HCAO News

Basic Health Could Improve Dental Coverage in Oregon

Fact Sheet. Center for Public Policy
September 5, 2014
Click here to download a PDF of this document.

Should Oregon enact a Basic Health Program, more than 87,000 low-income adults could gain access to dental insurance coverage they currently lack.[1] Oregonians without such insurance struggle to obtain necessary dental care and endure costly health problems.[2] Without a Basic Health Program, many low-income adults in Oregon who don’t have health insurance through work will continue to struggle to afford mandated health insurance, let alone dental coverage, which adds to the cost.

Presently, for low-income adults whose income is too high for the Oregon Health Plan, Oregon’s health insurance marketplace offers the best deal on insurance. In the marketplace, low-income adults — those earning between 138 and 200 percent of the federal poverty line — qualify for generous federal premium subsidies. But even with those subsidies, the cost of the insurance will remain out of reach for many of these adults.[3]

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Medicaid Home Births Coming in December, but Not for CCOs

The state plans to adopt an uneasy compromise that will carve out the pregnancy benefit package for women that will be delivered outside of the coordinated care organization program. Finding a permanent fix for such care by CCOs may take further legislation and will likely be an issue in the 2015 session.

By Christopher David Gray for The Lund Report, 9-4-14

Oregon women who receive care through the Oregon Health Plan should get the chance to receive the services of a midwife for normal childbirths starting this winter, but their care will take place outside the coordinated care organizations for the foreseeable future.

Starting Dec. 1, the rules should be in place for women to receive an “open card” for their pregnancy benefit package if they want the services of a midwife. This option will not be carved out of any care they already receive from CCOs, which haven’t found a way to offer the service.

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Insurers shoving “advanced illness counselors” on us

Operator? Business, Insurer Take On End-of-Life Issues By Phone
By Elana Gordon, WHYY
Kaiser Health News, August 27, 2014
Forward by Don McCanne, see comments below.

Kate Schleicher, 27,  is a licensed clinical social worker, who knows almost as little about you as you do about her. Except she knows your phone number, your insurance provider and that you are pretty sick.

Schleicher is one of 50 social workers at a company called Vital Decisions. After sending a letter (people rarely respond) counselors essentially cold-call to offer what they describe as “nondirected” end-of-life counseling.

The hope of this program, she says, is to build a relationship over the phone, so (the patient) might be comfortable discussing his situation and his goals. Then he’ll be empowered to communicate those things with others, including his family and his doctors. He could also choose to allow the counselor to talk to his doctors or family directly. It’s paid for by insurers and federal privacy rules permit this for business purposes.

And when these conversations do happen, there’s can be another byproduct: reduced costs. Res

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Oracle whistleblower figures prominently in state's lawsuit over 'shoddy' Cover Oregon work

 by Elizabeth Hayes Staff Reporter- Portland Business Journal
For Health Care Inc Aug 25, 2014,

The state revealed a secret weapon in its lawsuit against Oracle Cor p.: an unnamed former Oracle employee with first-hand knowledge of what went down at Cover Oregon.

Actually, it’s not clear if it’s one whistleblower or several, but either way, they have a few pointed things to say about Oracle’s work on the troubled website. For its part, Oracle has said the state’s account was “fictional” and that the truth would prevail both in this lawsuit and the one it filed in federal court two weeks ago.

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Oregon health reforms threatened by new federal directive, officials say

A new federal directive has thrown a wrench into Oregon Gov. John Kitzhaber's reforms to the Oregon Health Plan. (The Oregonian/Bruce Ely)

A new federal directive has thrown a wrench into Oregon Gov. John Kitzhaber's reforms to the Oregon Health Plan. (The Oregonian/Bruce Ely)

by Nick Budnick for Oregon Live
on August 21, 2014, updated August 22, 2014

Federal officials have thrown a wrench into the state's high-stakes reforms to the Oregon Health Plan, threatening a program that serves one in four Oregonians.

A new directive could eventually even force the state to return hundreds of millions of dollars received from the federal government – money that's already largely spent.

The federal agency that holds the purse strings for care of nearly 1 million low-income Oregon Health Plan members recently harshly criticized the state's system for distributing money to regional coordinated care organizations under the reforms.

The Aug. 7 letter from the Centers for Medicare and Medicaid Services says the state is employing "high-risk practices" as well as projections that "differ greatly" from those used by the CCOs themselves.

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Advertising Campaign Sparks Insurance Complaints

Last year, Moda Health Plan had the highest number of complaints among the major health insurers, while Regence BlueCross BlueShield followed closely behind.

by Diane Lund-Muzikant, for The Lund Report, 8-20-14

Complaints work! Just ask the Oregon Insurance Division, which has seen its complaint numbers spiral by 34 percent after launching an advertising campaign in May.

Better yet – those advertising dollars aren’t coming out of taxpayer pockets. 

After receiving around $1.9 million from multi-state settlements against insurance companies, the Division decided to put those dollars to work and is spending $833,000 on television, radio and billboards, along with print and digital advertisements -- encouraging people to file complaints after they’ve been denied care or faced delays getting their insurance company to pay the bills, according to Lisa Morawski, spokeswoman. Fish Marketing produced the segments, after receiving the $1.3 million contract.

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Report: Racial Discrimination Severely Undermines Black Women’s Health

All too often, when women of color are concerned about things outside of what appears to be the predominant white woman’s agenda, they aren’t considered "women’s issues." But, we cannot tell women of color what issues are important to them. (StoryOfAmerica / YouTube)

All too often, when women of color are concerned about things outside of what appears to be the predominant white woman’s agenda, they aren’t considered "women’s issues." But, we cannot tell women of color what issues are important to them. (StoryOfAmerica / YouTube)

by Elizabeth Dawes Gay, Reproductive Health Technologies Project
August 13, 2014
This piece is published in collaboration with Echoing Ida, a Forward Together project.

On Wednesday, August 13, the United Nations Committee on the Elimination of Racial Discrimination begins a two-day review of the United States government’s efforts, or lack thereof, to address pervasive racial discrimination in law and practice. When the United States ratified the International Convention on the Elimination of All Forms of Racial Discrimination in 1994, it consented to a periodic review by human rights experts of its progress toward meeting the goals in the treaty. The last time such a review was conducted was 2008, when the committee expressed specific concern about persistent and worsening disparities in sexual, reproductive, and maternal health in the United States—particularly for Black women—and offered recommendations about how the country could reduce those disparities.

It’s no secret that Black women are more likely than others to experience negative maternal health outcomes, such as preterm birth or stillbirth, to suffer from conditions like preeclampsia, and to die at higher rates from pregnancy-related causes. A new shadow report, Reproductive Injustice: Racial and Gender Discrimination in U.S. Health Care, by the Center for Reproductive Rights, the National Latina Institute for Reproductive Health, and SisterSong Women of Color Reproductive Justice Collective shares some alarming data on maternal health outcomes as well as disturbing firsthand accounts of the racial discrimination experienced by Black women.

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ACA plan renewal leads to rate shock and delayed tax refunds

An Ounce Of Prevention For The ACA’s Second Open Enrollment

gy Jon Kingsdale and Julia Lerche
Health Affairs Blog, August 4, 2014

Since recovering from its flawed rollout, the ACA has enjoyed a string of successes. By April, some eight million Americans managed to enroll.

Approximately 87 percent of Marketplace enrollees claimed premium tax credits, of which an estimated 85 percent, or six million, actually paid premiums. Many of the original six million, plus more recent enrollees, will experience their second enrollment between November 15, 2014 and February 15, 2015. They will also file with the IRS for a premium tax credit as early as January 2015.

The two events in combination represent a huge risk.

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