Document text
0 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation | Register x Forgot Password | Need an Account? e-edition | subscribe | newsletter | deals Classifieds Jobs Autos Real Estate FEATURED » NEWS NOW Hi-fi hunters gather for Grants Pass Record Convention ... Man hospitalized after stabbing at Sams Valley party ... Three rescued after boat capsizes near Shady Cove ... Hi-fi hunters gather for Grants Pass Record Convention ... Man hospitalized after stabbing at Sams Valley party ... Three rescued after boat capsizes near Shady Cove ... CHAMBER FORUM Health insurance industry faces its own ills in Oregon Mike Cotton, CEO of Providence Health Plan, tells chamber group the industry is still finding its way Comment By Greg Stiles Mail Tribune Follow @@GregMTBusiness MailTribune.com By Greg Stiles Mail Tribune Follow @@GregMTBusiness Posted Mar. 14, 2016 at 3:51 PM Updated Mar 14, 2016 at 4:44 PM By Greg Stiles Mail Tribune Follow @@GregMTBusiness Posted Mar. 14, 2016 at 3:51 PM Updated Mar 14, 2016 at 4:44 PM » Social News Financial losses have hit the health care industry hard, especially insurers, even though insurance rates have soared in many cases. "We all got stung, everybody did," Mike Cotton, CEO of Providence Health Plan, told a Chamber of Medford/Jackson County Forum audience Monday at Rogue Valley Country Club. "This is an underwriting cycle, this is a brand-new populace coming in," Cotton said. "You can make the best actuarial estimates in term of costs. No one knew how many people would be eligible, how many people would come in. As we get better at it over time, we'll get better at managing this. "This is a learning process for us as payers. ... A lot of this is pent-up demand where individuals had no access to care and now they do. They're doing what most people would do, and they're using the services." Dealing with the health care system elicits a variety of responses from consumers, he said. "It can be scary, it can be frustrating, it can be costly," Cotton said. "What we do as health care providers in delivering care is very important." The health care landscape is in continual flux, he said. "Insurance companies are buying other insurance companies, providers are becoming payers, payers are becoming providers. Physicians are joining these things called accountable care organizations." Providence Health Plan operates in five states, with operating revenue of $12 billion, and 77,000 employees who are part of a payroll of nearly $8 billion. The plan covers 600,000 people, including 31,000 in Jackson, Josephine and Douglas counties. Under the Affordable Care Act, and an accompanying state mandate, one in three people has his or her insurance paid by Medicare or Medicaid, he said. Soon more than 50 percent of the population will have insurance paid by the government. "When you add in the exchanges, that will be 2.2 out of every four individuals covered by some form of government insurance," Cotton said. He said the largest health insurance organizations are mirroring the consolidation of large accounting firms in previous decades. The seven largest national insurance companies are merging into three with Anthem's acquisition of Cigna and Aetna buying Cotton's former employer, Humana. "Those organizations will come together to make two very large mega-insurance companies to compete with the behemoth of United Health Care," Cotton said. "Think of three large insurance companies who will really drive most of the national payment process other than regional Blues across the country." Those companies will cover anywhere from 24 million to 30 million lives, he said. "And most of it will be government paid." Medicare is hoping to replace the fee-for-service model with value-based care payment by 2022, he said. Value-base care bases its payments not just on services provided, but also the outcomes of those services. "As we look at the insurance world," Cotton said, "the way Medicare goes is the way all payers will go." Consumers will see fewer insurance companies and plans in coming years, but there will be more providers, he said. "I believe we'll actually see more provider choice," he said. "For a short period of time there will be price and rate increases." The growing attention to cost reduction will take a lot of work, with payers, providers and consumers all pitching in, Cotton said. "That's a problem that can't be solved solely by the health care industry," he said. "We as individuals have to take ownership of what we eat, how we exercise and what we are doing to be healthy." Whether people agree with the Affordable Care Act, he said, there was a broader goal. "There are things about the ACA I do not like," Cotton said. "There are things about the ACA, well maybe they're OK. I think, at the end of the day, we as a community — as a country — have an obligation to make sure that people have access to health care." Reach reporter Greg Stiles at 541-776-4463 or [email protected]. Follow him on Twitter at www.twitter.com/GregMTBusiness , and read his blog at www.mailtribune.com/Economic Edge. By Greg Stiles Mail Tribune Follow @@GregMTBusiness MailTribune.com By Greg Stiles Mail Tribune Follow @@GregMTBusiness Posted Mar. 14, 2016 at 3:51 PM Updated Mar 14, 2016 at 4:44 PM » Comment or view comments Reader Reaction » STAY INFORMED Email NewsLetter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. Southern Oregon Directory Featured Businesses Loading... Business Name address Location, ST | website.com Find Southern Oregon Attractions Bars Restaurants Beauty Salons Entertainment Doctors Medical Specialists Contractors Education Lawn Services Lawyers Shopping Travel Tanning Used Cars Wedding Services ▼ Add your business here + Events Calendar Connect with MailTribune.com Facebook Twitter RSS Back to top Reader Services Reader Services Home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Announcements Obituaries Story ideas Since you asked Alerts Email Alerts RSS Feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Propel Marketing Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Mobile Site Stay Informed Email newsletter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. Your privacy is important, read our privacy policy. © Copyright 2016 Local Media Group, Inc. All Rights Reserved. Privacy Policy | Terms of Service | Local Media Group Publications Original content available for non-commercial use under a Creative Commons license, except where noted. MailTribune.com | P.O. Box 1108, Medford, OR 97501