Corporatization of Medicine

Sound familiar?

Cooking for Health Class Starts Tomorrow

The Seventh Day Adventist Church in Winston is holding a four week course about healthy eating.  Below was the calendar event posted on KPIC's website.  It does not say if it cost to attend, but if you want to learn to eat healthier, particularly a plant based diet, this religious group has been doing it for years.  Everyone should be able to learn something from their experience.  

 

 

Cooking for Health

Event Details

Date(s) & Time(s):

Weekly on Sunday at 4:00 PM until 6:00 AM from June 30, 2013 until July 28, 2013

Location: 1730 Winston Section Rd, Winston, OR 97496

Event Description

Our health is benefited by the nutrition in the food we eat. Learn about new choices we can make in the way we cook which will improve our lives. With good health, vibrant energy, and clear thought our lives will be desirable to live. Join us for five classes that take a look at topics such as: weight loss, diabetes, high blood pressure, and cancer. There will also be nutritious dishes demonstrated that favor good health. For the recipes shown there will be small samples given. Come and learn how to eat to your health. Starting on Sunday, June 30, at 4:00, they will be held at the Winston Seventh-day Adventist church - fellowship hall.

We the People Deserve CCO Transparency!

Oregon Patients Rights Association was formed late last year in response to concerns about policies being implemented by our new local Coordinated Care Organizations (CCO), Umpqua Health Alliance (UHA).  We quickly learned that although there seems to be a means to ensure local accountability, in practice there really is not.

Umpqua Health Alliance is solely owned by Douglas County Independent Practice Association (DCIPA).  Although there is a “board of directors” made up of people representing various providers under the Oregon Health Plan, as well as a county commissioner and at least one “community member”, according to the Secretary of State (as of today), UHA is owned by DCIPA.  This means that the “board of directors” is really only advisory in nature and does not have the legal authority or right to set policy for the CCO.

In a rush to get a handle on escalating cost for the state’s Medicaid program, the state jumped on the CCO bandwagon.  Unfortunately they failed to ensure CCO operate in the open or with sufficient safeguards for local accountability were in place.  The structure of our local CCO is just one example. 

There are two experiments going on today in Oregon regarding access and delivery to medical services.  One revolves around implementation of health insurance exchanges provided for under the Patients’ Rights and Affordable Care Act (ACA).  The other revolves around the ACA provision to expand Medicaid coverage to those whose household income is 133% or below of the federal poverty line. 

Oregon already has expanded Medicaid coverage, to those not otherwise eligible under federal Medicaid rules, via the experiment known as the Oregon Health Plan.  However those more will be added in 2014 when the ACA expands eligibility to those not currently covered under OHP. 

Although a May 2, 2013 New England Journal of Medicine Special Article, The Oregon Experiment-The Effects of Medicaid on Clinical Outcomes, reveals that the benefits of having Medicaid verses being uninsured in Oregon shows little in the way of overall health care improvements,  the state hopes to change this with implementation of the Coordinated Care Organization model.   The state has high hopes for this new delivery system:  they believe they will provide better care, with better health care outcomes, and save money too. 

The CCO is based upon provisions in the ACA for Accountable Care Organizations (ACO) to serve Medicare fee-for-service beneficiaries, particularly those with chronic health conditions.  Although the CCO is now just a Medicaid program, its set up is such that they can easily become recognized for Medicare as an ACO.   The concept is a good one.

Coordinated care is important for people with chronic health conditions and may be critical for people with multiple chronic conditions.  Coordinating care, making appropriate referrals, and doing follow-up has always been the model for good quality medical care, mental health services, and social services.  Having a way to make sure that happens is welcome. 

What is not welcome is the fact that how this will all happen is being done without the public’s knowledge or input.  Currently there is no means for us to know what policies, procedures, or plans are being made by our local Coordinated Care Organization:  Umpqua Health Alliance (UHA). 

Our group, OPRA came together because of some policies being enacted by several UHA members and although there are ways we are addressing some of our concerns through program appeals etc, we believe that the best way to address the basis of our concerns is through an open and public process for the development of plans, policies, and procedures regarding how coordinate care will take place in our community. This will not only serve our interest, it will serve everyone’s interest. 

This is not just the demand of a few disgruntled, OHP clients, but is based upon proven social psychology models that recognize the rights of the population being served, as well as their ability to help design programs that work to accomplish long term goals.  It is also based upon sound principles of good governance. 

So we have been working to get CCOs, particularly our local CCO, Umpqua Health Alliance (UHA), to operate in the open and be accountable to the public by promoting state legislative efforts that would accomplish this.  Now that the legislative session is almost over and there is little hopes in getting anything passed that will protect our right to know, OPRA will be asking our local CCO to voluntarily comply with Oregon Public Records & Meeting law.  

If UHA needs examples to follow, they can look to other CCO in Oregon who are open and transparent without being told to be.  These include Trillium and CareOregon, both are similar to UHA, where private doctors group owns the CCO, and they are able to operate in the open.  We should demand no less of our local CCO, Umpqua Health Alliance (UHA).  

 

 

 

CITED:  (n engl j med 368;18 nejm.org may 2, 2013)

Umpqua Health Alliance Looking for Community Advisory Council Members

Douglas County’s local Coordinated Care Organization (CCO), Umpqua Health Alliance (UHA) is taking applications through Friday, June 7, 2013 for people interested in serving on its Community Advisory Council (CAC).   The CAC is mandated by state Medicaid law and provides a means for community input into the operation of the CCO.

The CAC is open to anyone, but state law requires that a majority of the board represent Medicaid health care consumers. 

You can get more information and apply online at Umpqua Health Alliance website: 

http://www.umpquahealthalliance.org/recent-news/143-umpqua-health-alliance-uha-is-seeking-applicants

According to Umpqua Health Alliance, the “role of the Council is to provide advice to the UHA Board on various issues” including such things as “identifying preventive care practices, assessing the community’s current health status and needs, improving member engagement and providing recommendations to the transformation plan”, as well as help review our local CCO’s operations during the annual progress report process. 

You can also contact Patti LaFreniere at UHA for more information or assistance:  pattilafreniere@chiwest.com, 541-375-4612.

People Are Angry!

It seems that the folks involved with Oregon Patients Rights Association (OPRA) are not the only ones angry about what is going on regarding medical care in our community.  Check out Craigslist Roseburg and see the complaints that range from DCIPA, Mercy Medical Center, Parkway Medical Supply (owned by Mercy), and the current rants going on regarding ADAPT owned Federally Qualified Health Center, South River clinic in Winston. 

http://roseburg.craigslist.org/rnr/

Maybe if we all join together we can make something positive happen.

Oregon Insurance Commissioner Release Documents, Extends Public Comment Period for DCIPA/Mercy ATRIO Merger!

Oregon’s Insurance Commissioner extends public comment period regarding DCIPA's plans to transfer ownership interest in ATRIO (Medicare Advantage Plan) to DCIPA's new partnership with Mercy Medical Center, Architrave.  The extension was necessary after Oregon Patients Rights Association (OPRA) made a request at a recent hearing that additional documents regarding the application be released to the public.  After the hearing, Oregon Insurance Commissioner required more documents be disclosed and extended the time for public comment.

 

Anyone, with concerns about this transfer, can file objections with the Oregon Insurance Commissioner until 5:00 p.m., Tuesday, May, 21, 2013. According to the Insurance Commission, "Written comments must be RECEIVED by the Insurance Division by the deadline. Written comments may be submitted via e-mail to arussell.latham@state.or.us or by mail to Russell Latham, Financial Regulation Section, Oregon Insurance Division, P. O. Box 14480, Salem, OR 97309-0405."

 

You can read what DCIPA submitted to the state at: http://www.cbs.state.or.us/ins/insurer/financial_regulation/acquisition-merger.html before submitting your comments to the Commissioner. 

 

For more information about this and other efforts by Oregon Patients Rights Association to improve the quality of health care in our community, please contact: Oregon Patients Rights Association (OPRA) 541-236-3083, on facebook: Oregon patents rights, blog: http://opra4dc.blogspot.com/ or twitter.

OPRA Monthly Meeting Tomorrow

Oregon Patients Rights Association Public Meeting tomorrow, Wednesday, May 8^th from 5 to 7 pm.  Rm 310 Douglas County Courthouse, Roseburg.  First half of the meeting is business, planning, and sharing: the second half patients’ rights education.   We will be discussing the merger of DCIPA (our local doctors group) and Mercy Medical Center via Architrave and the problems with the growing medical monopoly in our community.     

Although Mercy Medical Center is a non-profit hospital whose mission is to provide charity, their CEO was compensated almost $700,000 during 2011, while their medical charity work dropped by about 25%.   DCIPA is a private for profit entity who has been moving to monopolize health care in our community for some time.  They own the medical records company your doctor uses, as well as one of three general durable medical equipment companies, DMES (one of the other two is owned by Mercy –Parkway).  

Because they are now attempting to join forces in a new company called Architrave, the Insurance Commissioner for Oregon is soliciting public comment about allowing DCIPA to transfer its 1/3 ownership interest in ATRIO to Architrave.   ATRIO is a Medicare Advantage Plan contractor.