State bureaucrats sought to plant negative stories about healthcare nonprofit

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State sought to plant negative stories about nonprofit


Oregon Health Authority planned to use media to dissuade lawmakers from passing legislation sought by Portland-area FamilyCare over health care rate dispute.


The government-funded public relations plan to demean a Portland-area healthcare nonprofit sounds like a toned-down mish mash of the TV series “House of Cards” and “Mad Men,” but with an Oregon twist.


Among the plan’s elements: Find an HIV patient to complain about lack of care at the nonprofit FamilyCare, Inc., and connect them off-the-record with a reporter, perhaps at Willamette Week. Get reporters to write about FamilyCare and “look for opportunities to hurt their credibility in the news.” Portray the nonprofit as “more concerned with the bottom line and increasing revenues than the health of Oregonians.”


And the spin doctors tasked with doing all this? State communications staff at the Oregon Health Authority.


The communications plan, released in response to public records appeal by the Portland Tribune, was forwarded between OHA’s head of lobbying, BethAnne Darby, director Lynne Saxton and others in January as a means to influence the 2017 Oregon Legislature.


It was prepared as FamilyCare and the state were doing battle in court over whether OHA is giving FamilyCare a fair rate of reimbursement for its care of low-income Medicaid patients. FamilyCare is one of 16 coordinated care organizations, or CCOs, set up by state reforms to act much like insurance plans or HMOs to provide low-income patients with health care under the Oregon Health Plan. FamilyCare been the most vocal one, often accusing state officials of incompetence, including in the ongoing case. The company’s critics call it excessively combative.


Asked about the plan and related documents, Oregon Health Authority spokesman Robb Cowie wrote in an email that they were intended to “sketch out a range of outreach options and messages we explored to counter FamilyCare’s aggressive and often incorrect public statements. They were never formally reviewed or approved, or fully implemented.”


State approach unusual


Even if the plan was not fully implemented, setting out detailed plans to plant negative stories about FamilyCare is highly unusual behavior, according to several current and former government communications staff interviewed by the Portland Tribune. It puts the state of Oregon and Gov. Kate Brown’s administration in a role of trying to demean a contractor that OHA is supposed to be cooperating with to help low-income people.


Prepared in response to the litigation, the plan was intended to influence and persuade lawmakers to stay out of the legal dispute and not pass any bills supported by FamilyCare to seek modifications of the state rate process, the documents show. OHA succeeded in this regard, and a FamilyCare bill died in committee.


But not everyone thinks disparaging FamilyCare was a productive approach. For instance, the state communications plan plan talks about working with lobbyists from other groups to spread negative stories — while, in contrast, praising Health Share of Oregon, another organization that, like FamilyCare, is part of the Oregon Health Plan and covers the greater Portland region as FamilyCare does.


But if the state had come to Health Share with this plan the CCO would have declined to collaborate in “disparaging” FamilyCare, said Janet Meyer, Chief Executive Officer of Health Share. She said “job one” in health care is taking care of patients, and demeaning those doing it “is not helpful.”


The plan was initially withheld by the Oregon Health Authority, but the Tribune in early July disclosed an email from January of this year talking about the plan — which was to “create enough information buzz” in the Legislature to dissuade lawmakers from supporting FamilyCare legislation, wrote Darby, OHA’s director of external relations. The Tribune article in early July, included the response of Sen. Laurie Monnes Anderson, D-Gresham, who called OHA’s approach “totally out of line.”


Concern was “reputation”


The Senator’s comment alluded to the fact that lawmakers in Oregon typically expect agencies to be neutral parties that do not try to manipulate the Legislature, and instead provide unbiased information.


The plan and related documents talk about the high stakes involved for OHA leaders: the need for OHA to “maintain” its “reputation,” which otherwise would be “at risk” if FamilyCare succeeded in passing legislation.


The documents also show how OHA planned to hide its efforts to disparage FamilyCare using third parties to maintain an appearance of neutrality.


The plan said to “identify key legislators to target and get background information and data to them as soon as possible. then use those legislators and/or other lobbyist to pitch stories to news media if possible so that OHA can staff neutral.” By “staff” OHA seems to have meant “stay.”


The documents show that OHA called for portraying in negative light how FamilyCare pays primary care physicians more than required by law.


FamilyCare has used the higher reimbursements to ensure patients can get appointments — a common issue for Medicaid patients.


Rep. Mitch Greenlick, D-Portland, told the Tribune in June that the FamilyCare approach is “a great idea,” but “they keep getting penalized for it” by OHA. Added Greenlick of FamilyCare, “I think they had some valid complaints.”


Tactics display ignorance


The OHA tactics were either misleading or based on ignorance in another aspect as well, interviews and records show.


Though OHA’s document calls for portraying FamilyCare as an “outlier” in its profits and reserves, the widely known reality is that pretty much all the CCOs enjoyed massive profits in the first couple of years of Oregon’s Medicaid reforms, according to current and former healthcare officials not affiliated with FamilyCare.


The main difference between FamilyCare and other CCOs is that FamilyCare has a relatively simple corporate structure, making its margins easy to discern. In contrast, profits at other CCOs are not as visible because of how payments are moved around between different subsidiaries.


That said, FamilyCare has an unusually healthy population of members, including many children, which has led to lower healthcare costs and caused the CCO to receive a lower reimbursement rate from the state. It’s that rate that FamilyCare is complaining about in court.


While the Oregon Health Authority’s Darby claims the document was merely a draft and a “brain dump” and was not implemented, in reality the agency has released statements portraying FamilyCare as prioritizing profits over people.


Following the Tribune’s successful records appeal of OHA’s earlier refusal to release the documents, the OHA communications plan has been shared with other media outlets. The Lund Report on Wednesday reported other aspects of the state’s communications plan, saying “The Portland Business Journal, Willamette Week, Portland Tribune, Oregon Public Broadcasting, Oregonian and The Lund Report have all received targeted press releases aimed at bolstering the state’s case, as well as personalized emails to journalists and other outreach.”


FamilyCare CEO Jeff Heatherington called the documents obtained by the Tribune “outrageous” and said the firm is exploring its legal options.

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