In an effort to provide additional and improved health care options for state employees who live outside the greater Salem area — and those living in rural Oregon in particular — the PEBB Board of Directors has voted to delay one year a Request for Proposal (RFP) for it's health care program.

 

AFSCME supported the one-year delay. Diane Lovell, Council 75's representative on the PEBB Board, says the goal is to provide the most members it can with the greatest number of and best possible options.

 

"To oversimplify it a bit, people around the state would like an option equivalent to the Providence Choice plan design," says Lovell. "But Providence Choice and/or its equivalent aren't available everywhere because there is not sufficient demand among purchasers. Providence has done a good job expanding their Choice program every year, but we haven't been able to make progress with providers in Eastern Oregon and other rural areas. By waiting, we can work to negotiate and encourage other providers to participate, creating more demand."

 

Lovell explains that the "Providence Choice" designation is actually available to any provider(s) who meets the standards of Providence Choice. The barrier is that most providers don't want to meet that higher standard of adherence to evidence-based standards and care coordination. In recognition of that challenge, PEBB has developed an additional pathway for providers to be certified, but that will take some time and encouragement.

 

Lovell recently toured Eastern Oregon during PEBB's Open Enrollment meetings and heard AFSCME members express concern about the lack of in-network providers and lack of access to the Providence Choice plan design. She and the rest of the PEBB Board are convinced delaying the RFP for 12 months is the best way to garner greater participation from providers.

 

"People are surprised to find out that even though the State of Oregon is a very large employer, other than in Marion County, PEBB does not include a sufficient number of concentrated enrollees to drive the required change in the delivery system," said Lovell. "Not only is this true for places like Pendleton, Umatilla and Ontario, it's even true for greater Portland. Therefore, we believe that this one-year delay is our best strategy for expanding the opportunity for well-coordinated, patient-focused health care for our members throughout the state."

 

Lovell says PEBB will spend the next year collaborating with both private and public health care purchasers in various regions of the state, both urban and rural. PEBB will share its approach to improving the health care delivery system while learning best practices from other employers.   

 

"The goal is to create a larger, more consistent approach to purchasing evidence-based, well-coordinated, health-focused care by many employers in a region," she said. "While no one is happy about the delay piece of the puzzle, again, we want to get the most options possible for the most people, and this is the way to do that."

 

The change means that PEBB will spend 2013 meeting with purchasers throughout the state, attempting to build consensus on a health care purchasing strategy. Subsequent changes would begin in 2015.