2011 Hospital Financial Profiles
The 2011 Community Hospital Profile report—the third edition—is a demonstration of the ongoing commitment of the OAHHS Board of Trustees to increase public access to essential health care information. Inside this report you will find a comprehensive picture of the activity and trends Oregon’s community hospitals have experienced over the past five years.
We’ve included utilization data (types and number of patient visits, lengths of stay and occupancy rates) as well as financial trends (revenue, charity care, and margins) for each of Oregon’s 58 community hospitals. We think you will find the numbers informative, encouraging, and in some cases concerning, as we continue to operate through a turbulent economy.
Oregon’s hospital financial picture has rebounded slightly from 2008 when the recession was first felt in our state, however in 2010 we have actually seen our statewide operating margin decrease from 2009. We are at a statewide margin of 4.19% vs. 4.29%, and fifty-two percent of Oregon’s hospitals have operating margins less than three percent. Two contributing factors: the continued rise in uncompensated care (charity care and bad debt), which reached $1.2 billion in 2010 (up six-fold, or over $1 billion since 2000)and the increase in the number of Medicare and Medicaid patients seen, which as you know pay hospitals less than their actual costs for care they provide. This population now makes up more than 55% of Oregon’s patient population. There has been a decrease year over year in the commercial market.
Of even greater concern is the condition of Oregon’s small rural hospitals that have less than 50 beds. These 32 hospitals saw their operating margins drop from 3.21% in 2009 to 2.28% in 2010. Moreover, 13 (41%) of these rural hospitals had negative operating margins in 2010, and 8 of the 13 actually had losses of more than 5%. These are the most vulnerable institutions in the economic crisis now being faced by Oregon’s hospital community.
Looking ahead doesn't seem much better for community hospitals in our state. There is a lot of uncertainty around health system transformation and the state funds available to pay for such a massive overhaul. Additionally, the historic state budget cuts to the Oregon Health Plan through 2013, joined with the loss of federal matching dollars will have a significant impact on access to health care for what is now a majority of the state's patient population.
As we deal with a changing payer demographic, and overhaul of the delivery system, and 2014 being the trigger point for federal reform to enable more than 160,000 Oregonians into the Medicaid system, the fear is we don’t have the resources in place now or in the foreseeable future to meet this demand. While increased access to health care services is a cornerstone of our work and the mission of our state’s hospitals, doing so during such a challenging time for our state and country could produce unintended consequences for everyone.
We believe that Oregon’s community hospitals are a critical asset to our state and its citizens both individually and collectively. The changes in health delivery we are talking about are a first for many. As we start to design implement health care reform efforts, having a strong and stable hospital infrastructure will be essential in meeting the current and future health needs of all Oregonians.
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