5 Things Oregon: DataDx, Medical debt legislation, opioid tapering

We have announced our date for our 2019 Oregon State of Reform Health Policy Conference. It’s a little later in the calendar this year on November 12th.  But, the hope is that will move us a little closer to the next legislature, and provide perhaps a bit more clarity about the role of health policy in 2020.

If you know you want to be with us this fall, you can get registered now and save a few bucks while the Early Bird rates are available…  We’d love to have you with us!

 

With help from Emily Boerger
and Sara Gentzler

 

 

1. Medical debt and access bill on-the-move

A bill that chief sponsor Rep. Andrea Salinas says answers key questions related to charity care and community benefit passed out of the House earlier this week. If it becomes law, 58 of Oregon’s 60 hospitals would have to establish policies that adjust costs to different levels according to a patient’s household income, up to 400% of the Federal Poverty Level. At 200% of FPL and below, costs would be adjusted to zero.

Also in the bill are requirements related to guarding consumers against medical debt and a mandate for OHA to set a community benefit spending floor for non-profit hospitals that meets specific criteria every two years. More on what’s in the bill here.

 

2. Cold water from California

Recent comments from Jennifer Kent, Director of California’s Department of Health Care Services, throw cold water on the likelihood of establishing a Medicaid prescription bulk purchasing partnership between California and Oregon. In a recent POLITICO California Pro Q&A, Kent discussed working with Oregon and Washington on bulk purchasing.

She says, “Their leadership in those states have said we want to join our Medicaid programs with your Medicaid program and let’s just buy all together. And we’re like, you combined as two Medicaid programs are a million people. We’re 13 million. So the purchasing and negotiation for us doesn’t get us anything.”



3. HERC eases up on opioid tapering

Last week, the Health Evidence Review Commission voted to scale back recommendations for controversial guidelines regarding opioid tapering for patients with neck and back pain. The original guidelines required tapering patients’ opioid usage within a year, which sparked public pushback.

An updated, less-stringent proposal still yielded criticism from many members of the medical community.  The commission ultimately approved less-prescriptive language requiring individual treatment plans with a tapering plan “where clinically indicated” and without a deadline. The changes go into effect in October. Also during the meeting, HERC tabled a recommendation to expand Medicaid coverage to patients with specific chronic pain diagnoses until more research is available.


4.  A first look at rate request changes for 2020 plans

Last week, the Oregon Division of Financial Regulation (DFR) released a first look at the requested rates for 2020 individual and small group health insurance plans. For the individual market, seven companies submitted rate change requests averaging 3.3%, and in the small group market, rate change requests averaged 8.7%. The full list of the rate requests is available here.

According to the DFR, these “moderate rate increase requests, recent health insurance company financial statements, and expansion into additional counties by multiple carriers reveal that the Oregon health insurance market is stabilizing in spite of continued uncertainty at the federal level.” The filings are now posted online and are available for public comment.

 

5. DataDx launched

A new resource aimed at providing real-time feedback and intelligence to medical practices launched this spring. The program, DataDx, aggregates a broad range of financial and operational data and analyzes the information to produce reports and business intelligence.

Examples of reports include a breakdown of patient visits by date, age, or geographic location, as well as detailed information on net collections. According to Kate Othus, President of DataDx, the goal is for medical practices to then utilize the reports and analytics to inform their decision-making. Emily Boerger digs into the weeds more here.