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bendbulletin.com TODAY'S READERBOARD Meen Iending —Readthe
AP's original report of the 'giant leap for mankind' from 45 years ago today.A3
HIGHWAYS
Oregon expores
OREGON'S COORDINATED CARE EXPERIMENT A three-part Bulletin series:Oregon is conducting a unique experiment on Medicaid, to see if a regional system of "coordinated care organizations" can improve health care, improve health and lovver costs.
Friday:TheBulletin exploredhow reforms are changing health care.
Saturday:Weexamined howreform affects actual health — andhow to measurethat.
funding
Today: W einvestigatehow money is being spent differently.
options
Q» Follow along atbeedbelletin.cem/ceerdinatedcare
By Andrew Clevenger The Bulletin
WASHINGTON — As lawmakers in the nation's capital
Supel' PACS — Big money donors are turning their eyes toward Oregon this cycle.B3
struggled this week to find additional revenue for the almost
depleted Highway
Luna Malvada —Ivlanwlth
Trust Fund, a pilot
Bend roots wins accolades for tequila.E1
program in Oregon may offer a glimpse of how America will
pay for its roads in
Leaving America — com-
the future.
panies seek lower taxes.F1
Since 1956, the Highway Trust Fund has been supported by a federal gas tax,
In WOrld neWS —Palestinians flee violence.A2
which has stood at
18.4 cents per gallon since the beginning
And a Wedexclusive
By Lily Raff McCaulou• The Bulletin
— The island of Tasmania produces 85 percent of the world's poppies for pharmaceutical use, but drug companies worry that all their flowers are in one basket. beedbelletin.cem/extras
More dads want paid paternity eave
the growing use of gas-sipping hybrid and electric cars has
ince March, St. Charles Health SysLOCAL AND LEADING THE WAY
tem has faced a new financial in-
led to a decrease in revenues for the trust
Gov. John Kitzhaber's model for Medicaid, and
centive to keep Oregon Health Plan patients out of its hospitals.
EDITOR'SCHOICE
of the Clinton administration. But
Before then, the hospitals were reimbursed by
eventually all of health care, focuses on prevention, and ours is among the first communities to test it, especially at the hospital level.
fund, even as Americans are driving more miles than ever. Over a decade ago, Oregon began
LOCAL PATIENT
ways to pay for high-
the state Medicaid program only if a patient walked through the doors and sought treatment. This is
exploring alternative
the standard financial model known as "fee for
way maintenance
and upkeep besides a gas tax. SeeHighways/A4
service."
Patients who are insured under Oregon's version of Medicaid are still covered if they have to go to the hospital. But under a new contract, St. Charles
now receives a monthly payment for each Central Oregon member of the Oregon Health Plan — and will profit the most if the patients don't have to be admitted.
Jet's dead
That shift is part of a big experiment in health care,to encourage coordinated care that emphasiz-
es prevention. Gov. John Kitzhaber developed this model for Medicaid, in an effort to accomplish the
By Brigid Schulte
are still in
so-called triple aim: better health care, better health
The Washington Post
and lower costs. Securing the third leg of that tripod — lower costs — involves what is likely the most revolutionary change of alL It also involves a generous definition of "lower," as the state is cutting the
war zone
Marc Carlson, a senior
manager at Ernst & Young in Detroit, took two weeks
of the company's standard paid parental leave for dads when his daughter, Rebecca, was born last year. Then, when his wife,
Instead of paying health care providers for each
Diana, went back to work
as a physician, Carlson declared himself the primary
bonuses. Several primary care clinics have switched to
caregiver and took the
this payment system. But for hospital services, Cen-
maximum four additional weeks of paid leave. Carlson, 35, changed diapers, took Rebecca for walks and struggled for
tral Oregon is the first community to put its money where the governor's mouth is.
get the uncooperative baby to drink from a bottle. "From the beginning, my wife and I really wanted our child care to be shared. And I wanted to
be engagedwith my kid," Carlson said. "I was a lit-
New York Times News Service
Andy TullisI The Bulletin
service they perform, the new system offers a fixed
per-member,per-month sum. The monthly payments are augmented by possible performance
what seemed like hours to
ByDavtdM.Heraxenhorn andSabrinaTavetnise
rate of growth in per-patient spending, not the total dollar amount.
KIEV, Ukraine — The Ukrainian
Lisa Severa's experience illustrates the state's overall strategy for reducing the cost of care, as a comprehensive checkup this spring, and later a colonoscopy, helped prevent what likely
government said Saturday that it had proof
that Russiahad provided the surface-to-
would have been costly treatments later.
air missile system that
shot down a Malaysia Airlines passenger jet
This could someday become the new model for all health care in Oregon. Earlier this year, the
state Public Employees' Benefits Board, which insuresmore than 130,000 public employees and their families, announced plans to switch its insur-
ance plansto more closely resemble the one used for the Oregon Health Plan. Regardless of how you get your health insurance — whether through Medicare or a private insurance company such as Moda — the story of Medicaid in Oregon could be a glimpse into your own
How Central Oregon's coordinated care organization performed on key benchmarks
on Thursday, killing al1298people aboard.
Chart ee A7 SeeCCOs/AG
That daim came
JEFFERSON
as officials from Malaysia and the Netherlands pleaded
for politics to be put aside so they could recover their dead, still lying in a field in
CROOK
in its first full year.
future.
tle hesitant about taking
over eastern Ukraine
AND: LOCAL REPORTCARD
DESCHUTES
a war zone. SeeJet/A4
the full six weeks off. But I wasn't worried about the stigma, or whether it
would affect my career advancement.Iwas more worried about the moun-
tain of work I'd return to." Carlson is part of a generation of young fathers who tell pollsters they
Teen's death putsfocusoncaffeine powder dangers By Ann Sanner The Associated Press
But it was one of the world's
drawn a warning from federal health authorities urging consumers to avoidit.
weeksbefore theirpromking's
most widely accepted drugs that killed Logan Stiner — a powdered form of caffeine so
death, students at an Ohio high
potent that as little as a single
"I don't think any of us reallyknewthat this stuff was
schoolhad attended an assembly on narcotics that warned
teaspoon canbe fatal.
out there," said Jay Arbaugh,
survey of 1,000 fathers,
about the dangers of heroin and
the majority rated paid parental leave as important
prescriptionpainkillers.
Mayhas focused attention on the unregulatedpowder and
want to be more than a
paycheck, or the fun dad on weekends, and instead to be fully involved in parenthood. In a recently released Boston College
COLUMBUS,Ohio — A few
The teen's sudden death in
superintendent of the Keystone
Local Schools. The Food and Drug Admin-
istration said Friday that it's
of Cleveland.
investigatingcaffeinepowder and will consider taking regu-
Stiner, awrestler, had more than 70 micrograms of caffeine latory action. per milliliter ofblood in his A n a utopsy f o un d t h a t system, as much as 23 times the Stiner had a lethal amount of amount found in a typical cofcaffeine in his system when fee or soda drinker, according he died May 27 at his home in to the county coroner. LaGrange, Ohio, southwest See Caffeine/A8
or extremely important,
although 96 percent reported they could take two weeks or less. Some said
their companies gave them one day. SeeDads /A5
TODAY'S WEATHER Partly cloudy High 85, Low51 Page B6
INDEX Business Calendar Classified
Ef - 6 Community Life Cf -8 Milestones C2 Pu zzles c6 D1-6 82 Crosswords C6, G2 Obituaries B4 Sp o rts G f - 6L ocal/State B f -6 Opinion/Books Ff -6 TV/Movies C8
The Bulletin AnIndependent
Q We use recycled newsprint
vol. 112, No. 201,
4e pages,
7 sections 0
88 267 0 23 3 0
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