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Oregon Dentists Cut Back On Opioid Prescriptions For Young People

The American Dental Association issued new guidelines for prescribing opioids Monday. Dentists in Oregon say they’ll be adopting them as soon as possible. 

For years, many dentists have regarded the opioid epidemic as a problem largely for medical doctors. After all, physicians often prescribe painkillers for patients struggling with chronic pain that can last years. On the other hand, dentists usually only prescribe medications for a few days. An example might be for a patient recovering from oral surgery.  But a recent study found dentists are the leading opioid prescribers for young people ages 10-19, many of whom get their first experience with opioids when having their wisdom teeth out.  “Brains continue to develop until about age 25 and during that period in a young person, their brain is more susceptible to remembering that first exposure to anything, such as a narcotic. And that creates more potential for misuse later," said Dr. Bruce Austin, dental director for the Oregon Health Authority. Oregon's new opioid prescribing guidelines say most patients only need about 10 pills after oral surgery — or three days worth of pain relief. In the past, it wasn’t unusual to be prescribed 30 pills, or 10 days worth.

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Report: Oregon Needs More Transparency In Health Care Costs

Oregonians need better information about health care costs, according to a new report from the consumer watchdog group OSPIRG.

The report says opaque health care prices mean Oregonians are both paying more and have less ability to make informed decisions.

“Most of us wouldn’t even buy a toaster without knowing how much it costs," said OSPIRG policy director Jesse O’Brien. "But you might be in a position where you have to buy a new knee, or some other very expensive procedure, without any clue what your bill is going to be and we think that’s frankly unjust.”

O’Brien says clearer pricing would help, but it won’t stop ever-increasing health care costs.

“Consumers have the right to know how much they’re going to have to pay, especially as their share of the medical bills keeps growing," said O'Brien.

"Price transparency can help contain the cost of health care.”

Philip Schmidt with the Oregon Association of Hospitals and Health Systems, agrees with the need for transparency. And he points to the ‘Oregon Hospital Guide’ website, where lots of price information is available. But he said issues other than price are also important, like the quality of care and following doctor recommendations.

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Oregon Wants To Know What The Public Thinks About CCOs

The Oregon Health Authority is asking the public to say what it likes, dislikes and wants to change about the state’s 15 coordinated care organizations.

The CCOs were set up in 2012. But their contracts run out at the end of next year, and the state wants to know how they should change.

Should mental and physical health be better coordinated? Is there inequity in the system?

The survey is online until April 15.

The chair of the Oregon Health Policy Board, Zeke Smith, said the board is particularly interested in things that aren’t usually addressed in the doctor’s office.

“We want to figure out how we can move toward addressing what are called the social determinants of health, things like housing and things like education — so those pieces of a person’s life that really affect their health but are not about their relationship with their doctor or their health care system,” Smith said.

Oregon’s CCOs have been relatively successful, saving $2.2 billion in health care costs since inception.

The big unknown is how new policies introduced by the Trump administration could change the system.

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Oregon Governor Signs Bill To Rein In Prescription Drug Prices

Oregon Gov. Kate Brown signed a bill Tuesday to rein in prescription drug prices.

Under Oregon’s new law, drug manufacturers who increase the price of a prescription drug by 10 percent or more must inform the state of its research and development costs, along with its marketing costs, profits and the cost of the drug overseas.

“Every Oregonian should be able to access the medications and treatments that allow them to live healthy, productive lives,” Brown said.

“This bill brings greater transparency around drug pricing, an important step toward making life saving and essential drugs more available and affordable.”

Patty Wentz with the group Oregonians for Affordable Drug Prices hopes that as more states pass similar bills, prices will stop rising quickly.

“I think it sends a very strong message to the pharmaceutical industry that enough is enough,” she said.

In addition, the new law requires insurance companies to report the 25 most expensive prescription drugs in their plans, which ones have increased the most and how those costs affect premiums.

As the transparency provisions are being implemented, the law also establishes a task force to look at what additional transparency measures will shine a light on high drug prices.

A spokesman for the drug manufactures group PhRMA says the new law purports to address drug prices, but really only focuses on some cost drivers. He said other drivers include insurance actuaries, wholesalers and pharmacy benefit managers.

Pharmaceutical companies will be required to report on price increases greater than 10 percent beginning summer 2019.

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Oregon Rural Emergency Services Suffer From Lack of Volunteers

In populated counties like Multnomah or Clackamas, emergency services contract to respond in something like six minutes or less — 90 percent of the time. In rural Oregon, emergency response can take much longer.

When you call 911 for an emergency, you expect help to arrive quickly.

In populated counties like Multnomah or Clackamas, emergency services contract to respond in something like six minutes or less — 90 percent of the time.

Bill To Rewrite Oregon's Advanced Medical Directives Passes Senate

advanced directive
The legislation would allow people to appoint a healthcare representative if they become incapacitated.

A bill to rewrite Oregon’s advanced medical directive form passed the Senate Tuesday.

Republicans are worried it erodes protections for people receiving end-of-life care.

Oregon was the first state in the nation to enshrine advanced directives in its statutes.

Democrats Question Trump's Effort To Allow States To Penalize Medicaid Recipients

Senate Democrats are questioning the Trump Administration’s authority to allow states to run Medicaid programs that penalize users.

The Trump Administration released guidance last week, saying states could require Medicaid recipients to work. It said states could do other things like put lifetime caps on Medicaid benefits and impose mandatory drug testing.

Oregon Senator Ron Wyden and 28 other Democrats have written a letter to acting Health and Human Services Secretary Eric Hargan, expressing serious concern. “The vast majority of Americans who get the Medicaid benefit either already have a job or are unable to work due to age or impairment," said Wyden.

“Harmful ideological policies such as work requirements, mandatory drug testing, time limits, onerous cost-sharing and the like undercut and exceed the statutory authority provided to the secretary under Section 1115 and contravene longstanding congressional intent,” said the letter.

“Ultimately, this leads to poorer health and more frequent use of the emergency room, all of which ends up costing the system and taxpayers more in the long run. Such harmful proposals clearly undermine the purpose of the Medicaid Act, prioritizing ideology over health.”

The Centers for Medicare & Medicaid Services recently approved a Medicaid waiver for Kentucky that imposed work requirements on eligible individuals and lockout periods that would hurt low-income individuals.

States like Oregon, that embraced the Affordable Care Act, have secured federal waivers to try to improve care and reduce costs.

The Democrats worry states will use the waiver to reduce the number of Medicaid recipients in areas where the act isn't popular.

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OSU Holds Student Vaccination Clinics For Meningococcal B

Oregon State University is holding mass vaccination clinics at its Corvallis campus to deal with a Meningococcal disease outbreak.

The clinics are part of an attempt by the university to control the spread of the disease, which has so far infected six students since November.

"We believe our students’ public health is very, very essential," said Steve Clark, vice president of university relations and marketing for OSU.

The disease is a serious, potentially fatal infection that can cause meningitis or a serious blood infection.

The clock to get all OSU students vaccinated began ticking in December last year, when the university began requiring all students age 25 and under to get immunized.

According to its website, OSU already required incoming students to get Meningococcal B vaccinations before expanding the requirement to all students.

Students have until Feb. 15 to get two of the required vaccinations. Those who don't get vaccinated won't be able to register for classes in the spring or receive final grades for the winter term.

"We’re very definite about this," Clark said. "It is so important that they act now."

So far, approximately 60 percent of OSU's 25,000 students have gotten at least one of the two required vaccines. About 9,000 more have not gotten vaccinated at all.

There are medical and non-medical exemptions for students, as required by state law. If an exemption is requested, the university says it's requiring students meet with a medical care provider to understand the risk of the disease.

The vaccine costs $235 a dose, which Clark says is covered under the Oregon Health Plan and a health insurance plan students can purchase through the university.

"We're going to work with them to determine ways that they can, in fact, be vaccinated," he said.

The OSU MenB clinic runs through Jan. 13.

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