5 Things We’re Watching – Oregon, December 2013

In 2013, State of Reform has grown to have almost 14,000 email subscribers in Oregon.  Our conference is now established as one of the key dates on the health care calendar.  And our Convening Panel members and sponsors are some of the best folks in Oregon health care.
So, during this holiday season, I want you to know how much we appreciate your support and are thankful for your engagement with us.  It means more than you may know.

Thanks for a good 2013, best wishes for 2014, and happy holidays to you and your family.

DJ 5 things updated

1. Gov. Kitzhaber announces campaign for re-election

Kitzhaber’s re-election next November to a fourth term would be historic.  Completing a full fourth term would put him at the top of the list of US governors for length of service.   And, if you listen to health care and business leaders at the recent OCHCP conference where Kitzhaber spoke, you might think that his victory was a foregone conclusion.

With Dennis Richardson, a Republican challenger for the office, at a cash balance of about $84,000 at the end of 2013, it seems to reinforce the point.  Kitzhaber starts his re-election campaign this month with $154,000 cash on hand, getting a boost from some early backers.

2. How Cover Oregon could undermine the Kitzhaber re-election

The robocalls out this weekend from Cover Oregon suggest a tone deafness and indifference that won’t help ease concerns from Oregonians.  Moreover, the anxiety from those that aren’t able to get enrolled – particularly those with cancelled plans – is visceral in a way that won’t easily be forgotten.

With the recent (excellent) reporting connecting the challenges at Cover Oregon to the ambitious scoping of the project called for by the administration, there is now a direct link from the problems at the exchange to the Kitzhaber administration.


3. “I don’t believe we’re going to see the numbers”

There has been a lot of good coverage of Cover Oregon’s problems – particularly by Nick Budnick at the Oregonian.  However, the impact on those organizations which invested resources in preparation for Cover Oregon’s launch is a story not yet fully told (ie: plans, providers, etc).

This month, we interviewed Dawn Bonder, CEO of Oregon’s Health Republic Co-Op to hear from her about the implications of Cover Oregon’s failure to her business model.  You can read the interview we did last month with Ralph Prows from Oregon’s Health Co-Op on the topic, too.

4.  Medicare moving to “value based payments” 

One of the last things Congress did before it adjourned for the holiday was move forward on a compromise bill to change the payment model to physicians who see Medicare patients.  If Congress can agree on anything, that’s noteworthy in itself.

The “doc fix” bill ends the SGR payment system in Medicare, fixes reimbursement rate growth on a 0.5% annual trend line, and institutes a “value based payment” (VBP) system to compensate providers on a ‘pay for performance’ model.  The Congressional Budget Office says this will mean an additional $67 billion in payments to providers from 2014-2018.


5.  “If Pres. Bush were doing this…” 

President Obama and the administration appear to be selectively implementing or ignoring parts of the Affordable Care Act with a focus on politics and the impacts on consumers.  No regard appears given to the providers, plans or other health care leaders that agreed to support the original compromise bill.

Now, with the individual mandate delayed for those facing “hardship,” and even some on the left saying this is “difficult-to-defend ground,” you start to wonder what Democrats would be saying if this were President Bush undermining the “individual mandate” by administrative fiat.

And the health care sector that signed up for this deal in 2010?  One might characterize their view of Obama’s actions and this deal like this.  (H/t Politico)