|| Print ||
|Articles - July/August 2014|
|Friday, July 11, 2014|
Page 5 of 6
Health care reform is about more than collaboration and prevention. New organizational models are also part of the shifting landscape. For example, as a compromise alternative to the hotly debated “public option” — a proposed government-operated insurer that would have competed with private companies — the ACA created a new, nonprofit type of insurance carrier called a CO-OP, a Consumer-Oriented and Operated Plan. These new entities were intended to improve competition in the insurance market — especially in local markets where just a few carriers dominate. As nonprofits, CO-OPs’ surpluses must be used for purposes such as lowering premiums or improving benefits; as “consumer-operated” plans, at least half of their board members must be policyholders.
Oregon is the only state with two CO-OPs: Health Republic and Oregon’s Health CO-OP. That puts these organizations in the unique situation of competing directly with each other. “Head to head,” says Health Republic CEO Dawn Bonder, a straight-talking ex-attorney who served as senior advisor on health information technology to former Gov. Ted Kulongoski.
The reality, however, is that the CO-OPs’ greatest threat comes from entrenched market players. The new entrants were supposed to get a boost in visibility by being presented alongside established carriers on the insurance exchanges. But in Oregon and elsewhere, of course, those exchanges never functioned as intended. “It’s been very difficult,” Prows says. “Our intention was that most of our enrollment would come through the exchange, and it didn’t.”
As Cover Oregon’s failings became evident, the CO-OPs pivoted toward more outreach to insurance brokers. Many agents, though, were leery of the newcomers. “It took a while for brokers to feel comfortable with this out-of-nowhere health plan,” Bonder says.
Cover Oregon’s failure notwithstanding, Health Republic and Oregon’s Health CO-OP fared decently in the 2013-14 enrollment period: The former enrolled more than 5,000 members, while the latter expects to hit the 5,000 mark by year’s end. Of course, compared with Moda, the 800-pound gorilla of the Oregon insurance industry, both CO-OPs are small fry. The regional insurer, with revenues of more than $2 billion, boasts more than 414,000 medical-plan members in Oregon.
Still, Bonder and Prows contend their organizations have structural advantages over traditional carriers. CO-OPs are legally required to reinvest surpluses in their organizations; in addition to touting their member-driven governance structures, both chief executives take potshots at Moda for spending premiums on building up big reserves or buying the naming rights to the Moda Center.
“We have a very consumer-focused mission,” Prows says. “It is not to build huge reserves. It is not to rebrand sports centers. It is only to build care the way people want it.” Moda spokesperson Jonathan Nicholas responds: “None of the money spent on partnership endeavors with the Portland Trail Blazers has any impact on Moda’s insurance rates in Oregon.”
Perhaps the biggest competitive advantage for CO-OPs is the fact that the insurers are indigenous to health care reform; they have, as it were, no preexisting conditions. “Trying to move a brand-new startup organization isn’t easy,” Bonder observes, “but it’s a lot more feasible than trying to move a behemoth.”
Friday, March 27, 2015
BY ROBERT MULLIN
A new energy-sharing agreement sparks concerns about independence and collaboration in the region's utility industry.
Friday, February 27, 2015
PHOTOS BY JASON E. KAPLAN
Images from the 2015 celebration of Oregon's great workplaces.
Tuesday, February 17, 2015
BY TAMSEN LEACHMAN | OB GUEST CONTRIBUTOR
It is important to understand the EEOC’s priorities, and ensure that your leadership understands the shifting expectations of regulators and the heightened standards to which you (and they) may be held.
Thursday, February 26, 2015
BY KIM MOORE | OB RESEARCH EDITOR
Employment in Oregon is almost back up to prerecession levels — and employers are having to work harder to entice talented staff to join their ranks. This year’s 100 Best Companies to Work For in Oregon project showcases the kind of quality workplaces that foster happy employees.
Friday, March 27, 2015
BY COURTNEY SHERWOOD | Photos by Jason E. Kaplan
Pacific Seafood, one of the world’s largest processors, is rebranding as a more transparent and consumer-friendly operation. A controversial CEO and monopoly accusations from coastal fishermen complicate the tale.
Thursday, March 19, 2015
BY DAN COOK | Photos by Jason E. Kaplan
An alliance of developers, academics and timber industry executives wants to position Oregon as a front runner in the glamorous new world of wooden skyscrapers.
Tuesday, February 24, 2015
BY KIM MOORE | OB RESEARCH EDITOR
A conversation with Donna Earley, director of sales and marketing for the Salem Convention Center.
|Get on the bus!|
|Bike Chic: 7 stylish options for cyclists|
|Emperor of the Sea|
|Downtime with the executive director of Greater Portland Inc.|
|Swiss bankers guilty of tax fraud avoid jail|
|US grants Texan rhino hunter permit to bring back trophy|
|Norwegian Air tweaks cockpit rules after Germanwings crash|
|Federal Consumer Agency addresses payday loans|
|Slave-caught seafood sold in America|
|Heinz, Kraft merge|
|West Coast lawmakers want earthquake warning funding|
Generations of students and graduates have been plagued by the question: What is my true calling in life? Four alumni from Corban University’s Hoff School of Business who graduated in different decades say the school helped them find the answer by giving them a practical, well-rounded education.
It’s happening whether anyone’s ready or not. Businesses here in Oregon and across the U.S. are already experiencing the effects of the largest generational shift in recent history, and these changing tides will impact every level of the workplace — from a company’s executive leadership to its cultural core.
Success stories spotlight meaningful career opportunities in Oregon's diverse and lucrative tourism industry.
Like the advent of the locomotive, the cloud creates business opportunities that simply weren’t possible before now. Get up to speed fast in May at an exciting cloud-empowered Portland event.
Registration is now open for Portland Business Alliance’s Annual Meeting, one of the largest business gatherings in Portland each year.
The Commission helps to advance the professionalism, equality and efficiency of Oregon's judicial branch of government.