You asked:

I am on the Oregon Health Plan. Will my medications still be covered? Can I still use the same pharmacy?

August 31, 2012

We answered:

Benefits will not be changing. If a medication is currently covered, it should remain covered. Coordinated care organizations may have a different pharmacy benefit manager, which could require you to change pharmacies. Contact the coordinated care organization you are enrolled in.


You asked:

Does the new health care reform provide access to affordable health care coverage for the average person? I am not totally understanding what the "Health Care Exchanges" are and how the average (someone who is working but does not have coverage) person may benefit from this. I currently pay $510 for health and dental through COBRA from my previous employer. However, that will expire after December 2012. I want to know what might be available.

July 31, 2012

We answered:

The Oregon Health Insurance Exchange will be a central marketplace where individuals who do not get health coverage through their employer can compare health insurance plans and access federal tax credits to help pay for coverage. The tax credits will be available monthly, to help make premiums more affordable to those who qualify. The Oregon Health Insurance Exchange has a calculator on its website where people can get an estimate of what help may be available to them starting in 2014.

 

You asked:

What are the telephone numbers for low or no cost dentists in the area?

July 5, 2012  

We answered:

You can connect to low or no-cost care at the following numbers:

  • Dental Access Program (emergencies only) 503-988-6942. Referral line for uninsured people in Multnomah, Clackamas, and Washington counties. Screening for income guidelines and urgent dental need. Fees on a sliding scale based on family size and income.
  • Multnomah County Dental Clinics, various locations, 503-988-3711. Routine and urgent dental care for Oregon Health Plan members (MultiCare and Capitol Dental) and those uninsured. Call for new patient appointments and referral to community clinics, hours 8 am. to 5 p.m. Monday-Friday.
  • OHSU School of Dentistry,  611 SW Campus Drive, 503-494-8867. Call one day in advance at 8 a. m. for urgent care up to $216. Reduced fees, due at time of service. Student work supervised by school of dentistry faculty. Limited availability.
  • Outside In Clinic, 1132 SW 13th, 503-535-3890. Accepting new patients who are homeless, under age 30 and with Oregon health Plan regardless of age and housing.
  • Project Dental Health/Russell Street, 214 N. Russell St, 503-494-6822, Low-cost dental program for insured and uninsured people including those with HIV/AIDS. Proof of income requested, sliding scale, call for appointment and screening. Walk in emergencies until 2:30 p.m.

You asked:

1. Will I have to change my primary care physician or my psychologist that I have now, especially if they work well with each other and with me?

2. Will I have fewer services or fewer options?

3. Will I be able to get an actual human advocate, that I can talk to face to face, to help me get the services and benefits that I need (and that my doctors say I need)?

4. Will I be able to get assistance with things that now interfere with my getting to appointments, like for example: safe appropriate housing, appropriate transportation, etc.?

April 18, 2012

We answered:

1. You will most likely be able to keep your current care providers. The relationship you have with your provider(s) contributes to the success of your care. Transformation will build on the successful coordination you already have between your providers.

2. Transformation shouldn’t result in fewer services or options. Your Oregon Health Plan benefits will not change. People who don’t have access to patient-centered care now will have more options available to them. One important focus of Coordinated Care Organizations (CCO) is on greater coordination of services, and this will likely improve your care experience.

3. Yes. The goal of transformation is better coordinated care, which means someone will be assigned to get you what you need. Non-traditional health workers and peer specialists will also be part of the CCO care team.

4. We know that it takes more than medical care to be well. Each CCO is required to work with social services and support agencies in order to improve overall health. The state’s application process requires the CCO to establish and maintain relationships with the Department of Human Services field offices, housing services, school districts, tribal organizations, juvenile departments and other social and support services.


You asked:

Would Oregon and Multnomah County's efforts be impacted by changes to, or an outright repeal of, the federal Affordable Care Act? If so, how?

 March 29, 2012

We answered:

Oregon has long been a leader in the reform of health care. The Oregon Health Plan was developed in the late 1980s, and expanded to include Medicaid, covered seniors and persons with disabilities in 1995. Seventeen years later, it still considered innovative. Governor John Kitzhaber and the Oregon Legislature are continuing that spirit of innovation with the current health system transformation. That transformation will move forward regardless of the fate of federal health reform.

We will not know until the U.S. Supreme Court justices rule whether the Affordable Care Act (ACA) will be struck down. The section of the law most hotly contested is around the individual mandate that requires every person not insured through their employer, Medicaid, or Medicare to purchase health insurance or pay a penalty. A ruling that strikes that requirement will have an impact on health insurance exchanges and on individuals who would purchase coverage through them. But the court’s ruling will not affect Oregon’s efforts to change the system of care for people on the Oregon Health Plan.

The Affordable Care Act does include funding incentives for states expanding eligibility for their Medicaid programs. If the Act is struck down, Oregon and other states planning to expand the population covered would not receive the additional federal funding to do so. In that case, there would not be a significant increase in people insured by Oregon Health Plan.

Thank you for your questions. We will continue to keep you updated about the transformation.


You asked:

Since the transformation of healthcare has immense implications to citizens of the state and the metro area, will the meetings that discuss the potential changes be open to the public? Since the meetings involve public funds, public officials, aren't the meetings subject to our laws requiring open meetings when discussing public business? If they are open, where can I find a schedule of the meetings? Thank you!

 February 28, 2012
 

We answered:

Public input is crucial to transforming and improving our state’s health system. From the outset of this statewide discussion in 2007, public input has helped to guide the transformation of the health system, and there will be many more opportunities for public input to continue guiding our community’s work.

The reform measures passed in the last year by the Oregon Senate and House to create coordinated care organizations (CCOs)  -- and the plan to implement them -- happened after 86 public hearings and work sessions since January, 2011. The gatherings included much spirited public debate. 


Any CCO will be required to conform to legislation and associated rules that stipulate health service delivery, measures of performance, governance and finance. These requirements were debated and agreed upon in a transparent public process.

The Oregon Health Policy Board, as part of that process, heard from more than 1,300 Oregonians at community meetings across the state and in the work groups convened over several months.

The board, which is responsible for overseeing reform, accepts public comment at its monthly meetings and will do so through the end of 2012. The next monthly meeting of the 10 public sessions scheduled for the rest of this year will be on March 13. 

Multnomah County has participated in meetings with nonprofits and other community partners in discussions on how transformation might happen in the metro region. Participants have also met with private providers and advocates for diverse communities, including people with disabilities and seniors and under-represented communities. Multnomah County created this website to provide the latest information and to respond to questions about the process.

The public is also invited to an educational forum on Thursday, March 15 that’s scheduled to be the first of many such public opportunities to discuss health system transformation and the process. That first public meeting will be on March 15 from 6 p.m. to 8 p.m. in the Multnomah Building, 501 S.E. Hawthorne Blvd.

Please watch this website for a list of upcoming events.