Oregon Public Broadcasting

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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Traces Of Pain Medications Found In Oregon's Oysters

A new study led by Portland State University finds that oysters in Coos and Netarts bays contain a cocktail of potentially harmful chemicals. But the state says it’s seen much of the data before and a health advisory is unnecessary. 

The Oregon Health Authority says the state knew about PCBs, mercury and pesticides in seafood. But what is new are all the pharmaceuticals, like pain relievers, antibiotics and antihistamines.

The new findings caused the state to issue an advisory saying how many oysters you’d have to eat to get one dose of each pharmaceutical.

OHA spokesman David Farrer said for the pain reliever Naproxen, it’s 160,000 pounds of oysters.

“We hope that that conveys it is a very low risk,” Farrer says.

The state did issue a health advisory for soft-shell clams last year. Scientists say the chemicals enter the bays via groundwater runoff and wastewater discharged into rivers.

Calls and emails to the Pacific Coast Shellfish Growers Association were not immediately returned.

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Health Insurance Spikes in 2017 May Mean More Competition

In the small universe that is health insurance, 2017 may turn out to be pretty nice for the men and women who predict how much insurers have to pay out in claims.

“Actuaries across the country will be able to sleep better at night for 2017,” John Bertko, chief actuary for Covered California, said.

Bertko says after three years actuaries finally have the information to more accurately forecast what they need to make a profit. Better data is just one signal that premiums on the Obamacare exchanges will likely go up more than this year. More sick people than expected and exploding drug prices are two other important signs.

Virginia, one of the earliest states to publicly report proposed increases, has posted that carriers are looking for hikes from 9 to 37 percent. The Kaiser Family Foundation’s Larry Levitt said another factor is that companies are losing the key federal subsidy called ‘reinsurance’ that helps cover costs for the most expensive consumers.

“The reinsurance money has allowed premiums this year to be about 5% lower than they would have been if that subsidy didn’t exist,” he said. 

Higher premiums will certainly mean more tax dollars to help cover the cost of subsidizing coverage.

But MIT economist Jonathan Gruber said individual consumers might not get whacked as much as you’d think.

Gruber says four out of ten people are shopping for the best deals.

“What’s exciting is people are paying attention,” he said

“Competition is working. We took a market that was disorganized, people had no idea what they were buying, or they were stuck with that product for many years. And they are taking it seriously.”

So many people switching plans puts pressure on the insurers.

Bertko said insurers – at least in the most competitive places – are fighting for market share.

“Once a year we play musical chairs to get down to the lowest or second lowest cost plan in the region. And the plans are all incredibly aware of that,” he said.

Bertko said the stakes can be high.

If an insurer ends up with one of the most competitively priced plans, they stand to attract some of those people who this year will likely be out there shopping due to the premium spikes.

That, said Bertko, is what you call an opportunity.

Copyright (C) 2016 American Public Media Group

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Finances Come First, Following Alzheimer's Diagnosis

More than 120 people who care for Alzheimer’s patients held a conference in Wilsonville Wednesday. They learned the first thing families should do when a loved one gets dementia.

Lawyers and caregivers alike said putting someone’s financial details in order is paramount — even before finding a care facility or deciding which family member will look after someone.

Susie Sample said her mother moved in with a stranger before the family fully understood how vulnerable she was to financial exploitation.

“It totally took away a huge part of her planning," Sample said.

"She had a home that went into foreclosure. She lost that. Other IRAs. She lost a huge chunk of money," Sample added. "We would have had her in a much better care situation had we had those assets.”

State-funded ‘Oregon Care Partners’ organized the Wednesday's conference.

Sixty-two thousand Oregonians currently live with Alzheimer’s — a number that’s expected to increase 35 percent over the next decade as Baby Boomers age.

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Oregon Researchers Frustrated By Federal Genetic Testing Block

Congressional efforts to block research on the genes of human embryos continue, and researchers at Oregon Health & Sciences University are finding it particularly frustrating.

The House Appropriations Subcommittee has included language in the Food & Drug Administration's budget for next year that effectively bans federal research on genetic editing in humans.

Philip Yeske, the science officer at the United Mitochondrial Disease Foundation, said the restriction is toughest on families with genetic disorders.

“Oh," he said, "we’re very disappointed.”

Researchers at OHSU have done breakthrough work on one kind of genetic editing — mitochondrial replacement therapy.

OHSU's Dan Dorsa said researchers were just about to submit a new study.

“What this will mean is here in the U.S., we’re precluded from moving ahead with this," Dorsa said. "And yet, in Britain and certainly other countries, this is already going on.”

Members of the appropriations subcommittee have said they understand the potential benefits of genetic modifications, but researchers don’t fully understand possible side effects.

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Nonprofits Try Partial Self-Insurance To Reduce Health Costs

Getting health insurance if you work for a nonprofit can be tough. To save money, employees often end up buying high-deductible plans, sometimes spending thousands of dollars in co-pays and fees.

But the Nonprofit Association of Oregon is teaming up with health broker Nonstop to allow small to midsize nonprofits to partially self-insure.

Jody Schreffler of Nonstop, said it works by keeping employees in plans, even if they have a high-deductible, while also having them pay into a reserve account. That money is then used to pay co-pays and fees.

Nonstop also offers healthcare benefits and administration for nonprofits with more than 50 employees on healthcare.

“We risk mitigate for these large non-profits. Drop the premiums, we administer the plan. And after six months, look at that reserve account. And if they have not exceeded what they’ve set aside, we return two thirds of that back to the nonprofit,” said Schreffler.

Jim White, the executive director of the Nonprofit Association of Oregon said the new system, "offers an immediate solution to containing premium costs."

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