Workforce shortages and rising expenses have led to financial insecurities at Oregon’s hospitals, and the Oregon Association of Hospitals and Health Systems (OAHHS) has led an effort to try and address those issues this legislative session.
State lawmakers face plenty of adversity themselves as a four-week long walkout—the longest in the Oregon Legislature’s history—has made it difficult for them to pass bills. The Senate last convened on May 2nd as GOP senators are in the midst of a boycott over an abortion and transgender healthcare bill that’s nearing passage (House Bill 2002). The session is scheduled to end on June 25th.
Despite the legislative challenges, some OAHHS-supported initiatives have made progress this session. OAHHS was able to reach a compromise with labor unions in supporting House Bill 2697, which aims to address the state’s healthcare staffing crisis. OAHHS President and CEO Becky Hultberg discusses this bill and other legislative initiatives in this Q&A.
State of Reform: OAHHS proposed a package of bills in the 2023 legislature to help rebuild the healthcare workforce, exempt certain labor costs from the state cost-growth target, and create a task force to explore ways to increase capacity in care settings outside of hospitals. How have these proposals progressed since the legislative session began?
Becky Hultberg: “Through collaboration with our labor partners as part of the hospital staffing package, the proposals have received bipartisan support. The bills have now made their way through various committees in both the House and Senate.
Our goals have remained the same: to support the current workforce and grow a future workforce so we can ensure access to quality care for Oregonians, in the right care setting, both now and in the future. Through current policy changes, investments, and future policy work, we can support frontline workers and our communities, while ensuring we have a strong, stable healthcare system available to take care of people when they need it.”
SOR: After initial disagreement between labor unions and the hospital association over HB 2697, which would implement minimum staffing levels at hospitals, the two sides have reached a compromise in supporting it. If lawmakers follow suit in supporting the bill, and it passes, how would it impact the state’s workforce?
BH: “The hospital association worked in partnership with labor on a package of investments and policy changes that will ensure access to care for patients and support the healthcare workforce in a number of ways.
HB 2697 will give professional, technical, and service workers a stronger, local voice in the creation of staffing plans and establish nurse-to-patient ratios in specified hospital units. It will also reduce many of the administrative burdens hospitals face that overburden workers and do not improve patient care.
Other important parts of the package include measures to help rebuild the healthcare workforce by increasing clinical education capacity and addressing the critical shortage of nurse educators, essential steps in growing the number of nurse graduates in our state.”
SOR: With expenses having outpaced revenues for more than two years, Oregon hospitals are struggling financially. Rising average patient length of stay is also a cause of strain for hospitals. How would expanding the workforce help address these problems?
BH: “Oregon hospitals’ financial performance in 2022 was the worst seen since data collection started in 1993. Nearly two-thirds of Oregon hospitals lost money last year. Hospitals saw expense growth that vastly outpaced revenue growth, and they struggled to find places to discharge patients once they no longer needed to be in the hospital.
On the expense side, labor costs were a key driver of increased expenses, along with pharmaceutical costs and general inflation. When hospitals are unable to discharge patients to the next appropriate place to continue their recoveries, they are often not reimbursed for the care they continue to provide. Rebuilding the workforce will help fix our broken continuum of care for patients and put hospitals on better financial footing moving forward.
These solutions will help with hospital financial challenges, but they will not solve them completely. Hospitals will not be economically viable in the long term if insurance companies and the government aren’t willing to cover the actual cost of care. During the pandemic, we saw insurance profits skyrocket as hospitals and other providers struggled to make ends meet. That has to change if we want to maintain access to health care in Oregon.”
SOR: What are some methods OAHHS has found to be effective in recruiting more workers to the industry?
BH: “Oregon’s hospitals are working hard to recruit and retain more healthcare workers. But hospitals face many of the same hiring challenges as other businesses, including a lack of affordable housing and childcare in their communities, and barriers to education and training.
This legislative session, we’re focused on the latter by supporting a $40 million package of investments that would address a lack of clinical capacity at Oregon’s hospitals and healthcare facilities, and the significant pay difference that exists between bedside nurses and nurse educators.”
This Q&A was edited for clarity and length.