The woes of Oregon\u2019s small rural hospitals have drawn the attention of policymakers, but they\u2019ve actually tended on recent years to report rosier finances overall than the state\u2019s largest hospital systems. It has often been the urban operations, like Legacy Emanuel and Providence Milwaukie medical centers, that have struggled most to meet costs. <\/p>\n
This is one key finding from a report published this week<\/a> on Oregon hospitals and their finances that purports to complicate claims of broad financial fragility within the key sector of the state\u2019s health care system. <\/p>\n Beginning its examination in 2013, the study tracks a relative boom period for hospitals, during which the reported value of their net assets more than doubled. It ends in 2023, when hospital finances were starting to look shakier. <\/p>\n \u201cAs a whole, the systems over the 11 years have done well,\u201d says Art Suchorzewski, who produced the study, referring to the 2013\u20132023 period. \u201cIt\u2019s been more challenging since the pandemic without a doubt.\u201d<\/p>\n A core factor in those more lucrative years was the Affordable Care Act, a major government investment in the health care system that dramatically reduced the proportion of uninsured Oregonians.<\/p>\n With the COVID-19 pandemic and its aftermath, hospital margins started flagging. Still, for certain subgroups like government-designated \u201ccritical access hospitals\u201d\u2014the smaller and more rural outposts that receive better pay for their services\u2014the finances looked notably resilient. <\/p>\n Take 2022, the only year in the report\u2019s time span in which Oregon hospitals, as a whole, reported net margins in the red. Boosted in part by better reimbursement rates that year, the state\u2019s 25 critical access hospitals, by contrast, reported a net margin of 6%.<\/p>\n At the same time, rural hospitals nationwide do face distinct challenges. A study by KFF found that<\/a> rural hospitals in the U.S. in 2023 tended to have lower operating margins than their urban counterparts. <\/p>\n Hospitals are not like any other business. Their economic models are shaped by massive and sometimes fickle government programs, and their finances are notoriously slippery. Thus, researchers have varying modes of analysis. <\/p>\n Notably, the new study comes a year after the Hospital Association of Oregon published its own report<\/a>, headlined \u201cOregon hospitals on the brink.\u201d That report sought to raise a warning about the bleak finances of Oregon hospitals, finding that their financial margins compared quite poorly to those of their peers nationwide. <\/p>\n \u201cOregon hospitals\u2019 aggregate operating margin over time consistently lags the national average,\u201d that industry study said. \u201cThis means that Oregon hospitals have less money to invest in services, make necessary capital improvements, and replace equipment than their peers nationally. Something unique is happening in Oregon that is putting patient services at risk.\u201d<\/p>\n The new study is produced by FamilyCare Health, an Oregon health policy group. (Disclosure: WW\u2019s health care reporting is supported by a grant from the Heatherington Foundation for Innovation and Education in Health Care, which FamilyCare Health established in 2014.) <\/p>\n The FamilyCare study focused on \u201cnet margins,\u201d arguing it\u2019s the most complete annual measure of financial sustainability. (It includes information like investments, for example.)<\/p>\n \u201cCertainly, when the Hospital Association talks about performance, they look at operating [margins],\u201d Suchorzewski says. \u201cBut our goal was to capture the entire picture. And the entire picture is your net.\u201d<\/p>\n Reached for comment, a Hospital Association of Oregon spokesperson referred WW to the \u201cOregon hospitals on the brink\u201d report. <\/p>\n Hospitals\u2019 ability to run robustly\u2014and by extension, everyday people\u2019s ability to access them\u2014are a particularly pressing subject in Oregon, which has some of the lowest hospital beds per capita figures in the nation. <\/p>\n Hospitals have also evolved into major economic forces. They bring billions of federal dollars to Oregon and are foundational institutions of the state\u2019s health care industry, which employs more Oregonians than any other sector.<\/p>\n The study examined Oregon\u2019s hospitals on the state level, and also in terms of individual systems and hospitals. Health systems\u2014like Legacy Health, Providence Oregon, Kaiser Permanente and PeaceHealth\u2014control 73% of net hospital assets statewide, the study says. <\/p>\n The system with the largest net profit margins in the 11-year period, it said, was the Asante Health System, with around 7%. Asante recently drew scrutiny<\/a> when it cited finances as justification to close inpatient services at a Southern Oregon hospital, even though the financial picture it had reported to the state looked relatively positive. <\/p>\n The Providence and Legacy systems, which are major players in the Portland area in particular, reported net margins of about 3% during the 11 years, the study said. <\/p>\n Hospital association representatives would say margins this low do not allow hospitals and hospital systems to reinvest in themselves. (Notably, in the case of Providence in particular, the system\u2014and its financial apparatus\u2014goes well beyond Oregon.)<\/p>\n In any event, few deny that strong financial headwinds have emerged in recent years for Oregon hospitals. Sometimes, the end result is lost access. In 2023, PeaceHealth closed its Sacred Heart Medical Center in Eugene, citing persistent losses. This year, Portland\u2019s lone long-term care hospital completely shuttered.<\/a> Hospitals have shuttered individual units and clinics, too. <\/p>\n FamilyHealth says it intends to update the study in subsequent years. Suchorzewski says he hopes the study can help the public critically assess hospital systems\u2019 financial claims. <\/p>\n","protected":false},"excerpt":{"rendered":"The woes of Oregon\u2019s small rural hospitals have drawn the attention of policymakers, but they\u2019ve actually tended on…\n","protected":false},"author":2,"featured_media":325661,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[134,527,111,139,69],"class_list":{"0":"post-325660","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-new-zealand","11":"tag-newzealand","12":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/325660","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=325660"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/325660\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/325661"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=325660"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=325660"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=325660"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}