An immediate existential threat to Oregon health care

This article provided by Oregon Transformation Newsletter,

By Dick Clark, CEO of The Portland Clinic
Dr. Karen Weiner, CEO of The Oregon Medical Group,
and Thomas Sanchez, CEO of The Oregon Clinic


While the nation is focused on the COVID-19 pandemic and its impact on hospitals, a silent national disaster is brewing.

Independent medical practices in Oregon are risking their own survival as they work to protect their communities and their hospitals from the COVID-19 surge.

Outpatient doctors and medical providers are doing everything they can to keep their patients home, safe and well. But because they are doing the right thing, independent medical practices are at imminent risk of financial collapse.

Unless drastic measures are taken on a local, state and federal level, physician practices in Oregon will begin to fail within weeks. When the dust finally settles, many communities in Oregon will find themselves without access to the doctors and clinics they rely upon for their preventative, acute and ongoing medical care.

Until recently, this situation has been overshadowed by the entire focus on COVID 19 response. This week, the Wall Street Journal editorialized in support of doctors in all health care settings (April 21, 2020) and the New York Times reported on the many Americans who are going underserved with other medical conditions (April 20, 2020).

A coalition of locally owned Oregon independent health care clinics is asking for help from the federal and state government now.

This coalition represents nearly 1,300 doctors and providers supported by more than 4,000 employees in Oregon. You may get your own medical care from some of these clinics, which include The Portland Clinic, The Oregon Medical Group in Eugene, The Oregon Clinic, Women’s Healthcare Associates, Oregon Anesthesiology Group, Northwest Primary Care, The Corvallis Clinic, Broadway Medical Group, North Bend Medical Center in Coos Bay, and Oregon Reproductive Medicine Fertility.

These clinics are responsible for providing medical and preventive care to a great percentage of citizens in their respective communities. When Oregon appropriately adopted social distancing practices to prevent rapid spread of this disease, medical offices in every community needed to rethink how to provide care. We kept healthy people out of our clinics and at home, started to serve patients remotely with minor illnesses, identified the patients who need immediate care and got them to the right location for that care, and finally, identified our high-risk patients with chronic diseases and cared for them as best we can so they don’t get worse during the pandemic.

We began “seeing” patients by telephone and then eventually began using video technology. Changing outpatient care delivery has required not only investments in new infrastructure, like the technology needed for telehealth, but has also required the cancellation of all routine, elective and preventive care. This has led to significant drops in revenue for physician practices – by up to 75 percent. Most practices have no more than 30 to 60 days of cash on hand and are now consolidating clinics, laying off staff and furloughing doctors to offset these losses as quickly as they can.

This situation is resulting in an existential threat to the survival of those medical groups. We appreciate Congress’s swift action to pass the CARES legislation. Only a portion of the $100 billion provided by the act for health care providers and designated to support health care has been allocated in Oregon.

From the federal government, the coalition requests:

  • Expand the current grant funding from the CARES Act to include Medicare Advantage and Medicaid patients. On April 13, HHS released grant funding based solely on traditional Medicare funding. In addition, provide at least $150 billion in new funding for medical providers like our clinics and hospitals throughout the nation.
  • Offer grant funding for specialized services such as OB/GYN and reproductive services.

On the State of Oregon level, the group looks forward to working with Gov. Kate Brown on:

  • Allow non-emergency surgeries and procedures to resume as soon as possible as part of the first wave of relaxing COVID restrictions.
  • Use funds provided by the CARES Act Emergency Relief Fund to assist our key medical providers. Oregon is expected to get approximately $1.6 billion.
  • Pause on the collection of the first and second quarter of the Corporate Activities Tax for these private independent health clinics.
  • Issue an executive order to commercial insurance plans to pay for telephone/audio-only visits at the same rate as audio/video and in-person visits.

Many of us will be affected by the COVID-19 virus, but many more of us will need access to a doctor for more routine care – care for diabetes, hypertension, cardiac issues, depression, infections, injuries, prenatal care, well child checks, vaccinations and more. The nation’s attention is currently riveted on whether hospitals can respond to the potential surge in COVID-19 cases, but without an immediate lifeline, the health care system we all rely on for our day-to-day health care may crumble.

This article provided by Oregon Transformation Newsletter,