated by shopping.

“You can find even with your insurance, three, four or five times variation in price. So we need to be conscious consumers of health care, just like we are of anything else we shop for,” Decker said.

The HealthSparq study found patients could save 5 percent by shopping for tests and surgical procedures; 1 percent by shopping for medications; and 5 percent by using telehealth — that is, contacting a doctor over a video call service like Skype.

Such savings would amount to about $90 per person, per month.

The HealthSparq report used data from 237,000 people, who accounted for more than 500,000 cost estimates during 2015.

HealthSparq's shopping applications is embedded in 70 health plans across the U.S. and allows comparison shopping within network.

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Oregon Adopts Federal Opioid Prescribing Standards

Oregon has adopted new federal standards for the prescribing of opioids.

More people die from drug overdoses every year in Oregon than in car crashes.  And 43 percent of those overdose deaths are associated with opioids prescribed by a doctor.

State epidemiologist Dr. Katrina Hedberg said doctors and the public need to be educated on using fewer opioids, for shorter periods of time.

“It is not that we want people to be in pain. It is that we have one tool and there need to be a variety of tools that are used to address chronic pain."

She said patients need to look to tools like acupuncture, exercise, and learn to function with low levels of pain.

The state task force on opioids will continue to meet into the summer to consider other issues, like how to deal with pain from dental work.

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Oregon Hospitals To Provide Costs For Procedures

Oregon hospitals have joined together to say they’ll provide patients with an estimate for services within three business days.

Getting a hospital estimate may not seem like a big deal. But hospital prices are notoriously hard to pin down, and they vary widely.

For example, a recent study on hip replacements in Oregon found prices 20 times higher in one hospital than another.

Felicia Hagins with Service Employees International Union called the hospital estimate a welcome idea, but not a fix. “Since most Oregonians, 95 percent of us have insurance, oftentimes, we don’t actually get to choose which hospital we go to," she said.

That means you can’t comparison shop.

Other problems are that to get an estimate, the procedure has to be scheduled — and that isn't always possible, as when surgery is needed after a car crash. Also, the five percent of Oregonians who don’t have insurance probably can’t afford to get a procedure done, even if they’re told how much it would cost.

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Oregon Health Insurance Cheaper Than National Average, For Now

Health insurance premiums in Oregon are lower than the national average, according to new numbers from the Robert Wood Johnson Foundation — but that may not last.

Some Oregonians were shocked last week when health insurance companies like Moda and Providence asked for rate increases of about 30 percent for next year for the individual marketplace.

But Kathy Hempstead with the Robert Wood Johnson Foundation, said the companies are just catching-up with national pricing.

“Even though you might have felt like you had sort of a lot of price increase between 2015 and 2016, the Oregon market is still kind of under priced, compared to the national market,” she said.

The Oregon Consumer Department will analyze the proposed new rates over the next two months, to make sure they’re sustainable.

About 70 percent of Oregonians who don’t get insurance through their jobs are eligible for tax credits to help reduce the cost.

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OHSU Scientists Seek Older Women For Heart Disease Study

Scientists at the Knight Cancer Institute are looking for 10,000-15,000 older women from Oregon and Southwest Washington for a study on heart disease and blood cancer.

Over the last few years, it’s become clear that as people age, they accumulate mutations in their blood. It’s not surprising perhaps that those mutations can cause blood cancers. But what scientists are surprised by, is that those mutations look like they can also cause heart disease.

Assistant Professor of Medicine Kim-Hien Dao said now the two diseases appear to be linked, they want to know whether blood cancer drugs might benefit heart disease patients as well, “So we’re looking for women over 65 years without a history of invasive cancer. And they’re willing to provide their health history and provide a blood sample every one to two years.”

The study, which is also being conducted by Maros Ferencik at OHSU, is currently limited to women because it requires a special test for the presence of two X chromosomes. That enhances the detection of blood mutations. Scientists hope to identify a high risk population carrying these mutations and follow the group over time.

Heart disease is the nation’s leading cause of death among women — it’s responsible for about one in every three deaths.

Heart disease in women is often less recognized as compared to heart disease in men and is also often under treated. There are still genetic and lifestyle risk factors that scientists and doctors have not fully characterized.

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