Oregon lawmakers, with support from prominent medical leaders, are pushing legislation to keep private investors and corporations focused on the profits they can make by acquiring medical practices that prioritize patient care. ing.
Ben Bowman, a Tigard Democrat, argued: House Bill 4130 Last week, he was flanked by former Governor John Kitzhaver and former Oregon Health Authority Director Dr. Bruce Goldberg. Bowman told lawmakers on the House Behavioral Health and Medical Care Committee that his bill would prevent private equity firms and large corporations from controlling Oregon's medical practices, something many analysts fear. He said that there is a tendency to a study A study released last year found that private equity firms own 30 percent of medical practices in about one-third of the nation's metropolitan areas. And in 13%, half was owned by retail investors.
While Oregon hasn't yet had the same wave of private investors buying up medical practices as it has elsewhere, big capital is gaining a foothold in the state's health care system. Two years ago, Amazon paid $3.9 billion to acquire One Medical, a primary care company with five offices in Oregon. And Optum, a subsidiary of United Healthcare and the nation's largest employer of physicians, acquired Oregon Medical Group in Eugene and Greenfield Health in Portland, creating a physician-owned system of 11 clinics in the central United States. is looking to acquire Corvallis Clinic. Willamette Valley.
Unsurprisingly, the bill has attracted the attention of major health care companies and investors like Amazon, who are pressuring the bill to be repealed.
Analysts say this trend should matter to consumers, as prices will soar and interest will plummet as private equity moves in.
a Harvard University research showed that private equity firms raise money and also borrow money to purchase healthcare institutions, forcing them to take on debt to repay them. Investors then consolidate and sell in a relatively short period of time (on average 3 to 8 years, according to research), making a quick profit. This practice drives up prices, Dr. Jane Zhu of Oregon Health and Science University said at a hearing last week.
“Our research and our colleagues actually show that when private equity acquires a medical practice, prices for both payers and patients increase by as much as 20 to 30 percent,” Zhu said. . “It's immediate. Today's evidence also suggests that private equity acquisitions are associated with staffing changes due to increased service volumes, but with commensurate improvements in quality of care.” I can’t see it.”
Kitzhaber and Goldberg testify
Kitzhaber, a former emergency physician who had a major voice in shaping Oregon's health care system during his 24 years as a senator and governor, said he would not give private equity more control over Oregon's medical practices. , said it would be a departure from the state's tradition of medical independence.
“Oregon has a long and strong tradition of shaping its health care future, from the Oregon Health Plan to coordinated care organizations,” Kitzhaber said during last week's hearing. “These innovations were rooted in the belief that Oregon should not remain passively at the mercy of federal inaction and unregulated corporate interests.”
He argues that while private equity buyouts and sales of for-profit clinics are taking money out of Oregon and enriching Wall Street, 250,000 Oregonians cannot afford health insurance and have no health insurance. He added that he did not have one.
“To me, there's something wrong with that photo,” Kitzhaber said. “House Bill 4130 is not the complete answer to this problem, but it is a very important step toward that answer.”
Goldberg echoed those sentiments, saying Oregon's health care reform is based on the belief that health care decisions should be made by patients and their health care providers, not profit-driven outsiders. It pointed out.
“Unfortunately, when patient care decisions are influenced by income considerations, or when the undue influence of corporate investors, shareholders, and compensation models prioritizes financial gain over patient care, patients and physicians “There is a potential for a breach of trust,” Goldberg said.
Goldberg said the issue affects both urban and rural communities, and could be especially detrimental to rural areas if clinics that aren't as profitable as investors close down. He said there is.
Objections from telehealth providers
Bowman's bill, scheduled for a committee vote Wednesday afternoon, would exempt telehealth providers. It would also ban non-compete clauses for most doctors. This would mean doctors would be able to take patients with them when switching practices, and would strengthen transparency requirements so patients know who is managing their practice. The bill has the support of physician groups, patient advocacy groups, health care unions such as the Service Workers International Union (SEIU), and the Oregon Nursing Association, which represents thousands of health care workers in Oregon. It also has received support from insurance companies, think tanks, the Oregon Academy of Family Physicians and the Oregon Pediatric Society, according to a news release.
But major health care companies oppose the bill and are increasing pressure to kill it, lawmakers said. Optum has hired high-profile lobbyists for powerful lawmakers, and now even groups that don't operate in Oregon have lobbyists in Salem to fight the bill.
If you are so afraid of this bill, why do you want me to come and invest in my state? We have people and other organizations that come to invest.
– Rep. Rob Nosse, D-Portland, Chairman of the House Health Care Committee
Lawmakers have pressured bill sponsors to remove their names, sought exemptions, called for the bill to be turned into an inquiry, and argued that the bill is too complex for a short session. He said he was using his usual tactics.
“There was a lot of push,” said one source. “It's easier to vote down a bill in a short session.”
Some opponents testified. Maureen McGee of Rayus Radiology, which is owned by private investors and works with independent physicians in Oregon, said the bill would limit innovation and force health care providers to change their practices. , said costs would rise.
Kyle Zebree, executive vice president of the American Telemedicine Association, also opposes the bill, although it excludes telemedicine companies. He said it would discourage private investment in Oregon's health care because it does not provide safeguards to protect investors' money.
Another opponent, Jessica Rigsby, vice president of telemedicine addiction treatment company Ophelia, said the bill would prevent telemedicine providers from entering Oregon. Ophelia is not currently operating in Oregon.
The committee chairman, Rep. Rob Nosse, a Portland Democrat, said he supports the bill and dismissed their concerns. He said Congress has eased the path for telehealth companies to operate in Oregon.
“If you're so afraid of this bill, why do you want me to come and invest in my state?” Nosse asked. “We have other people and other organizations coming to invest.”
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