Uncompensated Care at Oregon hospitals Reached $9.4 Billion From 2005-2013

The Lund Report conducted an extensive evaluation of all hospitals in the state, analyzing their charity care, bad debt and uncompensated care for each of the nine years, and also compared their overall uncompensated care with total revenue during the same time period.

The explosion of newcomers gaining health insurance since June 2013 will undoubtedly have a significant impact on the amount of charity care and bad debt at Oregon’s hospitals. That uninsured rate dropped by 63 percent over a one-year period, and only 202,000 Oregonians – roughly 5 percent of the state’s population--  still lacked insurance on Jun 30, 2014, according to an analysis by Oregon Health & Science University.

Although the total amount of charity care and bad debt at these hospitals during 2014 is months away from being calculated, The Lund Report decided to analyze the latest data from 2005 through 2013 using the state’s electronic DataBank system. The Oregon Association of Hospitals and Health Systems makes these files available to the Oregon Office of Health Policy and Research at quarterly intervals.  

To clarify, charity care is considered the total amount of healthcare charges for patients who lack insurance and are unable to pay, whereas bad debt represents the amount of money hospitals expect to receive but are unable to collect. Together they comprise what’s typically known as uncompensated care.

In 2005, Oregon hospitals calculated they gave $681,598,211 in uncompensated care compared to a 90 percent increase in 2013 of $1,287,828,698 – while the total for the nine-year period amounted to $9,404,452,971.

During that same nine-year time span, the dollar amount of charity care increased by 143 percent from 2005 to 2013 while bad debt only increased 43 percent over the same period.

The Lund Report also analyzed the amount of charity care, bad debt, and uncompensated care for all Oregon hospitals from 2005 through 2013, showing the amount of money and the percentile differences for each hospital as well as the cumulative totals.

Blue Mountain, PeaceHealth Rise to the Top 

Blue Mountain, West Valley, PeaceHealth Riverbend, Lake District, and Good Shepherd showed the most extraordinary individual percentage increase in charity care with increases jumping from 754 percent to 1689 percent. On the other end of the spectrum, Bay Area Hospital and PeaceHealth University District saw negative growth of -15 percent and -57 percent respectively.

Blue Mountain, Legacy Emanuel, St. Charles Redmond, Lake District, and Providence Newberg were the five individual hospitals that had the largest percentage growth in bad debt, ranging from a growth of 203 percent to 529 percent. Asante Ashland, Asante Three Rivers, St. Alphonsus – Ontario, Mercy Medical, and PeaceHealth University District showed the greatest percent decrease in bad debt ranging from -28 percent to -58 percent.

Blue Mountain, St. Charles Redmond, Legacy Good Samaritan, Legacy Emanuel, and PeaceHealth Riverbend showed the greatest percent growth in total uncompensated care which ranged from 322 percent to 825 percent.  Mercy Medical and Peace Health University District showed a negative total in the growth of uncompensated care of -12 percent and -57 percent respectively.

Looking at all the hospitals, charity care as a percentage of total uncompensated care steadily increased while bad debt as a percentage of total uncompensated care witnessed a decrease. In 2005, charity care as a percentage of total uncompensated care was 56 percent in 2005 and rose to 66 percent in 2013. Bad debt stood at 44 percent of total uncompensated care in 2005 and fell to 34 percent in 2013.

Large Hospital Systems See Increases

The largest hospitals systems – Legacy Health, Providence Health& Services, PeaceHealth and Samaritan Health Services -- all saw increases in the average percent growth in charity care, bad debt, and total uncompensated care between 2005 and 2013.

Legacy saw their uncompensated care reach $1,499,678,477 during the nine-year period that ended in 2013, and its total uncompensated care percentage witnessed a 234 percent change over that time span – the highest of any of the other large hospital systems, while its charity care percentage average growth was 263 percent and its bad debt, 175 percent.

Providence hospitals, meanwhile, had a total of $1,864,892,803 during the same time span, with a 91 percent change in total uncompensated care, 169 percent in charity care and 69 percent in bad debt. 

PeaceHealth landed in third place, with $708,303,643 in uncompensated care, representing a 113 percent change overall, 230 percent in charity care and 77 percent in bad debt.

Samaritan had the lowest amount of uncompensated care compared the other large hospital systems, with $291,069,575 in uncompensated care, an 84 percent change, and 168 percent in charity care and 40 percent in bad debt.

Total Revenue Factored in 

When The Lund Report looked at the percent of total revenue collected by hospitals in the state, uncompensated care grew by one percentage point, from 11 percent to 12 percent. Charity care, meanwhile, grew by two percentage points, from 6 percent to 8 percent, and bad debt fell by one percentage point, from 5 percent to 4 percent of total revenue.

Four hospitals -- Three Rivers Medical Center, Blue Mountain, St. Charles Redmond, and PeaceHealth – Sacred Heart University District – each saw a 7 percent or greater increase in total uncompensated care as a percent of total revenue growth. And, 13 hospitals had a negative change in total uncompensated care as a percent of total revenue with Mercy Medical, Silverton, and Peace Harbor seeing the largest decreases. The other hospitals that fell into the negative column were Curry General, Coquille Valley, Samaritan North Lincoln, Providence Hood River, Asante Ashland, Samaritan Albany, McKenzie-Willamette, Bay Area, and Pioneer Memorial.

Diane can be reached at [email protected]

Jen can be reached at [email protected]

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1. What are figures for total revenue of the four largest hospitals -- Legacy, PeaceHealth, Providence, and Samaritan, during these years? 2. What are the requirements of the DOJ regarding charity care (which is required, I presume, in order to keep not-for-profit status? 3. What is the fate of the Governor's study of transparency in billing (without which, figures on charitable giving are meaningless), the study by which he headed off the SEIU ballot initiative called Act Now for Oregon? Jim Parker

Jim Thanks for raising such pertinent questions, and we'll definitely look into these issues in the coming weeks. Diane Lund-Muzikant Executive Editor
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