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Oregon Hospitals See Fewer Patients Able to Pay Full Cost of Care in 2016

The data reveals an increase in charity care spending that seems to coincide with a decline in Medicaid enrollment last year. But there was wide variation across the state, with some rural hospitals still seeing charity care expenses continue to fall.
April 19, 2017

More patients struggled to pay their hospital bills in 2016 than the year before, in yet further evidence of a slight retrenchment in Affordable Care Act gains, according to a Lund Report analysis of financial data reported to the state.

In 2016, Oregon’s hospitals reported $349.4 million in charity care expenses, the industry term for the cost of forgiving unpaid bills sent to patients unable to pay for some or all of their care. That’s an 11 percent climb from the $315 million in charity care spending reported in 2015 – and represents a reversal after two years of charity care declines following the expansion of Medicaid through the state’s coordinated care organizations.

In private conversations with The Lund Report, industry insiders have turned to a range of explanations for the uptick in unpaid bills. Some speculate that high-deductible health plans are leaving even insured patients unable to cover the full cost of their medical needs, which has prompted some hospitals to broaden their charity care policies.

Others health insiders suggest that more stringent process of enrolling in coordinated care organizations may be keeping some people from accessing the Medicaid funded plans that target the state’s lowest-income residents. CCO enrollment in the state fell from 948,721 in January 2016 to 846,720 in January 2017, according to Oregon Office of Health Analytics data, a 10.8 percent annual decline. Roughly 20,000 members were added back to CCO rolls in the first three months of this year.

The increase in spending on charity care has not been experienced universally across all hospitals. The 25 largest, frequently urban, hospitals, in Oregon saw charity care spending climb an average of 14.4 percent last year. Those classified as Type A for Medicaid reimbursements – meaning they have fewer than 50 beds and are more than 30 miles from the nearest hospital – saw charity care spending climb an average of 15.9 percent last year.

But those hospitals classified as Type B –with fewer than 50 beds and less than 30 miles from the next nearest hospital – bucked the trend, on average, reporting an 11.6 percent decline in charity care spending last year.

Even with the broad overall uptick , hospitals are spending far less on charity care than before the passage of Obamacare. Oregon hospital charity care spending peaked at $844.57 million in 2013, after climbing steadily from $525.2 million in 2007 – as far back as state tracking goes.

Here’s how charity care spending at each hospital in the state climbed or dropped in 2016.

Larger and urban hospitals:

  • Adventist Medical Center spent $6,452,865 on charity care in 2016, down by 27.46 percent from the previous year.
  • Asante Rogue Medical Center spent $13,798,181 on charity care in 2016, up by 27.75 percent from the previous year.
  • Asante Three Rivers Medical Center spent $7,340,943 on charity care in 2016, up by .3 percent from the previous year.
  • Bay Area Hospital spent $2,692,082 on charity care in 2016, up by 78.59 percent from the previous year.
  • Good Samaritan Regional Medical Center spent $9,271,811 on charity care in 2016, down by 2.17 percent from the previous year.
  • Legacy Emanuel Medical Center spent $47,336,010 on charity care in 2016, up by 75.59 percent from the previous year.
  • Legacy Good Samaritan Medical Center spent $16,224,761 on charity care in 2016, up by 34.75 percent from the previous year.
  • Legacy Meridian Park Medical Center spent $12,734,360 on charity care in 2016, up by 70.12 percent from the previous year.
  • Legacy Mt Hood Medical Center spent $18,491,630 on charity care in 2016, up by 44.3 percent from the previous year.
  • McKenzie-Willamette Medical Center spent $61,106 on charity care in 2016, up by 509.72 percent from the previous year.
  • Mercy Medical Center spent $3,186,953 on charity care in 2016, up by 385.01 percent from the previous year.
  • OHSU Hospital spent $33,817,787 on charity care in 2016, up by 12.72 percent from the previous year.
  • PeaceHealth Sacred Heart Riverbend spent $10,020,728 on charity care in 2016, up by 37.42 percent from the previous year.
  • PeaceHealth Sacred Heart University spent $2,166,002 on charity care in 2016, up by 99.82 percent from the previous year.
  • Providence Medford Medical Center spent $11,579,228 on charity care in 2016, up by 9.21 percent from the previous year.
  • Providence Milwaukie Hospital spent $3,827,519 on charity care in 2016, down by 27.95 percent from the previous year.
  • Providence Portland Medical Center spent $18,273,211 on charity care in 2016, down by 29.39 percent from the previous year.
  • Providence St Vincent Medical Center spent $26,599,225 on charity care in 2016, down by 10.1 percent from the previous year.
  • Providence Willamette Falls spent $2,987,252 on charity care in 2016, down by 40.88 percent from the previous year.
  • Salem Hospital spent $21,902,753 on charity care in 2016, up by 4.49 percent from the previous year.
  • Samaritan Albany Hospital spent $5,430,061 on charity care in 2016, up by 2.99 percent from the previous year.
  • Shriners spent $207,578 on charity care in 2016, up by 30.69 percent from the previous year.
  • Sky Lakes Medical Center spent $8,856,399 on charity care in 2016, up by 41.1 percent from the previous year.
  • St Charles - Bend spent $7,122,635 on charity care in 2016, down by 16.49 percent from the previous year.
  • Tuality Healthcare spent $5,642,038 on charity care in 2016, up by 18.12 percent from the previous year.
  • Willamette Valley Medical Center spent $711,370 on charity care in 2016, up by .18 percent from the previous year.

Type A hospitals, which have fewer than 50 beds and are more than 30 miles from the next nearest hospital

  • Blue Mountain Hospital spent -$42,998 on charity care in 2016, down by 150.39 percent from the previous year.
  • Curry General Hospital spent $378,336 on charity care in 2016, up by 17.69 percent from the previous year.
  • Good Shepherd Medical Center spent $3,554,372 on charity care in 2016, up by 19.7 percent from the previous year.
  • Grande Ronde Hospital spent $2,559,717 on charity care in 2016, up by 41.6 percent from the previous year.
  • Harney District Hospital spent $204,967 on charity care in 2016, up by 3.32 percent from the previous year.
  • Lake District Hospital spent $483,522 on charity care in 2016, up by 80.48 percent from the previous year.
  • Pioneer Memorial Heppner spent $52,056 on charity care in 2016, down by 39.9 percent from the previous year.
  • St Alphonsus Medical Center Baker City spent $679,979 on charity care in 2016, up by 6.16 percent from the previous year.
  • St Alphonsus Medical Center Ontario spent $3,599,459 on charity care in 2016, up by 42.58 percent from the previous year.
  • St Anthony Hospital spent $1,219,639 on charity care in 2016, up by 47.92 percent from the previous year.
  • Tillamook County Gen Hospital spent $2,050,721 on charity care in 2016, down by 31.55 percent from the previous year.
  • Wallowa Memorial Hospital spent $157,762 on charity care in 2016, up by 19.58 percent from the previous year.

Type B hospitals, which have fewer than 50 beds and are less than 30 miles from the next nearest hospital:

  • Ashland Community Hospital spent $1,711,253 on charity care in 2016, up by 67. percent from the previous year.
  • Columbia Memorial Hospital spent $2,418,289 on charity care in 2016, up by 22.08 percent from the previous year.
  • Coquille Valley Hospital spent $117,012 on charity care in 2016, down by 43.63 percent from the previous year.
  • Lower Umpqua Hospital spent $197,333 on charity care in 2016, up by 61. percent from the previous year.
  • Mid-Columbia Medical Center spent $3,605,137 on charity care in 2016, down by 30.17 percent from the previous year.
  • PeaceHealth Cottage Grove spent $376,308 on charity care in 2016, down by 8.61 percent from the previous year.
  • PeaceHealth Peace Harbor spent $869,067 on charity care in 2016, down by 11.75 percent from the previous year.
  • St. Charles Prineville (was Pioneer Memorial Prineville) spent $679,073 on charity care in 2016, down by 27.28 percent from the previous year.
  • Providence Hood River Hospital spent $2,991,185 on charity care in 2016, down by 22.11 percent from the previous year.
  • Providence Newberg Medical Center spent $4,879,843 on charity care in 2016, down by 15.67 percent from the previous year.
  • Providence Seaside Hospital spent $1,325,297 on charity care in 2016, down by 53.05 percent from the previous year.
  • Samaritan Lebanon Hospital spent $4,559,937 on charity care in 2016, down by 6.72 percent from the previous year.
  • Samaritan North Lincoln Hospital spent $2,306,672 on charity care in 2016, down by 21.81 percent from the previous year.
  • Samaritan Pacific Community Hospital spent $3,407,849 on charity care in 2016, down by 3.51 percent from the previous year.
  • Santiam Memorial Hospital spent $660,439 on charity care in 2016, up by 70.84 percent from the previous year.
  • Legacy Silverton Medical Center (was Silverton Hospital) spent $4,029,054 on charity care in 2016, up by 17.11 percent from the previous year.
  • Southern Coos Hospital spent $38,378 on charity care in 2016, down by 71. percent from the previous year.
  • St Charles - Madras spent $611,628 on charity care in 2016, down by 15.13 percent from the previous year.
  • St Charles - Redmond spent $2,107,218 on charity care in 2016, down by 14.03 percent from the previous year.
  • West Valley Hospital spent $857,104 on charity care in 2016, down by 5.72 percent from the previous year.

Reach Courtney Sherwood at 503-208-4173, or [email protected].

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