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Portland, OR—When it comes to seeking—and responding to—what people want from their health insurer, Oregon’s Health CO-OP has developed a powerful approach: let members lead. The process started as far back as 2012, when, in developing their plans, the CO-OP asked more than 2,000 Oregonians to describe their vision of the ideal health plan, then designed innovative benefits around people’s wants. And it continues today, most recently with their first-ever member forum held on June 10.
“The member forum was more than an opportunity for us to connect with members and see how we’re doing,” says CEO Dr. Ralph Prows. “It was a dialogue in the truest sense of the word.” The event attracted a diverse group of members from across the state, and provided an opportunity for them to share their ideas with the CO-OP’s senior leaders in a relaxed, workshop-style environment.
The mere fact that a group would assemble to discuss health care and health insurance on a sunny 75 degree Tuesday evening says something about the passion of Oregonians to get involved. During the breakouts, small groups brainstormed ways to improve the CO-OP, and then presented their thoughts and insights to the larger body of attendees. As Martin Taylor, a CO-OP member and the meeting’s facilitator puts it, “When members meet …when they literally run the meetings and set the priorities, that’s democratized healthcare. It’s the difference between a ‘corporate-centered’ health plan and a ‘member-centered’ health plan. And that’s unprecedented in insurance until now.”
Members will continue to steer growth, and control their healthcare choices
Members will soon have even more power in leading the CO-OP’s direction. This summer, the CO-OP will seek applications for its member-driven Board of Directors, inviting its members to run for a seat.
“Unlike traditional Boards, which are typically made up of handpicked individuals, the majority of our Board of Directors will be composed of elected members,” says Dr. Prows. This is in accordance with the Affordable Healthcare Act, which requires all 23 national healthcare co-ops to move to a member-driven Board.
“It’s a major shift from what people have grown used to—and tired of—among corporate health insurance,” Dr. Prows says. “Here, actual members will have formal decision-making authority to create changes that benefit the entire organization.” Such member-driven control will provide direction around nearly every aspect of how the CO-OP evolves, adds services, lowers rates, creates new wellness initiatives and expands coverage across the state.
An interim Foundational volunteer board has lent its expertise to Oregon’s Health CO-OP’s since 2012, guiding the organization as it grew from start-up and into a strong, member-driven health insurance company.
“We were born of ideals, opportunity, skills and partnerships,” says Dr. Prows. “Our member-oriented structure and mission will continue to reform healthcare and improve health for all Oregonians.”
The application process will take place during June and July, followed by a review and an announcement of candidates later in the summer. Board elections will take place during October and November.
The responsibilities of respective Board Members will vary, and will include strategic goal setting, input into budgeting and financial reporting, developing policies for business operations, overseeing the CEO and other duties.
As the transition from Foundational to Member Board continues, the CO-OP anticipates that within two years, 51% of its Board will be members.
“We see this as a revolutionary time for us and for the industry,” Dr. Prows says. “What this amounts to is creating greater member control, and giving voice to consumers who, for too long, have had very few opportunities to speak and be heard.”
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Oregon Sick Leave is here, and changes to the federal white-collar worker regulations are on the way. This workshop will prepare you for both. We invite you to participate in an interactive discussion on how to start planning now for the future impact on your operations and finances.
Presented by OEN + CENTRL + YESpdx.
This Roundtable will cover numerous issues under the employer "shared responsibility" rules of the Affordable Care Act, including how to track the "full-time" status of variable-hour employees, temporary or seasonal employees, and employees who experience a change in status or a break in service. Additionally, we will provide a brief overview of Code sections 6055 and 6056, which require most mid-sized and large employers to submit their first information reports to the IRS in early 2016 regarding the health insurance coverage being offered to employees. We invite you to participate in an interactive discussion on how to prepare for the future impact of the shared responsibility rules on your operations and finances.