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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, January 27, 2015
Smartwatches are all the rage. But old-fashioned timepieces keep on ticking.
Tuesday, January 27, 2015
BY LINDA BAKER
Researchers in a multitude of disciplines are searching for ways to soak up excess carbon dioxide, the compound that contributes to global warming.
Friday, December 12, 2014
BY LINDA BAKER
Studying ground-running birds, a group that ranks among nature's speediest and most agile bipedal runners, to build a faster robot.
Sunday, December 07, 2014
BY LINDA BAKER
On Friday, Uber switched on an app — and with one push of the button torpedoed Portland’s famed public process.
Friday, January 02, 2015
BY JACOB PALMER | OB DIGITAL NEWS EDITOR
The University of Oregon football team looked unstoppable on the field Jan. 1 — and the university is reaping the benefits of the new postseason format.
Friday, January 23, 2015
BY LINDA BAKER | OB EDITOR
The Northwest Environmental Business Council previews the 2015 legislative agenda as Hatch Oregon celebrates Oregon's new community crowdfunding rules.
Thursday, December 18, 2014
2014 was a year of wild contradictions, fast-paced growth and unexpected revelations.
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Is your business ready to join us in the call for action? This opening panel includes Oregon businesses who will discuss why they signed the Oregon Climate Declaration, the investments they are making to reduce carbon emissions, and how their actions are affecting their companies.
Get ready for two days of special events produced with the EPA, Portland Timbers and ISOS before and after the GoGreen Conference on October 16.
hubbub health uses behavior change science to rethink wellness programs.
In Ashland, a public-private partnership results in online resources to help diversify the local economy.
How sports tourism is driving economic growth and making cities across Oregon a better place to live.
If you have given a former employee access to your company’s electronic information by virtue of assigning a desktop or laptop computer and you suspect he or she of having taken electronically stored data, there are several steps to follow to preserve electronic forensic evidence from spoliation.
The official launch will be Jan. 14.
In a switch on the traditional trade show, representatives from UO departments and local and state agencies will host tables to connect with businesses and vendors. The fourth Reverse Vendor Fair will take place Wednesday, Feb. 25, in Eugene.