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Public Employees' Benefit Board Meeting Minutes, June 3, 2008
Public Employees’ Benefit Board
Tuesday, June 3, 2008, 10:30 a.m. to 12:00 p.m. – Minutes
DAS General Services Building/PEBB-OEBB Board Room
1225 Ferry St SE, Salem OR
Approved June 17, 2008

Board Members Present
Diane Lovell, Chair
Sue Nelson, Vice Chair
Peter Callero
Rocky King
Rep. Tina Kotek
Paul McKenna
Rich Peppers
Jeanene Smith
Bret West
 
PEBB Staff Present
Bobbie Barott
Adrienne Binam
Ed Deery
Wendy Edwards
Chelsea Hollingsworth
Isabel Joslen
Joan Kapowich
 
Jordan Lewis
Lydia Lissman
Nicole Merrithew
Ingrid Norberg
Brian Olson
Margaret Smith-Isa
Sandy White-Gallardo
Guests Present
Elizabeth Gartman, SHS
Kristina Herron, Providence Health Plans
Sally Hill, Providence Health Plans
Kelley Kaiser, SHS
Renee McDonald, Regence BCBSO
 
Megan Myrick, Willamette Dental
Jean Poling, Kaiser Permanente
Tamara Strauss, SHS
Dallas Weyand, Legislative Fiscal Office
Dr. Rick Wopat, SHS
 
Consultants Present
Mikel Gray, Mercer
 
 
 
Agenda
Convene Public Session
Written Request from Samaritan Health Plans
Public Comment
Samaritan Health Plans Request for Reconsideration
Adjourn
 
Convene Public Session
Diane Lovell called the meeting to order and provided an overview of the meeting.
 
Written Request from Samaritan Health Plans
Lydia Lissman provided an overview of materials prepared by staff and gave a summary of staff’s communications with Samaritan Health Plans.
 
Rich Peppers moved to grant Samaritan Health Plan’s request for reconsideration of renewal for the 2009 benefit year.
Sue Nelson seconded the motion.
Sue Nelson expressed concern regarding the process the Board used to make the decision not to renew Samaritan for the 2009 benefit year.
 
Hearing no further discussion, the Board voted as follows:
 
 
Peter Callero:
Nay
Rocky King:
Aye
Paul McKenna:
Aye
Sue Nelson:
Aye
Rich Peppers:
Aye
Jeanene Smith:
Aye
Bret West:
Aye
  • The Board Chair acknowledged the motion passed with a vote of 6-1.
Public Comment
Diane Lovell advised that testimony presented during the public comment period is considered public record.
 
Testimony #1
Kelley Kaiser stated that she was the Chief Executive Officer of Samaritan Health Plans and thanked the Board for the opportunity for reconsideration and recognized the short notice. She stated she had additional information to share with the Board, but first she wanted to talk about the PEBB Vision and introduced Dr. Rick Wopat.
 
Dr. Rick Wopat stated that he is the Medical Director for Samaritan Health Plans. He thanked the Board for reconsidering and understood this decision was new territory for the Board. He did not want to start by making excuses for the past but rather to talk about where Samaritan is now and their hopes and expectations for the future. Dr. Wopat then provided a brief history of how he came to Oregon in 1979 and formed Mid-Valley Healthcare, which then collaborated with Corvallis, Albany, Lincoln City and Newport in forming Samaritan Healthcare. This background shows Samaritan’s commitment to community-based healthcare and is what makes Samaritan different from other health plans. He does not like to call Samaritan a health plan but rather a Health Asset Management Organization. He was excited when conversations about PEBB Vision first started in 2003 and the fact that PEBB took the leadership roll. Samaritan Health Services stretched to complete the RFP and since that RFP went through they have completely implemented electronic records for all primary care physicians. They also have e-prescribing, secure e-mail, and chronic disease registry. They signed up for Leapfrog, and the Oregon Patient Safety Commission. They have started health risk assessments online and on paper. They have also completed ACIC assessment for chronic disease care in all primary care offices. They have implemented a chronic care model for the Stanford program, and implemented physician and patient incentives. To a great extent, the PEBB Vision and PEBB contract helped them do these things. In his opinion, Samaritan is at the point where they are seeing a return on their investment and that it takes time to build a vision and implement the systems. His hope is that there is a way for PEBB and Samaritan to continue working together because he feels the Board has been an influence on the health delivery system in the state of Oregon.
 
Kelly Kaiser stated that in terms of costs, Samaritan’s high costs have come primarily from their bariatric surgery opportunities and services. She also stated mental health costs related to prescription drugs and professional visits have increased since 2007 and that these are the main reasons there has been an increase in Samaritan’s costs.
 
In terms of Samaritan’s responsiveness, she apologized if they had not been as responsive as they should have been and she will ensure it does not continue. She also recognized there was confusion on Samaritan’s part over expectations presented in the PEBB contract. She takes responsibility for this confusion and now understands the expectations very clearly. She also believes that as of this point Samaritan has provided everything asked for by staff.
 
Kelly Kaiser and Dr. Rick Wopat then reported on their successful eValue8 analysis where they were commended for their creative health plan design. Dr. Wopat stated that while most of the evaluations were positive he recognizes Samaritan’s need to improve their gathering and reporting of data and thinks they are close to providing precise electronic records with the implementations previously discussed.
 
They concluded their public comment with information on bariatric surgery and how it is a long-term commitment that needs to be looked at over a 10 to 20 year period and that the return on investment is not going to be reflected in year-to-year insurance premium costs.
 
Bret West asked if Samaritan has an actual plan for addressing the administrative issues expressed by the Board.
Kelley Kaiser replied that monthly meetings had been set up with staff and that from now on she will be attending these meetings to ensure follow-through. As well, a Dashboard plan will be put in place so Samaritan can respond to staff requests on a monthly basis.
Dr. Rick Wopat added that they are prepared to give full executive commitment to nurture this relationship and improve communication.
 
Diane Lovell asked if Samaritan has any data for bariatric surgeries and mental health care costs, and why they are significantly affecting overall costs.
Kelley Kaiserreplied that yes, those numbers are available.
Diane Lovell responded by asking why this data was only available under the treat of termination.
Kelley Kaiserreplied that Samaritan was unclear that the Board wanted specific level detail on that. They had been working on the standard normal reports and had not pulled back to look at the big picture.
Diane Lovell thanked Kelley Kaiser and Dr. Rick Wopat for their testimony.
 
Samaritan Health Plans Request for Reconsideration
Rich Peppers moved to continue to provide a self-insured plan for Samaritan, and to accept a 6% increase in the administrative fee for the 2009 benefit year, and for a workplan to be developed mutually by staff and Mercer by July 3, 2008. Additionally, Samaritan must demonstrate progress by September 1, 2008 or the Samaritan renewal contract for the 2009 benefit year will be terminated. Further, staff will deliver monthly reports on the status of Samaritan’s progress.
Paul McKenna seconded the motion.
 
Hearing no further discussion, the Board voted as follows:
 
Peter Callero:
Nay
Rocky King:
Aye
Paul McKenna:
Aye
Sue Nelson:
Aye
Rich Peppers:
Aye
Jeanene Smith:
Aye
Bret West:
Nay
  • The Board Chair acknowledged the motion passed with a vote of 5-2.
Paul McKenna moved to approve the implementation of a weight management program per specifications for the Samaritan medical plans for the 2009 benefit year.
Peter Callero seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Rocky King moved to approve the implementation of a four visit per lifetime model for all members, and four visits per year for those with chronic health conditions or who are enrolled in a weight management program with uniform benefits across all plans, and to examine costs before determining a general benefit for Samaritan Health Plans for the 2009 benefit year.
Rich Peppers seconded the motion.
  • Hearing no further discussion, the motion passed unanimously.
Adjourned