Community Benefit Policy Pledge

In March 2015, OAHHS announced a new, voluntary community benefit policy pledge. The two-part policy pledge demonstrates hospitals' commitment to the communities they serve at a time when the Affordable Care Act is changing the health care landscape in Oregon.

The first part of the initiative provides free care for families who are not Medicaid eligible and whose income is below 200% of the federal poverty level. This program will help ensure that even as Medicaid expands, those who do not qualify and are unable to attain insurance will receive the hospital care they need. It is estimated that 87,000 Oregonians fall into this category, and providing them with free hospital care builds on the success of Medicaid expansion, which covers people below 139% of the federal poverty level.

The second part of the initiative involves hospitals keeping overall community benefit spending at or above levels from prior years. During a time when charity care – free care for patients who do not have the ability to pay—is dropping statewide as a result of record numbers of Oregonians obtaining insurance coverage through Affordable Care Act, hospitals have committed to maintain their 2015 community benefit spending based on an average of prior years, as reported to the Oregon Health Authority. This commitment will allow hospitals to reinvest those dollars in other community benefit activities which support local health needs, in addition to fulfilling their charitable obligations to their communities as tax-exempt organizations.

Media Coverage of Community Benefit


Our View: Like it or not, this sounds like progress

by Coos Bay World editorial board

We wonder if opponents to the Affordable Care Act — Obamacare — saw this one coming.

This week in Salem, Andy Davidson, the president of the Oregon Association of Hospitals and Health Systems, told The Associated Press that hospitals in the state are spending far less on uncompensated charity care since more Oregonians signed up for health insurance — Obamacare.

"The ACA has been so successful, and the uptick happened so quickly that charity care has really dropped significantly," Davidson said.

The result, Davidson added, is that hospitals around the state will continue to spend the amount of money they used to spend on charity care to fund other public services like research, health screenings and education.

According to the Oregon Health Authority, hospitals spent more than $400 million on charity care in 2013. All but two of Oregon’s hospitals are nonprofit enterprises, and those nonprofits are required to benefit the community to retain tax-exempt status.

Simply put: Fewer Oregonians needing charity; more funding for community health needs.

Despite all the continuing debate about the ACA and the constant drumbeat from Republicans who continually promise they will kill the bill, this news sounds like a benefit, doesn’t it?

Some of us may remember, others not, that the same debate surrounded the birth of Medicare, which turns 50 this year.

While most Americans have come to see Medicare as a given, existence of a national health care program was never assured. Through the 20th century, conservative opposition branded such medical programs as socialism and said any form of national health care would create a Soviet-style model. Even the Communist Party of America opposed a proposed health care bill in the 1930s.

Conceived during the Cold War era, Medicare was under attack even by the American Medical Association, which viewed the measure as an attack on personal freedom. AMA president, Dr. Morris Fishbein, warned the public against "peasant medicine" and "medical Soviets." Ronald Reagan cut a record for the AMA played for their “ladies auxiliaries” (doctors’ wives) in homes across America warning that the program would lead to the destruction of freedom.

Such fuss over a program that many Americans now feel is their birthright.

Makes one wonder how Americans will feel about Obamacare in 50 years.

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Oregon hospitals seeing fewer uninsured patients

KOIN 6 News

Oregon hospitals say they won’t reduce their spending on services that benefit the community, even though they’re seeing far fewer uninsured patients.

An Oregon hospital industry group said Tuesday its members will provide free care to anyone who earns less than double federal poverty level and is not on Medicaid. The group also said that total spending on so-called “community benefit” services will remain at historical levels.

Community benefit programs included services such as charity care, research, health screenings and medical education.

Hospitals are seeing a big drop in their spending on charity care since the federal health care overhaul gave insurance to hundreds of thousands of people who didn’t previously have it.

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Oregon hospitals vow community spending

by Medford Mail Tribune staff

Oregon hospitals say they won't reduce their spending on services that benefit the community, even though they're seeing far fewer uninsured patients.

An Oregon hospital industry group said Tuesday its members will provide free care to anyone who earns less than double the federal poverty level and is not on Medicaid. The group also said that total spending on so-called "community benefit" services will remain at historical levels. 

Community benefit programs included services such as charity care, research, health screenings and medical education. Hospitals are seeing a big drop in their spending on charity care since the federal overhaul gave insurance to hundreds of thousands of people who didn't previously have it.

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Group urges Oregon hospitals to provide free care

by Tara Bannow, Bend Bulletin

Thousands of Oregonians make more than the roughly $16,200 annual threshold to qualify for Medicaid, the federal health care program for low-income individuals. But that doesn’t mean they don’t have trouble making ends meet.

“What we know all too well is that amount of money doesn’t go very far,” said Andy Davidson, president and CEO of the Oregon Association of Hospitals and Health Systems.

To help fill the gap, Davidson’s organization is asking its 62 member hospitals to provide free care to all patients with incomes less than 200 percent of the federal poverty level, about $23,500 annually for an individual.

Here in Central Oregon, St. Charles Health System already provides free care for patients whose incomes are at or below 250 percent of the federal poverty level, or about $29,400 for an individual, so long as the care is deemed medically necessary.

“It’s part of how we do business, so I don’t see this as really a change except a formal commitment to honor that,” said Jennifer Welander, St. Charles’ chief financial officer.

Medicaid, known here as the Oregon Health Plan, expanded in 2014 to cover individuals up to 138 percent of the federal poverty level in states that agreed to the expansion. The OAHHS estimates 87,000 Oregonians fall in the gap between qualifying for the Medicaid expansion and the 200 percent threshold.

St. Charles provides varying levels of financial assistance to patients up to 400 percent of the federal poverty level, or $47,080 a year for an individual.

In recent years, Oregon hospitals have spent less money on so-called charity care, which is care provided to patients who can’t pay their bills. In the first quarter of 2010, 4.4 percent of median patient revenue across hospitals was spent on charity care. Over the same time in 2014, that dropped to 2.3 percent, according to Oregon Health Authority data.

At St. Charles, the proportion of patient revenue spent on charity care is less than the state average. At the Bend hospital, it was 1.3 percent in the first quarter of 2014, compared with 2.3 percent statewide. The proportion of charity care has decreased, too. In 2010, St. Charles Bend spent 4.4 percent of net patient revenue on charity care.

After the implementation of the Affordable Care Act, St. Charles’ charity care allocations have increasingly gone to covering a portion of the cost of providing care to Oregon Health Plan, or Medicaid, beneficiaries, Welander said. Government programs such as Medicaid and Medicare do not cover the full cost of providing care, so hospitals accept a loss when they treat those patients.

“I would say we’re no different from other hospitals,” Welander said of the decline in charity care.

Many of the doctors and specialists who provide care at St. Charles are not employees of the health system, but rather see patients there on a contract basis. In those situations, such as in the Bend emergency room, patients who have had their bill forgiven by St. Charles can still expect to receive bills from individual providers, Welander said.

The new OAHHS initiative also calls upon participating hospitals to ensure spending on community benefit programs, a broad array of health care services provided without the expectation of payment, remains at the same levels this year as their averages over the past three years.

Community benefit programs include charity care, health education, health screenings, research, health professional education and community-building activities.

Hospitals submit their estimated spending on community benefit programs to the Oregon Health Authority. St. Charles Bend’s was 32.3 percent of patient revenue in 2013, compared with the statewide average of 20.9 percent, and up from its community benefit spending of 26.5 percent in 2012.

So far, 93 percent of OAHHS members have agreed to provide free care to patients up to 200 percent of the federal poverty level, and another 82.5 percent have agreed to keep community benefit spending in line with previous years.

Davidson said he’s not aware of any other state that has voluntarily implemented a program that promises to treat low-income patients.

“This is a very unique approach that we believe leads the rest of the country in terms of really grabbing the mantle and taking the lead and doing this, rather than being forced into it or required to do it through state or federal legislation,” he said. “It’s really about trying to do the right thing by our patients and our communities.”

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Oregon Hospitals to Provide Free Care to Families in Need Through New Policy Package

by Kirsten Nicolaisen, GoLocalPDX.com

On Tuesday, The Oregon Association of Hospitals and Health Systems (OAHHS) announced a new 'community benefit' policy package, that will provide free care for families in need and keep charity spending levels equal to years prior.
The two-part package aims to demonstrates hospitals' commitment to the communities they serve at a time when the Affordable Care Act is changing the health care landscape in Oregon, according to OAHHS. 

The first initiative will provide free care for families who are not Medicaid eligible, and whose income is below 200 percent of the federal poverty level. Approximately 87,000 Oregonians fall into this category, and providing them with free hospital care builds on the success of Medicaid expansion, which covers people below 139 percent of the federal poverty level, according to OAHHS. 

The second initiative involves hospitals keeping overall community benefit spending at or above levels from prior years. In Oregon, "community benefit" is defined as health care-related services that nonprofit hospitals provide without the expectation of compensation. While free care for patients who cannot pay is dropping statewide as a result of record numbers of Oregonians obtaining insurance through the Affordable Care Act, the Oregon Association of Hospitals has committed to keep community benefit spending levels equal to years past. This will allow hospitals to reinvest those dollars in other community benefit activities, according to OAHHS. 

"Oregon's hospitals are leading the way by enacting a set of initiatives voluntarily that seek to close the coverage gap for the shrinking percentage of uninsured and underinsured, while maintaining their significant investments in their communities and in the people they serve 24/7/365," said Andy Davidson, President and CEO of OAHHS. "Hospital and health system leaders in Oregon are proud to play such a vital role at this pivotal time in our state's health care transformation." 

In 2013 Oregon hospitals provided more than $1.9 billion in community benefit contributions to their communities, while providing care for 336,153 inpatients, more than 9.9 million outpatients, and more than 1.2 million emergency room visits, according to OAHHS. 

More information about Oregon's community benefit reporting program can be found online at MyOregonHospital.org.

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Oregon hospitals to maintain community benefit spending

by Jonathan J. Cooper, Associated Press
(this story was reprinted in the Eugene Register-Guard and the Salem Statesman Journal)

Oregon hospitals won't reduce spending on services that benefit the community, even though the facilities are spending far less on uncompensated charity care because more people are insured, an industry group said Tuesday.

The need for charity care has dropped precipitously since President Barack Obama's health care overhaul — the Affordable Care Act, or ACA — took effect. Only 5 percent of state residents remain uninsured, compared to 14 percent before the ACA.

"The ACA has been so successful, and the uptick happened so quickly that charity care has really dropped significantly," said Andy Davidson, president of the Oregon Association of Hospitals and Health Systems.

The association said Oregon hospitals will provide free care to low-income patients who are not on Medicaid.

Out-of-pocket costs will be paid for patients earning up to 200 percent of the federal poverty level, or $48,500 for a family of four, it said. That includes people who have low-cost insurance plans with high deductibles and copays, Davidson said.

The group said its total spending on community benefit services — which includes charity care, research, health screenings and medical education — will remain at historical levels.

All but two of Oregon's hospitals are nonprofit organizations, requiring them to benefit the community to retain their tax-exempt status. Charity care has historically been a significant portion of their community benefit portfolio.

If charity care spending drops, the hospitals will make up for it with more spending on other public services, the group said.

In 2013, hospitals collectively spent $405 million on charity care, about 4.5 percent of total revenue, according to data from the Oregon Health Authority.

Compliance is voluntary for individual hospitals, but Davidson said the guidelines were thoroughly debated internally and he anticipates nearly all of Oregon's 58 hospitals will participate.

Sen. Alan Bates, D-Medford, and Rep. Mitch Greenlick, D-Portland, welcomed the announcement. Both are influential on health policy issues.

"If they don't do these things, then of course we start questioning why they're tax-exempt," Bates said. "I think they're doing the right thing. I appreciate it and I applaud them for it."

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Oregon hospitals agree community benefit spending won't drop

by KGW News

Oregon hospitals say they won't reduce their spending on services that benefit the community, even though they're seeing far fewer uninsured patients.

An Oregon hospital industry group said Tuesday its members will provide free care to anyone who earns less than double federal poverty level and is not on Medicaid. The group also said that total spending on so-called "community benefit" services will remain at historical levels.

Community benefit programs included services such as charity care, research, health screenings and medical education.

Hospitals are seeing a big drop in their spending on charity care since the federal health care overhaul gave insurance to hundreds of thousands of people who didn't previously have it.

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Media Contact Info

Philip Schmidt
Associate Vice President for Public Affairs
Direct: (503) 479-6020
pschmidt@oahhs.org

Andy Van Pelt
Executive Vice President
Direct: (503) 479-6018
avanpelt@oahhs.org