A healthcare crisis is looming over Oregon, and it's leaving thousands of patients and providers in a state of uncertainty and confusion. The impending exit of PacificSource from the state's Medicaid program has sent shockwaves through the community, with nearly 90,000 people facing an uncertain future regarding their healthcare coverage and access.
For Angie Wright and her husband, Robert, this news is particularly devastating. Robert, who suffers from chronic and debilitating illnesses, has been relying on PacificSource as his coordinated care organization for three years. Angie, who has not received any official communication from either the state health authority or PacificSource, is left feeling frustrated and worried about the lack of clarity and support.
"Keeping us in the dark is just wrong," Angie said, expressing her concern for the well-being of her husband and the thousands of others affected by this change.
But here's where it gets controversial: the state's reimbursement rate to PacificSource is not covering expenses, according to the insurer's leaders. This has led to a breakdown in negotiations, leaving the future of healthcare provision in Lane County up in the air.
The Oregon Health Authority has stated that it intends to find a new provider by 2026, but for now, the situation remains uncertain. Officials have referenced a "process" when asked about the expiration of PacificSource's contract on January 1st, leaving many to wonder what this process entails and how it will impact those affected.
And this is the part most people miss: the impact on primary care clinics and healthcare practitioners. Amanda Warner and Eden Sisk, who recently opened Perigon Medical Clinic in Eugene, are now facing a new setback. Their clinic, which aimed to provide care to Lane County's Medicaid patients, had no warning of this transition and is now reevaluating its approach.
"That's just scary for a lot of people," said Warner, a registered nurse and family medicine practitioner. The worsening shortage of healthcare access and providers in the county has already led to years of consolidation, leaving thousands searching for primary care. The strain on the system is evident, with emergency departments overwhelmed and patients facing lengthy wait times.
Warner and Sisk's business model, which focused on making care affordable for Oregon Health Plan members, is now in jeopardy. They are considering adopting a sliding scale or contracting with Trillium, the other coordinated care organization in the county, to continue serving these patients.
"We are here, and we are going to do the work," Sisk, the clinic's operations manager, said. "We won't stand down from a challenge."
However, uncertainty remains. Clinics and Oregon Health Plan members are concerned about the capacity of Trillium to absorb such a large number of patients. PeaceHealth, which accepts both Trillium and PacificSource, is an exception, as McKenzie Willamette Medical Center recently ended its contract with Trillium, accepting only PacificSource patients.
When asked about its ability to accommodate 90,000 more patients, Trillium spokesperson Courtney Johnson assured that they have the capacity and are working closely with the health authority. But the health authority has not confirmed whether it will transition PacificSource members to Trillium or bring in another provider, leaving even government-run Community Health Centers of Lane County in the dark.
During a recent board of commissioners meeting, elected leaders emphasized the importance of advocating for county patients and focusing on the best possible outcome. "It's not time for hand-wringing," Commissioner Pat Farr said. "It's a time for a march to action."
For Angie and Robert Wright, the situation is especially dire. Angie hasn't had a break since their home burned down in 2022, and Robert, who was diagnosed with chronic obstructive pulmonary disease around that time, relies heavily on his oxygen machine and regular medical appointments.
"I can't find a job that would hire me due to my disabilities," Robert said. "I can't go a few minutes without oxygen, so an eight-hour shift is out of the question."
Robert also suffers from frequent pneumonia and brittle bone disease, making him vulnerable to fractures. The couple's calendar is filled with medical appointments, and a lapse in care could have severe consequences.
While the health authority has promised no disruptions and advised PacificSource members not to take any action, Angie worries whether this is the right approach and if the agency can adequately support families with complex medical needs.
"When you have multiple specialists and home healthcare involved, it's a whole different ball game," Angie said. "Our lives are already challenging enough without adding more uncertainty to the mix."
This story is a reminder of the human impact of healthcare policy decisions. It raises important questions about the responsibility of government agencies and healthcare providers to communicate effectively and ensure a smooth transition for those affected. As the situation unfolds, the community awaits answers and a resolution that prioritizes the well-being of its most vulnerable members.
What are your thoughts on this healthcare crisis? Do you believe the authorities are handling the situation effectively? Share your experiences and insights in the comments below.
