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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.
Tuesday, July 01, 2014
BY HANNAH WALLACE | OB BLOGGER
Demand for organic food continues to soar: Last year, sales of organic food rose to $32.3 billion — up 10% from 2012. In Oregon, organic produce wholesaler Organically Grown Co. has been championing organic growing methods for four decades.
Monday, July 07, 2014
BY TOM COX | OB BLOGGER
Named after the 2010 experiment by Thomas Ryan, "Robin Sages" are fake social media profiles designed to encourage linking and divulging valuable information.
Thursday, July 31, 2014
BY MARY SPILDE | OB GUEST CONTRIBUTOR
Faced with the aftermath of the “great recession,” increasing concern about the environment and dwindling family wage jobs, we have some very important choices to make about our future.
Tuesday, August 26, 2014
BY DEBRA RINGOLD | OP-ED CONTRIBUTOR
Why has six years become an acceptable investment in public undergraduate education that over-promises and underperforms?
Friday, July 18, 2014
BY JASON NORRIS | OB GUEST CONTRIBUTOR
Back in May, we shared a common Wall Street quote about investing, “Sell in May and go away.” Fast forward to July and the most common question we have been getting from clients is, “When is the market pullback going to occur?”
Tuesday, August 19, 2014
BY TOM COX | OB BLOGGER
Tom Cox interviews Steve Balzac, author of "Organizational Psychology for Managers."
Thursday, July 03, 2014
BY TED AUSTIN & MIKE BAELE | GUEST CONTRIBUTORS
The Office of Economic Analysis announced that Oregon is currently enjoying the strongest job growth since 2006. While this resurgence has been welcome, the lingering effects of the 2008 “Great Recession” continues to affect Oregon businesses, especially with regard to estate planning and business succession.
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