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|Articles - July 2010|
|Saturday, June 26, 2010|
TACTICS: THE GOOD DOCTOR
STORY BY ADRIANNE JEFFRIES // PHOTOS BY KATHARINE KIMBALL
An old sign, discovered in an antique shop, hangs over the front of Dr. George Brown’s desk: “A deposit of $5 is required on all hospital cases.” Brown is prone to hypotheticals, as
in “if I knew the answer to that” and “if I had a dollar for every meeting I went to.” So one such as “if a hospital visit were $5” amuses him. Five dollars would probably be more like$100 today, depending on when the sign was made. But the reminder that hospital care once cost so little and paying for it was as simple as putting down a deposit contrasts starkly with the expensive and complicated system we have now.
Preparing for health care reform meant more than talking to Congress and switching over to electronic records. Brown is co-chair of a task force of Oregon health care professionals that has produced innovation and cost savings in administration, payment and treatment. He’s also a strong proponent of an experiment in primary care that improves patient and staff satisfaction and quality of care and will hopefully cut costs: the patient-centered medical home.
Imagine having a regular team of doctors, nurses and medical assistants in your neighborhood who know all about you, your medical history, your diet and when you’re due for a mammogram or a prostate screening. “Medical home” has different definitions depending on whom you ask, but the common threads are data, continuity and proactive care. Legacy has five medical homes — the first opened in 2007, and the newest opened last year. The medical home “wraps its arms around a population,” Brown says, so medical homes can tailor services to their patients; Legacy’s Good Samaritan medical home has enough elderly patients to merit three geriatricians and a geriatric psychiatric nurse practitioner. The hope is that medical homes will cut costs by diverting patients from the emergency room and catching problems early.
Payment reform is key to the medical home experiment. Traditional insurance only pays for certain things; it might pay for a doctor to explain in five minutes a medication you’ve already been taking for years, but not for a 20-minute conversation with a nurse about how to improve your diet. By contrast, Legacy’s medical homes receive a flat fee per patient from the Oregon Health Plan, CareOregon. They’re also paid based on quality measures such as whether patients get timely appointments — something that will become more common as health care reform phases in.
There are other medical home-type clinics in Oregon, but Legacy’s serve a wide range of patients, including commercially insured, Medicare and Medicaid patients, older patients, and patients with HIV. And Brown wants to open more. He’s partial to a single-payer model like the military’s. But medical homes, even if they’re multi-payer (some medical homes aren’t), are a vast improvement over what we have now. The next step is to make them profitable — Legacy’s medical homes are supported by grants.
Medical homes are a part of the future of health care, Brown says. But health care reform will take at least a decade and the churning has just begun. Some parts of the federal Patient Protection and Affordable Care Act don’t come into play until 2018, although the first rules will take effect this month. Brown’s priority is to keep himself and his staff engaged during what he calls “a stressful time” for hospitals. With reform coming from Congress, the state and the private sector, the ramifications are not fully known, except for one: Change is happening.
Friday, April 24, 2015
BY AMY MILSHTEIN
Male tech workers speak out on the industry's gender troubles.
Friday, May 22, 2015
BY LINDA BAKER | EDITOR
Roy Kaufmann always lands on his feet.
Friday, May 15, 2015
BY KIM MOORE | RESEARCH EDITOR
The Portland Bureau of Transportation is seeking input from businesses on a $5.5 million initiative to create a network of biking, transit and pedestrian trails within Portland’s central city.
Wednesday, May 27, 2015
PHOTOS BY JASON E. KAPLAN
Oregon Business celebrated the 100 Best Green Workplaces with an awards luncheon yesterday at the Nines Hotel in downtown Portland.
Friday, April 24, 2015
BY BEN DEJARNETTE | INVESTIGATEWEST
Timber companies and environmental groups take a stab at collaboration to boost logging and restoration in Oregon fires.
Thursday, May 28, 2015
BY LINDA BAKER | EDITOR
Reinventing capitalism. Office dumpster divers. Handprints versus carbon footprints. These are some of the ideas panelists and attendees discussed during the second annual Oregon Business “Green Your Workplace” seminar yesterday.
Friday, May 22, 2015
BY JACOB PALMER | DIGITAL NEWS EDITOR
The recent tragedy in Philadelphia has called attention to Amtrak and the nation's woefully underfunded rail service. Here are six facts about the Amtrak Cascades corridor between Eugene and Vancouver B.C.
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Tonkon Torp helps seed sustainability at Gunderson.
Oregon-based Environments helps companies create inspired workspaces. “Simply put, we help companies future-proof their workspaces,” says Chris Corrado, president. Since 1988,Environments has witnessed firsthand the changing landscape of business. Native Portlander and Environments founder Corrado says, “We help our clients navigate the complex realities of the workplace today and plan for their future in a very mindful, strategic way. We think of ourselves as their partners in the process.”
One hundred years ago, the Willamette River might easily have been mistaken for a sewer. Unchecked industrial activity and decades of pollution made it unrecognizable compared to the clean river that now flows north for 187 miles from Eugene through the center of Portland.
The Oregon Entrepreneurs Network (OEN) will be presenting its third annual Entrepreneurial Summit on Friday, June 5 at Castaway in Portland, Oregon.
On June 13th Mayor Charlie Hales will attend nonprofit organization Dream Change’s inaugural Love Summit and will introduce one of its keynote speakers, Dan Wieden of Wieden+Kennedy advertising agency.
34 spots for food, 17 places to sip, and 7 sites to choose a brew beckon visitors.