5 Things We’re Watching – Oregon, October 2013

With October being the month of exchanges, it’s hard to get one’s head up to see the bigger picture in health care today.  So, while we are keeping one eye on the exchange – and the possible implications of its rocky start – we are also trying to keep an eye on the bigger picture.

Cover Oregon, hospital safety, CCO transformation, and co-op plan sustainability are among the 5 Things We’re Watching this month.

DJ Wilson - Host, State of Reform

1. Cover Oregon continues to grind

We were honored to have Cover Oregon deliver a keynote for us at our annual event this year.  It was clear that, while the start has been rocky, the audience engagement pointed to a strong level of support from the health care community for the team at Cover Oregon.  Their stakeholder outreach is paying off now when they need it most.

That said, people are talking.  “Will Cover Oregon be able to recreate the public interest once the site is functional?”  “If young, healthy people don’t enroll because of functionality issues, how badly will that hit plans’ bottom lines?”

So, much of what Cover Oregon has done to date has been “top of class” in the nation.  But, with the site still not yet up and running, the question is when will confidence, political support, and system viability start to erode in reform.

2. Health Share about to make a big move

Janet Meyer, CEO of Health Share, is about as passionate of a speaker on Oregon’s transformation project as you’ll find.  And, she’s leading Health Share, Oregon’s largest CCO, towards what appears to be a significant step forward:  the integration of 9 new risk-bearing dental plans and a non-emergency medical transport into the CCO.

In a presentation over the weekend comparing the Oregon CCO project to the environment in Washington State, Meyer laid out that the CCO is continuing to work to expand beyond the initial group of risk-bearing partners in Health Share.  She called it “Health Share 2.0.”  We’d call it a major evolution in developing multi-stakeholder risk-bearing system improvement in Oregon.

lifewise

3. Here is what State of Reform looks like

We were really pleased with our annual conference here earlier this month.  If you were there, you know it was a dynamic, stakeholder-driven agenda with a very diverse audience – something truly unique on the calendar.

Wonder what you missed?  Check it our short video here.

4. Hospital news is mixed  

There were a couple of interesting bits of news from the hospital world recently that caught our eye.  First, Leapfrog is out with its hospital rankings.  While some statewide views show mixed performance, on hospital safety, it was a pretty mixed report for Portland hospitals, too.

The other was the news that a hospital had to pay $2.4m in damages for not taking action that would have prevented the sex abuse and rape of its patients by an anesthesiologist now serving a 23 year prison term.  It was the amount that turned our heads.  It doesn’t strike us as being that much, to be honest, though I’m sure there are many that would disagree with us.

Regence Oregon

5. What future for the health co-ops?

Oregon got some buzz for being the only state with two co-ops formed as a result of the ACA.  It was taken as a sign of the consumer-centricity of the state.  We generally agree, and were honored to feature both co-op CEOs at our conference as speakers.

But, starting any new health plan is a fragile undertaking.  Doing it with a consumer focus while your primary enrollment tool, Cover Oregon, is not able to function properly makes it even tougher.

Co-ops are starting to fail in other states, and with limited working capital, the pressure for these new entities to make it is intense.  We wish them the best of luck, and hope to celebrate their success in a year’s time.  But we wonder what kind of collateral damage the Cover Oregon site being down might be doing.