Finance and Revenue April 2025 update
The Finance and Revenue Committee of the UHPGB met on April 15, 2025
Summary by Sandra Coyner, HCAO/HCAO-Action (SandraCoyner@hcao.org)
After introducing new Executive Director Mimi McDonell and reviewing the Board’s Pause Procedure, the main business was a presentation on Healthcare Administrative Costs by Don Osborne from Vancouver Coastal Health in British Columbia. Vancouver Coastal Health handles a budget of $6.2 Bn Canadian [sc: about 10-15% of the projected budget for universal health care in Oregon] and has numerous interesting differences from our envisioned system. Its goal is to keep admin/support costs under 10% of that budget. [sc: not strictly equivalent to what we would call “admin” in our proposal.]
The Committee reviewed staff member Kim Yee’s parallel lists of tasks for consultant ECONorthwest and this F&R Committee, and the committee discussed impossibility of meeting target dates of September 2025. What will happen if this committee disappears before it has a final model?
Discussion included the need for public feedback sooner rather than later, and the decision by the CECC (Community Engagement and Communications Committee) that they will not do general outreach, only to the groups specified in the legislation. ECONorthwest also will not do it.
Why are we obsessed with taxes when we don’t know what the plan will cover? LTC Workmen’s Comp, Public Health – “will be decided.” The differences can be billions of dollars. Refer to the Optumas work. We should build on the Optumas model, not reinvent it.
We could have a model with several options–most, middle, least aggressive.
There are objections to adopting Optumas’s tax model as it is.
Questions about why F&R is supposed to decide a cost number before the Plan Design Committee makes its recommendations on what will be covered. Very few people know what both committees are doing.
Task force model left $5 billion or more in savings on the table.
Need to tie down cost for ambulatory services and administrative billing expense.
Today’s guest speaker showed that TF/Optumas estimate of fraud and abuse was excessive. It is tied in part to the reimbursement method.
Future meetings:
Staff tried hard to fulfill the committee's request for a panel of experts on administrative costs but was unable to make it happen.
Skip having a second April meeting
Public comment: Lou Sinniger – We don’t need such fancy coding. Supports deciding plan structure before calculating costs.
