Health Care Reform for
Providers

The average cost for premiums has risen 73%  since 2000 and many Oregonians have seen their level of coverage decrease or disappear.  Providers have seen an increase in the number of uninsured patients.

The Healthy Oregon Act continues the reform efforts that have been ongoing since 2005 by creating a public board, the Oregon Health Trust Board, to work with state agencies and gather public input on key reform concepts, finalize the concepts into the comprehensive plan and present it as legislation for consideration by the 2009 Legislature.

Sharing Responsibility, Sharing Risks

The Healthy Oregon Act sets up the Oregon Health Fund which, upon adoption by the 2009 Legislature, will allow businesses and individuals to join and “pool” their health care dollars to increase their buying power and share the risks across a larger spectrum. 

Oregonians who join will receive an Oregon Health Card that provides an affordable essential benefits package through an insurance provider of their choice and can choose their doctors and hospitals.

The Healthy Oregon Act will propose ways to place a renewed focus on preventative and primary care by setting criteria for insurers to become Accountable Health Plans.  It will also encourage wellness with incentives that encourage healthy behaviors. 

The legislation calls for fair and fast reimbursements for providers. The renewed focus in the bill on primary and preventative care will lower costs and save lives.

Benefits of Fixing Health Care for Providers

• Fair and fast reimbursements and increased reimbursement for primary and preventative care

• Reduced paperwork for claims billing

• All Oregon residents have coverage

• Coordinated delivery models and electronic health records

• Centralized electronic advance directive and POLST form access

• Time and point-of-service enrollment

Frequently Asked Questions from Providers

Is this a state or socialized plan?

No. Oregonians will still be able to purchase plans through the insurer of their choice and will continue to choose their own health care providers.  The legislation calls for “public and private health care partnerships that integrate public involvement and oversight, consumer choice and competition within the private market.”

Will this plan create more paperwork?

Just the opposite!  The Healthy Oregon Act calls for a streamlining of claims forms to help reduce administrative  costs for every practice and provider across the state.

My patient has a pre-existing condition, will she be covered?

 Yes. The legislation creates the Oregon Health Fund to “pool” health dollars to leverage better rates and share the risks of illness and injury.  Because of the projected number of people who would join the pool, pre-existing conditions will be covered.

What will the essential benefits plan look like?

After the Healthy Oregon Act passes, a citizen board and sub-committees will begin to gather public input and priorities.  One thing is certain: a renewed focus on primary and preventative care is necessary to lower costs.  Dental, vision and mental health are also discussed in the bill

As a provider, why will I want to accept the Oregon Health Card?

We expect the Oregon Health Card will be widely accepted because at least 600,000 Oregonians will be carrying one and because of the plan's focus on fair and fast reimbursements for providers.

I'm a specialist, will this plan reduce my reimbursements?

No. We will always need  highly-qualified specialists.  But, the plan does call for focus on primary care to reduce our long-term health costs, especially around preventative care, smoking, and obesity.