5 Things We’re Watching – Oregon, July 2013

Just think:  for your entire career, you’ve probably said the health care system is broken.  “There ought to be a law!”

This is the time you’ve waited your whole career for – where everything is in play, and everything has tremendous potential to make things better for our neighbors and families.  It’s why we’re all doing this, right?

Enjoying the ride during this time of transformation.  It is what underpins the 5 Things We’re Watching this month.

DJ Wilson - Host, State of Reform

1. The best exchange marketing campaign anywhere

Selling insurance exchanges is perhaps the White House’s top goal for the year.  In our own tracking of exchange activity in seven states, no other state-based exchange appears to have given as much thought to their marketing campaign for the fall as has Cover Oregon.  We think it’s got “award winning” written all over it – though some might quibble with that.

And, like so many other things Cover Oregon has done, this marketing campaign is setting the standard compared to other efforts nationwide.  Connecticut underwhelms.  Kentucky animates.  Colorado overstates.  Oregon lives long.

2. October 9th Conference Agenda announced next week

We are thrilled to be working with this year’s Convening Panel for our fall conference.  The list of participants reads like a list of some of Oregon’s smartest health care leadership.

We’re finalizing the Topical Agenda and expect to announce that next week.  We take our time developing these agendas, with a lot of stakeholder outreach.  This email is part of that effort.  Have an idea you’d like to see discussed?  Let us know.  We’ll see if we can make it happen.

Family care

3. The other stories in Oregon system transformation

CCOs are rightfully a central topic in the Oregon transformation narrative.  But there are some very interesting transformations taking place in Oregon health care that go beyond the CCO narrative that are very interesting to watch.

CareOregon’s transformation story continues to unfold in potentially very innovative ways.  The Northwest Health Foundation is fundamentally realigning their areas of focus.  Cambia’s diversification strategy is creating powerful new consumer engagement tools outside of its traditional line of insurance business.  ODS’s brand change to Moda Health positions them well for deeper growth in the state, as well as broader success beyond Oregon.

These other stories don’t always get much attention, but we think they are worth keeping an eye on.


4. “Don’t move the goal posts”

“We are in a time of massive transformation.  Don’t move the goal posts now.  Just get across the end line.”  That advice to legislators seemed pretty smart to me – but I’m not a legislator.

The sheer amount of legislation produced this session on health care was concerning to many policy observers I spoke with this year.  Some pointed to HB 3260, a bill to study a single payer system for the state now sitting on the Governor’s desk, as an example of well-intentioned but distracting legislation.

The gist of the bill?  The OHA find time away from what its doing and fundraise $600,000 from a third party to develop a study to consider transforming the health care system.  Seems like a distraction to me… 


5.  It’s in the weeds but it hits the bottom line

Lots of changes have been proposed recently to billing and coding in Medicare.

On July 8th, CMS proposed a rule to make outpatient payments more “episodic” or in “packages,” which some identify as being similar to the bundled payment methodology in hospitals.

Later, CMS proposed a new rule that would trim or raise select physician payments, with some cuts of up to 26%, in order to facilitate episodic payment to physicians.

Finally, MedPAC identified 78 different services performed across multiple settings – inpatient versus outpatient – which were paid different rates.  By paying the lower amount for the same service (typically the outpatient rate) MedPAC reports it can save Medicare $1.5 billion annually.