Portland Health Care
Portland Metro Area Health Care
Before we begin let’s define a few terms:
Like most metropolitan areas in the USA, the Portland area has a comprehensive array of health care providers.
The Portland metro area is not lacking in hospitals and other types of patient treatment. Many health care organizations in the Portland area bill themselves as offering complete health care (e.g., clinics, recovery units, therapy, health insurance, etc.).
The three main players are Kaiser Permanente, Legacy Health, and Providence Health & Services in Oregon. Another player is the Oregon Health Science University (OHSU) that treats patients and also includes a medical and dental school as well as a hospital. OHSU also runs a children’s hospital. There is also a well-regarded veteran’s hospital.
Alternative medicine (e.g. homeopathic, chiropractic, acupuncture, etc.) is big in Portland as some traditional health care providers even offer alternative medicine that is used together with conventional medical treatment in a belief that it “complements” the treatment.
Kaiser Permanente Northwest
Kaiser Permanente is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct groups of entities: the Kaiser Foundation Health Plan and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the autonomous regional Permanente Medical Groups. Kaiser Permanente operates in nine states and the District of Columbia, and is the largest managed care organization in the United States.
Kaiser Permanente has 8.9 million health plan members. In its most recently reported year, the non-profit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported a combined $1.6 billion in net income on $47.9 billion in operating revenues. Each independent Permanente Medical Group operates as a separate for-profit partnership or professional corporation in its individual territory, and while none publicly report their financial results, each is primarily funded by reimbursements from its respective regional Kaiser Foundation Health Plan entity.
Kaiser Permanente Northwest serves approximately 480,000 members in the Portland metro area, Salem, and southwest Washington. Only Regence BlueCross BlueShield of Oregon has more members insured with their health plan. The region is home to 27 medical offices, 17 dental offices, and 11 administrative offices as well as Kaiser Permanente Sunnyside Medical Center 196-bed acute care hospital in Clackamas.
In 2013 Kaiser Permanente Northwest’s health plans are among the top-ranked plans in the nation for quality of care and customer satisfaction, according to the nonprofit National Committee for Quality Assurance. Its private health insurance plan ranked second out of 484 HMO and PPO plans in the nation, while its Medicare plan ranked third best out of 405 plans. Both plans achieved the top regional ranking in the Oregon-Washington area for the third year in a row (e.g., 2011, 2012, and 2013).
JobDango rated Kaiser Permanente Northwest as number five as one of the “100 Best Companies to Work for in Oregon.”
Legacy Health is a non-profit hospital system located in Portland. It consists of six primary-care hospitals and allied clinics and outpatient facilities. The system employs about 10,000 staff members and is the second-largest system in the Portland metro area, after the Providence Health System. Legacy Health System was formed in 1989 by the merger of Good Samaritan Hospital and Medical Center and four other Portland-area hospitals managed at that time as part of HealthLink. It was renamed in 2010 as Legacy Health.
The system’s hospitals are: Legacy Emanuel Medical Center, Randall Children’s Hospital at Legacy Emanuel, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, and Legacy Mount Hood Medical Center in Oregon, and Legacy Salmon Creek Medical Center in Washington.
Providence Health & Services
Providence Health & Services is a not-for-profit Catholic health care ministry committed to providing for the needs of the communities it serves – especially for those who are poor and vulnerable. The health system includes 27 hospitals, more than 35 non-acute facilities and numerous other health, supportive housing and educational services in the states of Alaska, Washington, Montana, Oregon and California. Providence Health & Services was founded by the Sisters of Providence and was managed by the Sisters of Providence until 1979, when the first lay-person was made president of the system because of the declining numbers within the religious community.
Today, Providence Health & Services is the largest health care system in Washington state and one of the largest employers in the state where it is headquartered in Renton, Washington.
In the Portland area they have eight clinics and three hospitals:
They also operate five other hospitals in Oregon communities: Hood River, Medford, Newberg, Seaside, and Willamette Falls.
Oregon Health Science University
Oregon Health & Science University (OHSU) is a public university in Oregon with a main campus, including two hospitals, in Portland and a smaller campus in Hillsboro. It was formed in 1974 as the University of Oregon Health Sciences Center, combining state dentistry, medicine, and nursing programs into a single center. It was renamed Oregon Health Sciences University in 1981 and took its current name in 2001, as part of a merger with the Oregon Graduate Institute of Science and Technology (OGI), in Hillsboro.
The main campus, located on Marquam Hill (colloquially known as “Pill Hill”) in the southwest neighborhood of Homestead, is home to the university’s medical school as well as a 534-bed general medical and surgical facility. The OHSU hospital is a Level I trauma center and general hospital; Doernbecher Children’s Hospital is a children’s hospital that specializes in pediatric medicine and care of children with long-term illness. The Casey Eye Institute is also part of OHSU and is located in the same area. The university maintains a number of outpatient primary care facilities including the Physician’s Pavilion at the Marquam Hill campus as well as throughout the Portland metropolitan area. Additionally, the Portland Shriners Hospital for Children is located on the OHSU campus. OHSU shares technology, personnel, and training with the Portland Veterans Affairs Medical Center to help keep health care costs down.
OHSU Expands in South Waterfront
With the Marquam Hill campus running out of room for expansion, OHSU expanded into the South Waterfront District, along the Willamette River in the South Portland neighborhood east of Marquam Hill and south of city center. The Center for Health & Healing earned LEED Platinum certification in February 2007, becoming the largest health care center in the U.S. to achieve that status. As existing surface streets were deemed insufficient to connect the two campuses, the new Portland Aerial Tram was built as the primary link between them and opened December 1, 2006.
In October 2011, three of Oregon’s universities broke ground on a unique project that will combine the resources of these institutions. The OUS/OHSU Collaborative Life Sciences Building will place portions of Oregon Health & Science University, Oregon State University, and Portland State University under one roof. In doing so, the facility will extend partnerships between the universities, create new employment opportunities, and expand the schools’ teaching facilities, class sizes and research activities. The location of the building is between the Marquam Bridge and the Ross Island Bridge. It will open in 2014.
The 480,000-square-foot building will include lecture halls, classrooms, labs, specialty research centers, offices and a state-of-the-art facility for the OHSU School of Dentistry. The Collaborative Life Sciences Building will foster collaboration in undergraduate and graduate education between students and instructors from multiple institutions.
OHSU School of Medicine
The OHSU School of Medicine confers a variety of degrees, including Doctor of Medicine, Doctor of Philosophy, Master of Science, Master of Physician Assistant Studies, and Master of Public Health. In 2013, the US News and World Report ranked OHSU amongst the top medical schools in the country, placing the school third overall in Primary Care Rankings and 31st in Research Rankings. In addition, the publication ranked the school fifth in Family Medicine.
The School of Nursing at OHSU offers nursing programs at the undergraduate, graduate, and doctoral levels. The graduate nursing program was most recently ranked seventh overall in the nation by the US News and World Report and fifth in the gerontology/geriatric specialty.
OHSU’s School of Dentistry was merged with the university in 1945. Accredited through the Commission on Dental Accreditation, the school has departments in endodontics, orthodontics, pathology and radiology, oral and maxillofacial surgery, periodontics, and pediatric dentistry, among others.
The College of Pharmacy offers the Doctor of Pharmacy degree that allows you to work as a pharmacist anywhere in the United States. The Doctor of Pharmacy students study two years at Oregon State University and then spend their third year at OHSU in Portland, helping foster collaboration among the health sciences and a multidisciplinary approach to studying pharmacy theory and practice.
Research at OHSU
The Oregon Clinical & Translational Research Institute is the integrated home for clinical and translational research across OHSU and provides a coordinated infrastructure of core services to serve clinical research investigators and staff.
There are 1,131 principal investigators at OHSU, working on 3,045 research projects. OHSU researchers brought in $359 million in fiscal year 2012. The National Institute’s of Health is OHSU’s most significant source of funding, providing over $226 million last year.
U.S. News 2013: Ranks OHSU No. 1 Hospital in Oregon
U.S. News ranked OHSU nationally in five adult and eight pediatric specialties. It ranked #19 in pediatric cancer treatment and #32 in geriatrics. OHSU is among the top hospitals in the country as far as patient complexity and severity of illness.
There are 67 hospitals total in Oregon. For the Oregon page of the rankings, click here.
Other Hospitals and Care Facilities in the Portland Metro Area
Clinics and Group Practices
Medical practices today operate very differently than they did a few years ago due to the economics of health care. There are still a handful of physicians that work as a sole proprietorship, but mainly we have group practices that are staffed with a number of health care practitioners including physicians, physician’s assistants, lab techs, etc. The type of medical care a group practice offers can be primary care as well as secondary care such as ophthalmology, pediatrics, etc. For example, if you have a primary care doctor at one of these group practices and need a knee replacement your primary care person refers you to an orthopedic surgeon at an orthopedic group practice.
Portland has numerous group practices and a few physicians that operate as an individual practice. So if your insurance plan isn’t tied to an HMO such as Kaiser or Providence you can chose your own physicians.
Another change is that your next primary care appointment may be at a drugstore. Walgreens recently announced that the drug chain will have its nurse practitioners and physician assistants begin to diagnose and manage chronic conditions, such as hypertension and diabetes.
Finding a Doctor at a Group Practice
Finding a clinic and/or group practice isn’t easy and most often a friend or co-worker will recommend someone.
You can search for a physician at the Medicare Web site on a page called Physician Compare that has information about healthcare professionals. You can enter numerous parameters and refine your search in many different ways at the Physicians Compare site. You can search in a city/state or zip code for these three items: Physician, Other Healthcare Professional, or Group Practice. Another useful search is this parameter: “Only show providers who accept the Medicare-approved amount as payment in full.” You can further define this search to show only providers in a city or zip code.
Alternative Medicine: Three Schools in the Portland Area
Portland is home to three nationally recognized institutions: the National College of Natural Medicine (NCNM), the Oregon College of Oriental Medicine, and the University of Western States (which graduates chiropractors, massage therapists, physical therapists, and nutritionists). Many of these graduates who come to the school elect to stay in the Portland area and practice their newly acquired skills. As a result, there are numerous clinics in the area offering naturopathic medicine and other alternatives.
Chinese medicine may have originated in centuries-old ancient texts like the Nei-Jing and the Shang Han Lun, but the Americans who now benefit from its two-millennia history should give thanks to President Richard Nixon. During a preparatory trip to China advancing the president’s famed breakthrough visit of 1972, a press corps reporter named James Reston suddenly felt a stabbing pain: appendicitis. His surgery at Beijing’s Anti-Imperialist Hospital went smoothly, but severe abdominal pains followed, which the Chinese treated with acupuncture. Reston praised the ancient technique in the New York Times, and American doctors took notice. Some even traveled to China to experience acupuncture for themselves. Clinical trials followed and, soon after, acupuncture schools.
Most Chinese medicine schools today teach “Traditional Chinese Medicine” (TCM), the more standardized version popularized by Mao Tse-tung in the 1950s. TCM practitioners use acupuncture, herbs, dietary therapy, moxibustion (burning herbs near certain points on the body), cupping (using heat and a glass cup to create a suction on the skin), and other practices to restore the qi (or “life force”) of the body. Older, more nuanced variations, known as “Classical Chinese Medicine,” are enjoying a renaissance as well at schools like Portland’s National College of Natural Medicine.
National College of Natural Medicine (NCNM) is the oldest accredited naturopathic medical college in North America. NCNM programs in naturopathic medicine and classical Chinese medicine blend ancient healing wisdom with modern science. NCNM offers a Doctor of Naturopathic Medicine, Master of Science in Oriental Medicine, Master of Acupuncture and Master of Science in Integrative Medicine Research. In addition, a variety of natural medicines certificates are offered. NCNM is located in the Lair Hill area just minutes south of downtown.
Founded in 1983, Oregon College of Oriental Medicine (OCOM) is a single-purpose professional graduate school that offers two specialized degree programs — Master of Acupuncture and Oriental Medicine (MAcOM) and Doctor of Acupuncture and Oriental Medicine (DAOM). OCOM’s academic programs provide students with a foundation in acupuncture, Chinese herbal medicine, therapeutic massage, and qi cultivation, as well as a focus on collaboration between Chinese medicine and Western biomedicine. OCOM is located to Portland’s historic Old Town Chinatown district.
The University of Western States (UWS) offers seven distinctive programs: Doctor of Chiropractic, Massage Therapy, MS in Exercise and Sports Science, MS in Nutrition and Functional Medicine, BS in Human Biology, Prerequisite Program, and Radiology Residency. The University of Western States campus is located in Northeast Portland, just off Interstate-84 at 2900 NE 132nd Avenue.
The ancient art of Tai Chi and QiGong are taught at a number of centers and health clubs in the metro area. Taoist Tai Chi is a low impact exercise designed to enhance health by doing exercises that emphasize relaxation, stretching, and stress reduction. For more information about chapters in the Portland metro area visit the Web site of the Oregon branch of the Taoist Tai Chi Society.
Affordable Care Act: Comparing Physicians, Hospitals, Nursing Homes, Home Health Agencies, and Dialysis Facilities
The Affordable Care Act is designed not just to control health care costs but also to improve quality of care. The federal government has created several tools that allow you to compare a variety of quality measures of health care and service providers. In addition, the Partnership for Patients program highlights hospitals and other providers that have made a commitment to reducing medical errors, improving health care quality, and reducing costs. The Affordable Care Web site has a complete page where you can compare.
Many of the below sites have an abundance of information and take some time to explore them. Here is the list:
Insurance Exchanges: Cover Oregon
Given all of the rhetoric about the Obama administration’s health care law, it’s not surprising that many consumers are confused about how the new insurance exchanges will actually work. Some states (Florida, Georgia, Ohio, Missouri, etc.) that oppose the law have gone as far as intentionally limiting the information that trickles out to its residents. But Oregon is not one of them. Rather it has been a leader in setting up the structure and tools to make the transition as smooth as possible.
Oregon and Washington are among the first six states to get preliminary approval from the Obama administration to operate health insurance exchanges, the U.S. Department of Health and Human Services (HHS) announced in December 2012. All have Democratic governors and were the first of 14 states to submit their plans to operate an exchange, reported The Hill’s Healthwatch.
Because the six states have made sufficient progress building their online marketplaces, HHS granted them conditional approval to begin enrolling members in October 2013 and coverage will begin on January 1, 1014. Oregon’s insurance exchange is being marketed as Cover Oregon. Federal officials say Oregon’s application was given conditional approval because the state hasn’t completed all required actions.
Tax credits will available through Cover Oregon starting in October. They’ll be offered on a sliding scale for those with qualifying incomes — for instance, to individuals earning $45,960 or less, and families of four earning $94,200 or less. The tax credits can be applied up front based on expected income, to reduce premiums throughout the year.
The Centers for Medicare & Medicaid Services (CMS) announced in early May 2013 that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from twenty-one to three pages, and the application for families is reduce by two-thirds. In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children’s Health Insurance Program (CHIP) and tax credits that will help pay for premiums. The applications can be submitted starting on October 1,2013 and can be found here: http://cciio.cms.gov/resources/other/index.html#hie.
Timetable for Insurance Exchange
To see insurers’ proposed benefits and rates click here. Follow these steps:
Rates for the insurance exchange can be found at the Oregon Health Rates Web site. The site allows you to search for insurers offering coverage in your area, and download a chart comparing proposed premiums for a limited selection of plans. The rate proposals all may be modified by the state after a review of reasonableness. The Web site shows examples that apply to individuals who are buying their own insurance, as well as to businesses with 50 or fewer employees. The proposed rates don’t apply to people with Medicare.
Co-ops Are Required for Health Care Insurance Exchanges
The Affordable Care Act called for at least one co-op in every state to boost competition and bring health care costs down. But federal budget woes put a stop to the program after 24 received funding. The only state to receive federal funding for two co-ops was Oregon. These two will have to sink or swim in an insurance market already ranked among the most competitive in the country.
Armed with federal loans, two startup health insurers jumped into a crowded and confusing Oregon market just as the biggest changes to U.S. health care in generations rolls out this fall. Oregon’s Health CO-OP and Health Republic aim to offer something different: a consumer-run experience. Oregon’s Health CO-OP also is filling a niche for care from naturopathic doctors. It worked with the state Association of Naturopathic Physicians to credential naturopathic doctors to let them act as primacy care providers and bill for procedures other insurers currently don’t allow.
The two companies filed new policy details and proposed rates with the state, which can be found at oregonhealthrates.org. Health Republic proposed premium for a single non-smoker, age 40, is $251 a month. Oregon’s Health CO-OP proposed premium is $234 a month for the same conditions.
In October, they will go head-to-head with about a dozen established insurers to appeal to small businesses as well as more than 200,000 expected to buy their own insurance next year. Rates and benefits for small business and individual consumers will be easily compared at the state marketplace, Cover Oregon, set up to help people enroll and qualify for new federal tax credits.
Update on Cover Oregon: Mid October 2013
Birthed in optimism and with a head start over other states, Oregon’s health insurance exchange has instead become mired in delays.
Despite spending $82 million so far — two weeks past its launch date — the online exchange hasn’t enrolled anyone.
So what happened? Officials cite a number of contributing factors, including higher standards on website functionality than other states, more ambitious vision than most states of how the exchange will work, late-breaking new rules from the federal government, and delays by contractors in meeting quality and testing standards expected by the state.
With the state’s online health insurance exchange still not able to enroll people, Cover Oregon officials have turned to processing forms by hand rather than electronically.
On October 22, Cover Oregon staff began processing eligibility applications manually as a first step prior to helping people get enrolled in either a government program or the commercial insurance of their choice.
The applications are a backup plan to what was intended to be the exchange’s online enrollment function. Applications will now be considered by Cover Oregon employees, rather than its Web site, to determine if people qualify for the Oregon Health Plan, tax credits to reduce premiums, or other government assistance.
Shop for Health Care
Web Sites dedicated to revealing hospital prices have appeared all over the place lately. Portlanders have several options if they need to get a price quote for various medical procedures. This kind of information was impossible, to find just a few months ago. Here are five:
In the summer of 2013 NerdWallet, working with the Portland Business Journal, analyzed six major hospitals in Portland and found that they offer 96 of the top 100 nationwide hospital inpatient treatments. Providence St. Vincent had the lowest charge for 40 of the 96 procedures, followed by Providence Portland Medical Center, which had the most affordable rate for 30 procedures. In other words, the two Providence hospitals had the lowest charges 73 percent of the time.
The Leapfrog Group is a voluntary program aimed at mobilizing employer purchasing power to alert America’s health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded. They rate hospitals and other health care providers.