Oregon hospitals are struggling financially, and need more resources in order to provide healthcare services for those in need.
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Stakeholders discussed hospital conditions during a Senate Interim Committee on Health Care meeting on Thursday. Oregon Health Authority (OHA) CFO Dave Baden said OHA receives financial reports from 60 general acute care hospitals around the state.
“The operating expenses are increasing pretty dramatically and revenues are not enough to make up [for it],” Baden said.
In 2021, the state’s total operating revenue for hospitals was $15.96 billion, total operating expenses were $15.66 billion, and the net patient revenue was $14.92 billion.
Becky Hultberg, President and CEO of the Oregon Association of Hospitals and Health Systems (OAHHS), referenced data from the Oregon Hospital Utilization & Financial Analysis for the second quarter of 2022.
“It shows us an astonishing 65% of hospitals lost money, their median operating margin of -4.7% was a historical low, and expenses continue to outpace revenue,” Hultberg said. “In the first six months of the year, the cumulative loss was about $215 million in operating losses.”
A nationwide labor shortage, patient discharge delays, and rising expenses are some of the main reasons hospitals are struggling, Hultberg said.
“We are at a point where incremental change may not address our underlying problems,” she said. “So our goal over the next few years must be to stabilize the system while we search for long-term solutions. There’s not one solution that is going to fix all of these problems.”
Hultberg said there were 353 patients boarding in emergency departments, 481 patients waiting to be discharged, and only seven pediatric ICU beds available in the state. She discussed the conditions at Curry General Hospital in Gold Beach, an 18-bed critical access hospital that stabilizes sick patients, then transfers them to another hospital for a higher level of care.
“Because hospital beds are filling up across the state, the wait times to transfer patients have grown really long,” Hultberg said. “Last week, one cardiac patient waited 54 hours before being sent to a hospital that could provide a higher level of care. Another patient waited 36 hours. Every minute a hospital holds a patient needing a transfer really matters.”
OAHHS will be requesting support for several initiatives during the upcoming legislative session, Hultberg said.
“In the coming months, you’re going to hear a lot about nurse staffing,” she said. “Our association is in strong support of repealing the current nurse staffing law to allow for the kind of flexibility that our hospitals are going to need so they can meet the critical demand for patient care.”
OAHHS plans to ask the state to fully fund the Disproportionate Share Hospitals program, which requires that states make Medicaid payment adjustments for hospitals that serve a disproportionate share of low-income patients with special needs. OAHHS will also ask lawmakers to fully fund Oregon Health & Science University’s Graduate Medical Education program, Hultberg said.
“OAHSS is going to be proposing a package of bills to address workforce development retention, to protect access to quality care, and to stabilize the healthcare system,” she said. “We believe we must make long-term investments in cultivating the workforce we need to grow that pipeline so there are enough skilled healthcare workers for hospitals to hire to meet their immediate needs so they don’t have to rely on travel nurses.
This includes offering clinical training sessions, expanding the healthcare provider incentive program to include registered nurses and licensed practical nurses, and extending tax credits to nurse educators.”
Protecting access to care could also mean paying hospitals a per diem rate or fixed amount to help cover the costs of caring for patients whose discharge is delayed for many days, Hultberg said.
“Because long-term care facilities are experiencing workforce shortages as well, hospitals are finding it difficult to discharge patients to the appropriate place for their care,” she said. “And hospitals are generally not getting paid for patients who are awaiting discharge.”