Oregon Public Broadcasting

Briefly: Oregon Levies Its Largest Ever Civil Fine On Legacy Health

Legacy Health Systems is being fined $5 million — the largest civil fine ever imposed by the Oregon Bureau of Labor and Industries.

But Legacy said it’s fighting the penalty.

The fine comes after employees complained about being forced to skip meals and break times at Legacy's Meridian Park, Mount Hood Medical Center and Good Samaritan hospitals.

A statement from Legacy said it fundamentally disagrees with BOLI’s findings. It also said the investigation didn’t take into account the needs of patients and families, which sometimes require meal breaks to be deferred.

"Legacy Health has always been committed to creating a safe and healthy work environment. Legacy Health provides support for all of our staff in their work, including getting the meal breaks they are entitled to under the law. We remain 100 percent committed to ensuring the continued health and safety of our workforce," the health network said in a statement.

The statement also said Legacy will seek a hearing on the findings and vigorously defend itself.

The Bureau of Labor and Industries delivered notices of the fines to each of the three different hospitals. They said Legacy executives knew of the violations, but chose not to address them.

Legacy was fined more than a quarter of a million dollars last year for not giving staff breaks.

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Study: Urban/Rural Divide Narrows If Patients Get Same Treatment

Researchers at the Fred Hutchison Cancer Research Center in Seattle found that patients enrolled in the same study have similar outcomes -- regardless where they live.

Survival rates for cancer depend on where you live — at least partially.

Urban patients tend to do better than rural patients. Researchers have long tried to figure out how that divide happens in the first place.

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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