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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, August 14, 2015
BY JACOB PALMER | DIGITAL NEWS EDITOR
17 airlines make stops at Portland International Airport, but not all are created equal when it comes to customer service.
Wednesday, September 30, 2015
BY KIM MOORE
Striving for social equity is the mission of many nonprofits, and this year’s 100 Best Nonprofits to Work For in Oregon survey shows employees are most satisfied with their organizations’ fair treatment of differing racial, gender, disability, age and economic groups. But as a national discourse about racial discrimination and equity for low-income groups takes center stage, data show Oregon’s 100 Best Nonprofits to Work For still need to make progress on addressing these issues within their own organizations.
Wednesday, September 30, 2015
Oregon Business magazine has named the seventh annual 100 Best Nonprofits to Work for in Oregon. The rankings were revealed Wednesday night during an awards dinner at the Sentinel Hotel in Portland.
Monday, September 28, 2015
BY JOE CORTRIGHT
Corporate headquarters are no longer a marker of economic prowess.
Wednesday, September 16, 2015
BY GREGG LEWIS | OP-ED
The issue of green-washing remains a significant challenge to those of us who would like to see the building sector in this country do more than make unverifiable claims of sustainability. Transparency about the impacts of a given material is the only way to allow designers to make intelligent choices when selecting building products.
Wednesday, August 19, 2015
BY JACOB PALMER
A Power Lunch at Bob's Red Mill Whole Grain Store and Restaurant.
Wednesday, August 19, 2015
BY GARY THILL | PHOTOS BY JASON E. KAPLAN
A storied institution climbs down from the ivory tower.
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Hans N. Hugglerhas joined Lane Powell as an Attorney in the Litigation Practice Group, where he will focus his practice on complex litigation.
Over 300 attendees will gather to learn from 50+ regional leaders pushing the sustainability needle forward. GoGreen Portland offers a distinct platform of bringing people together across industries and sectors to build viable networks and cross-pollinate best practices throughout the regional business community.
Are you planning a meeting, party, gala, fundraiser, holiday party, golf tournament, retirement party, team building or birthday? You won’t want to miss this show to get hundreds of great ideas!