Portland, Ore. - Following the Oregon Health Authority’s (OHA) decision to allow Providence’s joint venture with Compassus to proceed, union-represented home health and hospice clinicians from the Oregon Nurses Association (ONA) have asked OHA to revise and strengthen the conditions of the proposed order.  

ONA has sent multiple communications to OHA with their concerns. The documents sent include:

ONA members believe the conditions around the merger are inadequate, incomplete, and fail to live up to the Health Care Market Oversight (HCMO) program’s statutory mandates. 

The intent of the HCMO program is to protect Oregonians by ensuring that proposed health care business deals support the goals of health equity, lower costs, increased access, and better care. Yet some of the conditions on this venture are worded more loosely than similar previous conditions placed on other transactions by HCMO. 

“Without proper oversight, this joint venture risks undermining our ability to continue providing high-quality patient care. We cannot rely on Providence and Compassus to put patients and caregivers first. That’s why the HCMO process must impose strong conditions on this transaction to protect the public’s access to quality home health and hospice care across the state,” Kara Hayden, augmentative and alternative communication–speech-language pathologist at Providence Home Health and Hospice.

Unfortunately, the list of conditions in the proposed order for the joint venture lack repercussions or penalties if not followed. The conditions go out of their way to put profit over patient care. They cite “commercial reasonableness” as a rationale to shutter service areas and discontinue vital services. It sets the bar ridiculously low, saying that if the new joint venture has a financial loss for any stretch of 6 months, Providence and Compassus are released from all obligations to maintain services at current levels and in current geographies. One condition only mandates current staffing levels be maintained for the first six months following the closing date.

The proposed order allows the joint venture to increase caregivers’ patient loads and pressures caregivers to use AI technology for decision-making rather than experienced clinical judgment. 

“AI should not be making decisions about patient care—frontline caregivers should be, based on a holistic view of the patient,” said Hayden. “When companies push algorithms instead of clinical judgment, patient care suffers and caregivers’ licenses are on the line. Policies like these will only accelerate the exodus of experienced caregivers who entered this profession to care for patients, not to spend all their time justifying clinical judgement to override computer algorithms.”

ONA is requesting that OHA review and amend the conditions in the proposed order to address the issues raised by ONA members. Specifically,

• Extend the length of time that the Joint Venture is required to maintain the level and geographic reach of its services to five (5) years as it has done in other orders;

• Ensure that physicians and clinicians employed by the entity shall be responsible for all clinical decisions by making explicit that AI tools cannot be used in place of physician or clinician judgement;

• Require the joint venture to use an EMR system that is compatible and integrates with patient medical records; and

• Require that Providence maintains its 50% stake in the joint venture for the originally requested five (5) years.

“As home health and hospice caregivers, we will fight every step of the way to ensure this joint venture works for our patients and communities across Oregon. People depend on these services to recover, manage chronic conditions, and live with dignity in their own homes. We are committed to holding Providence and Compassus accountable so patients continue to receive the care they deserve,” said Hayden.

Oregonians and clinicians deserve a home health and hospice provider that prioritizes patient needs over profits, is committed to maintaining current service areas and staffing, and will support and invest in caring for Oregon’s homebound population.

 

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