Oregon Hospital Data Reveals Growing Reliance on Government Payments

Government programs pay a large and growing share of Oregon’s hospital bills, and were billed for two thirds of all medical charges in the first half of 2016, with insurance and individuals billed for only a third of those charges, according to a Lund Report analysis of hospital payment data.

And while the Affordable Care Act gets some credit for the state’s growing reliance on government-funded care, the gap between how much the private sector pays and how much taxpayers contribute has been growing since long before the ACA was passed.

The year 2007 was also the last time that the state’s hospitals charged more to individuals and health insurance companies than to Medicaid and Medicare programs. That year, hospitals charged government programs for 49.9 percent of medical care costs, and charged private-sector payers for 50.1 percent of costs, according to data tracked by the Oregon Office of Health Analytics.

In 2013, when ACA provisions significantly boosted healthcare access, Medicaid and Medicare were billed for 58.4 percent of Oregon hospital charges. By the first half of 2016, the most recent period available, those government programs were billed for 66.1 percent of Oregon hospital charges.

With Republicans and the Trump administration pushing to repeal the ACA, and Oregon facing a state budget shortfall of $1.7 billion, it’s not clear what lies ahead for government payments to hospitals – or how any shifts will affect Oregon hospitals’ bottom lines.

PeaceHealth Peace Harbor Hospital, a tiny 21-bed acute-care facility in Florence, and even smaller Lower Umpqua Hospital, with 16 beds in Reedsport, each billed the government for more than 80 percent of their total charges. In each case, Medicare, the government insurance program for older Americans, was the primary reason.

In the first half of 2016, PeaceHarbor billed Medicare for 61.9 percent of charges, and Medicaid for 19.2 percent. Lower Umpqua billed Medicare for 59.8 percent of charges, and Medicaid for 20.7 percent, in the same period.

Only two hospital billed government programs for less than half of its charges in the first half of 2016: 25-bed Pendleton-based St. Anthony, and 114-bed McKenzie- Willamette Medical Center in Springfield.

In the first half of 2016, St. Anthony billed Medicare for 29.5 percent and Medicaid for 5.6 percent of charges, and said 64 percent of charges were billed to insurance and other payors. But those payment figures are unusual – most years, St. Anthony has charged government programs for more than half of its expenses. In 2015, it billed Medicare for 33.6 percent and Medicaid for 17.8 percent of chargers, compared to billing insurance and other payors for 47.6 percent of charges.

Mc-Kenzie-Willamette billed government programs for 45.7 percent of its charges in the first half of 2016 – 22.6 percent of charges were Medicare, and 23.1 percent were Medicaid. Private insurance and other payors were billed for 52.6 percent of charges.

Adventist Medical Center, charges, first half of 2016:

• * Medicare: 42.5 percent
• * Medicaid: 20.1 percent
• * Self pay: 1.7 percent
• * Insurance and any other payors: 35.7 percent
• * Total charges: $420,135,820

Asante Ashland Community Hospital, charges, first half of 2016:

• * Medicare: 52.2 percent
• * Medicaid: 19.4 percent
• * Self pay: 2 percent
• * Insurance and any other payors: 26.3 percent
• * Total charges: $67,502,502

Asante Rogue Regional Medical Center, charges, first half of 2016:

• * Medicare: 53.2 percent
• * Medicaid: 22.2 percent
• * Self pay: 1.4 percent
• * Insurance and any other payors: 23.2 percent
• * Total charges: $695,431,864

Asante Three Rivers Medical Center, charges, first half of 2016:

• * Medicare: 54.2 percent
• * Medicaid: 25.2 percent
• * Self pay: 1.7 percent
• * Insurance and any other payors: 18.9 percent
• * Total charges: $264,910,978

Bay Area Hospital, charges, first half of 2016:

• * Medicare: 48.3 percent
• * Medicaid: 18.0 percent
• * Self pay: 4.1 percent
• * Insurance and any other payors: 29.6 percent
• * Total charges: $221,378,567

Blue Mountain Hospital, charges, first half of 2016:

• * Medicare: 47.8 percent
• * Medicaid: 18.0 percent
• * Self pay: 3.3 percent
• * Insurance and any other payors: 31.0 percent
• * Total charges: $16,161,157

Columbia Memorial Hospital, charges, first half of 2016:

• * Medicare: 47.0 percent
• * Medicaid: 21.1 percent
• * Self pay: 2.9 percent
• * Insurance and any other payors: 29.0 percent
• * Total charges: $102,527,875

Coquille Valley Hospital, charges, first half of 2016:

• * Medicare: 59.4 percent
• * Medicaid: 19.0 percent
• * Self pay: 2.2 percent
• * Insurance and any other payors: 19.5 percent
• * Total charges: $20,468,716

Curry General Hospital, charges, first half of 2016:

• * Medicare: 48.0 percent
• * Medicaid: 20.9 percent
• * Self pay: 2.5 percent
• * Insurance and any other payors: 28.7 percent
• * Total charges: $27,455,531

Good Samaritan Regional Medical Center, charges, first half of 2016:

• * Medicare: 48.6 percent
• * Medicaid: 17.7 percent
• * Self pay: .9 percent
• * Insurance and any other payors: 32.8 percent
• * Total charges: $393,335,848

Good Shepherd Medical Center, charges, first half of 2016:

• * Medicare: 33.8 percent
• * Medicaid: 29.3 percent
• * Self pay: 2.4 percent
• * Insurance and any other payors: 34.4 percent
• * Total charges: $72,448,331

Grande Ronde Hospital, charges, first half of 2016:

• * Medicare: 42.4 percent
• * Medicaid: 22.8 percent
• * Self pay: 4.7 percent
• * Insurance and any other payors: 30.1 percent
• * Total charges: $69,675,752

Harney District Hospital, charges, first half of 2016:

• * Medicare: 42.9 percent
• * Medicaid: 26.9 percent
• * Self pay: 3.0 percent
• * Insurance and any other payors: 27.2 percent
• * Total charges: $14,660,905

Lake District Hospital, charges, first half of 2016:

• * Medicare: 43.8 percent
• * Medicaid: 16.0 percent
• * Self pay: 4.6 percent
• * Insurance and any other payors: 35.7 percent
• * Total charges: $14,683,462

Legacy Emanuel Medical Center, charges, first half of 2016:

• * Medicare: 24.0 percent
• * Medicaid: 39.3 percent
• * Self pay: 2.0 percent
• * Insurance and any other payors: 34.7 percent
• * Total charges: $789,747,155

Legacy Good Samaritan Medical Center, charges, first half of 2016:

• * Medicare: 46.8 percent
• * Medicaid: 20.2 percent
• * Self pay: 1.3 percent
• * Insurance and any other payors: 31.7 percent
• * Total charges: $405,590,082

Legacy Meridian Park Medical Center, charges, first half of 2016:

• * Medicare: 51.0 percent
• * Medicaid: 12.1 percent
• * Self pay: 2.0 percent
• * Insurance and any other payors: 34.9 percent
• * Total charges: $275,019,507

Legacy Mount Hood Medical Center, charges, first half of 2016:

• * Medicare: 40.2 percent
• * Medicaid: 31.7 percent
• * Self pay: 3.1 percent
• * Insurance and any other payors: 25.0 percent
• * Total charges: $210,818,028

Legacy Silverton Medical Center, charges, first half of 2016:

• * Medicare: 25.8 percent
• * Medicaid: 27.9 percent
• * Self pay: 2.8 percent
• * Insurance and any other payors: 43.5 percent
• * Total charges: $113,076,745

Lower Umpqua Hospital, charges, first half of 2016:

• * Medicare: 59.8 percent
• * Medicaid: 20.7 percent
• * Self pay: .9 percent
• * Insurance and any other payors: 18.6 percent
• * Total charges: $16,928,282

McKenzie-Willamette Medical Center, charges, first half of 2016:

• * Medicare: 22.6 percent
• * Medicaid: 23.1 percent
• * Self pay: 1.8 percent
• * Insurance and any other payors: 52.6 percent
• * Total charges: $317,516,551

Mercy Medical Center, charges, first half of 2016:

• * Medicare: 51.1 percent
• * Medicaid: 22.9 percent
• * Self pay: 1.2 percent
• * Insurance and any other payors: 24.8 percent
• * Total charges: $312,741,713

Mid-Columbia Medical Center, charges, first half of 2016:

• * Medicare: 51.7 percent
• * Medicaid: 20.0 percent
• * Self pay: 1.7 percent
• * Insurance and any other payors: 26.7 percent
• * Total charges: $122,537,831

OHSU Hospital, charges, first half of 2016:

• * Medicare: 31.9 percent
• * Medicaid: 26.2 percent
• * Self pay: 1.3 percent
• * Insurance and any other payors: 40.6 percent
• * Total charges: $1,694,093,362

PeaceHealth Cottage Grove Community Medical Center, charges, first half of 2016:

• * Medicare: 51.0 percent
• * Medicaid: 27.0 percent
• * Self pay: 2.1 percent
• * Insurance and any other payors: 19.8 percent
• * Total charges: $21,509,250

PeaceHealth Peace Harbor Medical Center, charges, first half of 2016:

• * Medicare: 61.9 percent
• * Medicaid: 19.2 percent
• * Self pay: 1.0 percent
• * Insurance and any other payors: 18.0 percent
• * Total charges: $53,852,091

PeaceHealth Sacred Heart Medical Center at RiverBend, charges, first half of 2016:

• * Medicare: 49.5 percent
• * Medicaid: 21.7 percent
• * Self pay: 2.1 percent
• * Insurance and any other payors: 26.7 percent
• * Total charges: $731,682,060

PeaceHealth Sacred Heart Medical Center University District, charges, first half of 2016:

• * Medicare: 44.1 percent
• * Medicaid: 29.9 percent
• * Self pay: 3.2 percent
• * Insurance and any other payors: 22.9 percent
• * Total charges: $113,294,597

Pioneer Memorial Hospital Heppner, charges, first half of 2016:

• * Medicare: 49.3 percent
• * Medicaid: 19.0 percent
• * Self pay: 5.2 percent
• * Insurance and any other payors: 26.5 percent
• * Total charges: $4,684,302

Providence Hood River Memorial Hospital, charges, first half of 2016:

• * Medicare: 43.4 percent
• * Medicaid: 18.4 percent
• * Self pay: 1.9 percent
• * Insurance and any other payors: 36.3 percent
• * Total charges: $75,111,989

Providence Medford Medical Center, charges, first half of 2016:

• * Medicare: 55.6 percent
• * Medicaid: 20.4 percent
• * Self pay: 1.2 percent
• * Insurance and any other payors: 22.8 percent
• * Total charges: $280,988,818

Providence Milwaukie Hospital, charges, first half of 2016:

• * Medicare: 40.9 percent
• * Medicaid: 23.8 percent
• * Self pay: 1.8 percent
• * Insurance and any other payors: 33.5 percent
• * Total charges: $109,533,347

Providence Newberg Medical Center, charges, first half of 2016:

• * Medicare: 38.8 percent
• * Medicaid: 19.7 percent
• * Self pay: 1.9 percent
• * Insurance and any other payors: 39.6 percent
• * Total charges: $113,037,669

Providence Portland Medical Center, charges, first half of 2016:

• * Medicare: 42.4 percent
• * Medicaid: 20.0 percent
• * Self pay: 1.3 percent
• * Insurance and any other payors: 36.3 percent
• * Total charges: $761,602,469

Providence Seaside Hospital, charges, first half of 2016:

• * Medicare: 49.7 percent
• * Medicaid: 21.9 percent
• * Self pay: 1.6 percent
• * Insurance and any other payors: 26.7 percent
• * Total charges: $59,069,881

Providence St Vincent Medical Center, charges, first half of 2016:

• * Medicare: 42.8 percent
• * Medicaid: 15.7 percent
• * Self pay: 1.3 percent
• * Insurance and any other payors: 40.3 percent
• * Total charges: $853,524,397

Providence Willamette Falls Medical Center, charges, first half of 2016:

• * Medicare: 36.2 percent
• * Medicaid: 24.2 percent
• * Self pay: 1.4 percent
• * Insurance and any other payors: 38.2 percent
• * Total charges: $133,722,892

Saint Alphonsus Medical Center - Baker City, charges, first half of 2016:

• * Medicare: 47.2 percent
• * Medicaid: 24.6 percent
• * Self pay: 2.0 percent
• * Insurance and any other payors: 26.1 percent
• * Total charges: $27,951,904

Saint Alphonsus Medical Center - Ontario, charges, first half of 2016:

• * Medicare: 43.0 percent
• * Medicaid: 25.5 percent
• * Self pay: 3.1 percent
• * Insurance and any other payors: 28.3 percent
• * Total charges: $83,235,769

Salem Hospital, charges, first half of 2016:

• * Medicare: 47.3 percent
• * Medicaid: 22.8 percent
• * Self pay: 1.5 percent
• * Insurance and any other payors: 28.4 percent
• * Total charges: $718,953,182

Samaritan Albany General Hospital, charges, first half of 2016:

• * Medicare: 43.9 percent
• * Medicaid: 23.7 percent
• * Self pay: 1.7 percent
• * Insurance and any other payors: 30.6 percent
• * Total charges: $163,780,193

Samaritan Lebanon Community Hospital, charges, first half of 2016:

• * Medicare: 45.5 percent
• * Medicaid: 26.5 percent
• * Self pay: 2.0 percent
• * Insurance and any other payors: 26.0 percent
• * Total charges: $113,540,131

Samaritan North Lincoln Hospital, charges, first half of 2016:

• * Medicare: 48.5 percent
• * Medicaid: 24.8 percent
• * Self pay: 1.9 percent
• * Insurance and any other payors: 24.8 percent
• * Total charges: $50,787,375

Samaritan Pacific Communities Hospital, charges, first half of 2016:

• * Medicare: 46.9 percent
• * Medicaid: 24.2 percent
• * Self pay: 2.2 percent
• * Insurance and any other payors: 26.7 percent
• * Total charges: $87,165,601

Santiam Memorial Hospital, charges, first half of 2016:

• * Medicare: 41.3 percent
• * Medicaid: 23.0 percent
• * Self pay: 3.3 percent
• * Insurance and any other payors: 32.4 percent
• * Total charges: $45,354,658

Shriners Hospital for Children, charges, first half of 2016:

• * Medicare: .1 percent
• * Medicaid: 53.9 percent
• * Self pay: 5.5 percent
• * Insurance and any other payors: 40.6 percent
• * Total charges: $25,049,108

Sky Lakes Medical Center, charges, first half of 2016:

• * Medicare: 49.4 percent
• * Medicaid: 24.2 percent
• * Self pay: 1.8 percent
• * Insurance and any other payors: 24.6 percent
• * Total charges: $295,692,922

Southern Coos Hospital & Health Center, charges, first half of 2016:

• * Medicare: 57.6 percent
• * Medicaid: 17.3 percent
• * Self pay: 1.7 percent
• * Insurance and any other payors: 23.4 percent
• * Total charges: $10,730,064

St Anthony Hospital, charges, first half of 2016:

• * Medicare: 29.5 percent
• * Medicaid: 5.6 percent
• * Self pay: .9 percent
• * Insurance and any other payors: 64.0 percent
• * Total charges: $64,143,022

St Charles Bend, charges, first half of 2016:

• * Medicare: 53.7 percent
• * Medicaid: 18.8 percent
• * Self pay: 1.4 percent
• * Insurance and any other payors: 26.0 percent
• * Total charges: $578,038,529

St Charles Madras, charges, first half of 2016:

• * Medicare: 36.8 percent
• * Medicaid: 42.1 percent
• * Self pay: 2.0 percent
• * Insurance and any other payors: 19.1 percent
• * Total charges: $27,552,175

St Charles Prineville, charges, first half of 2016:

• * Medicare: 53.5 percent
• * Medicaid: 26.3 percent
• * Self pay: 2.2 percent
• * Insurance and any other payors: 18.0 percent
• * Total charges: $32,542,850

St Charles Redmond, charges, first half of 2016:

• * Medicare: 44.7 percent
• * Medicaid: 29.5 percent
• * Self pay: 1.6 percent
• * Insurance and any other payors: 24.2 percent
• * Total charges: $93,061,644

Tillamook Regional Medical Center, charges, first half of 2016:

• * Medicare: 48.9 percent
• * Medicaid: 21.5 percent
• * Self pay: 3.9 percent
• * Insurance and any other payors: 25.7 percent
• * Total charges: $63,035,588

Tuality Healthcare, charges, first half of 2016:

• * Medicare: 48.0 percent
• * Medicaid: 24.0 percent
• * Self pay: 4.5 percent
• * Insurance and any other payors: 23.6 percent
• * Total charges: $212,277,532

Wallowa Memorial Hospital, charges, first half of 2016:

• * Medicare: 50.7 percent
• * Medicaid: 17.4 percent
• * Self pay: 2.1 percent
• * Insurance and any other payors: 29.8 percent
• * Total charges: $13,786,423

West Valley Hospital, charges, first half of 2016:

• * Medicare: 39.0 percent
• * Medicaid: 28.9 percent
• * Self pay: 3.4 percent
• * Insurance and any other payors: 28.7 percent
• * Total charges: $27,359,681

Willamette Valley Medical Center, charges, first half of 2016:

• * Medicare: 47.8 percent
• * Medicaid: 24.9 percent
• * Self pay: 1.6 percent
• * Insurance and any other payors: 25.7 percent
• * Total charges: $176,217,814

Reach Courtney Sherwood at sherwood@thelundreport. Follow her on Twitter at @csherwood