HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

April 17, 2003 Hearing Room 50

3:15 PM Tapes  94 - 95

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

 

MEMBERS EXCUSED:            Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

 

GUEST MEMBERS:               Rep. Mitch Greenlick

                                                Rep. Gordon Anderson

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:                     Informational Meeting

                                                Managed Care and Fee-For Service Cost to State Comparisons

                                                Judy Mohr-Peterson, Ph.D., Department of Human Services

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 94, A

003

Chair Westlund

Calls meeting to order and opens the informational meeting.

INFORMATIONAL MEETING

006

Berkobien

Gives an explanation of the information presented at the dais. (EXHIBIT A & B)

019

Judy Mohr-Peterson

Introduces herself as Manager for the Analysis and Evaluation Unit in the Office of Medical Association.  Presents testimony and begins presentation. (EXHIBIT C)

085

Rep. Greenlick

Asks if the retro active costs are included in the fee for service.

087

Mohr-Peterson

Responds that if they incurred any costs at that time, they will pay for it and it will be paid for on the fee for service side, and continues presentation.

138

Rep. Bates

Comments that the eight percent paid to FCHIP is understandable to him, but I have trouble imaging that fee for services clients can be managed for two percent, there must be other costs in doing that.

140

Mohr-Peterson

Responds that it is two percent of the total and elaborates.

180

Rep. Bates

Comments that most commercial insurers feel like they are doing a good job if they can get their administrative costs down to six to eight percent and you are doing it for two percent.

198

Mohr-Peterson

Answers that it is two percent of total and elaborates.

205

Rep. Bates

Asks if they charge on the eight percent to FCHIP and does any of that two percent get charged to them.

209

Mohr-Peterson

Comments that they get paid a capitated rate for these services and then 8 percent on all that capitation, elaborates and continues presentation.

322

Vice Chair March

Asks if there is a reason for the drop in transportation in the fully capitated.

325

Mohr-Peterson

Responds that no, she is still trying to find a reason for the drop.

TAPE 95, A

012

Rep. Greenlick

Asks if she has a sense that there is some sort of time lag for Managed Care to get organized and how do you account for the growing difference between them.

021

Mohr-Peterson

Responds to the lag time and organization of Managed Care.

038

Rep. Greenlick

Makes comments that they may be managing at a tighter and tighter to the capitation rate and there is no such limitation on that in terms of the fee for service.

042

Mohr-Peterson

Responds that, that is correct and elaborates.

050

Vice Chair March

Asks if she could describe what data set she is working from.

056

Mohr-Peterson

Explains what data set they use for their information.

075

Vice Chair March

Is there some sort of equivalency evaluation of the clients prior to enrollment.

077

Mohr-Peterson

Responds no and explains how they gauge individuals health is the paperwork submitted on their behalf.

087

Vice Chair March

Thanks the witness for her testimony and adjourns 4:25.

 

 

EXHIBIT SUMMARY

 

A – Oregon’s Medicaid Program, Medicaid Payments and the Impact of Proposed Budget Reductions, Key Findings from an Independent Evaluation by The Lewin Group, 4 pp.

B – Analysis of Medicaid Reimbursement in Oregon, The Lewin Group, 59 pp.

C – Testimony Presented by Judy Mohr-Peterson; Managed Care & Fee For Service Cost to State Comparisons 1999-2002, 14 pp