Summer Fall 2017

10 » A magazine for and about Oregon Community Hospitals. HOSPITALS STEP UP Amid uncertainty, hospitals step up during legislative session Coming into the 2017 Legislative Session in Salem, hospitals knew there was tough work ahead. Oregon faced a large budget shortfall and just came off a very bitter, partisan election cycle which saw over $25 million spent fighting over the gross receipts tax ballot measure. Hospitals began work to help solve that difficult budget problem collabor- atively to ensure coverage for the more than one million Orego- nians who depend onMedicaid. They also wanted to help resolve many other health care policy issues relating which come up in the typical legislative session. And indeed, there was a legisla- tive focus on hospitals’ community benefit commitment and a new effort to address health care costs. Throughout, hospitals worked collaboratively with legislators and stakeholders in order to be solution-oriented on shared policy goals. The budget gap Early on, the budget gap was expected to be the key focus as lawmakers worked to balance the budget. Of the projected $1.4 billion shortfall, over $900 million of it was directly related to funding for the state’s Medicaid program, also known as the Oregon Health Plan. The decreasing amount of federal sup- port was the key driver of the revenue shortfall. Knowing the importance of the Oregon Health Plan to over one million Ore- gonians and our state’s health care system, hospitals began working to find solutions to the problem well before lawmak- ers even arrived in Salem. The plan they coalesced around involved working towards fund- ing solutions that ensured no changes to enrollment or eligibil- ity for our state’s Medicaid recipients. This hospital-led fund- ing plan was presented to the Governor and lawmakers in the early days of the legislative session, and unfortunately was not accepted whole cloth. Instead, legislative leadership presented a plan, that the OAHHS Board of Trustees reluctantly supported, that extended the hospital tax to rural hospitals, eliminated the Hospital Transformation Performance Program, raised the tax on the largest hospitals including. It also found fund- ing through a premium tax on commercial insurers along with certain cost savings from the Coordinate Care Organizations. This plan provided the state two years in which to consider addi- tional solutions to sustainably fund the Medicaid program and to ensure we do not move backward as a state in our commit- ment to health care for Oregon’s most vulnerable. Focus on hospitals’ charitable commitment As the health care landscape shifted in the wake of the Afford- able Care Act and the resulting increased health insurance cov- erage, hospitals wanted to redefine and increase accountability on their community benefit commitments to their communi- ties. Oregon hospitals have already pledged to maintain their historic levels of community benefit, but felt it was important to proactively make changes via legislation. Hospitals proposed an evolution of community benefit spending and transparency requirements that would ensure clarity and accountability to their communities related to property tax exemptions. Unfor- tunately, politics, stakeholders, and legislative timelines pre- vented this effort and hospitals were not successful. Nothing is more important to a hospital than the health of the commu- nity it serves—and community benefit activities are a key com- ponent of addressing health issues. A new effort to address health care costs As health care costs rise nationally and in Oregon, our hospi- tals are looking to partner with organizations in the health care community, policymakers, and experts to look at ways our state could address the issue. There is a need for a comprehen- sive solution, to ensure the quality patient care and access that Oregonians expect and deserve. Of the many bills this legisla- tive session addressing this issue, the one hospitals supported, SB 419 , was the only one that did so in a responsible, thoughtful manner. SB 419 was amended and signed into law with hospi- tal support. It will set up a taskforce of various stakeholders in this debate to study the issue and come back to the legislature in 2019 with recommendations on how to address the cost con- tainment in a comprehensive and thoughtful way. The road ahead In the legislative session, hospitals were among the key groups working to solve pressing issues. Their commitment to quality, affordable care and a healthy Oregon, led them to work across traditional lines and find good compromises. There are many problems to be addressed ahead, but Oregon’s hospitals will continue to be the proactive, patient-centered voices of reason that they’ve been for decades.  H