OAHHS Hospital Voice Fall/Winter 2019

18 » A magazine for and about Oregon Community Hospitals. short time. At first, we saw less bad debt and charity care because our hospitals had more people coming through the doors with insurance. But this uptick in financial benefit quickly began to erode. Consumption of services increased, so that meant you had to hire more people, you had to buy more technology, you had to increase capacity, and those all come with higher associated costs. Coupled with commercial health plan design changes that result in huge “first dollar” responsibility for patients, we are seeing huge variations in financial stability again, much like we did pre-ACA. So, the great news is that hundreds of thousands of Oregonians now have insurance as the result of the ACA, but many of these same individuals cannot afford their willing part of a solution to bring health care coverage to people that wouldn’t otherwise have it. Now, if you look at what’s transpired over the last 14 years, the hospital provider tax revenue alone has grown from about $180 million in a biennium to more than $1.2 billion. Then when you think about the federal money that draws down, it’s remarkable. We are leveraging something north of $3.5 billion for the Oregon Health Plan. This is a testament to the willingness of hospital leaders to do the right thing. How did the passage of the ACA effect this equation? The ACA was incredible for a state that believes in an expanded Medicaid program. Governor John Kitzhaber was critical in obtaining $2 billion in a one-time funding from the federal government which ultimately allowed Oregon to initiate the CCO system while also stabilizing the overall program funding as we transformed to a new payment model. The ACA was wonderful for the people of this state, and it was wonderful for Oregon’s hospital finances, for a It’s been a terrific learning experience for me to watch our rural members sort out how their missions align with the changing healthcare payment models. They have been bold!