OHCA Spring Summer 2017

13 / 28

Spring/Summer 2017 The Oregon Caregiver 15
PUBLIC POLICY
rates keep pace with the rising labor costs,
particularly in home and community based
care. The state and federal government
is the largest payer of long-term care
services. This is what economists call a
“monopsony,” when there is a dominant
payer in the market (in contrast to a
monopoly when there is a dominant seller).
OHCA has historically advocated for
cost of living adjustments to Medicaid
rates to keep pace with inflation. This
session we are asking legislators for a 5%
per year increase due to the rising labor
costs. This increase could be a particularly
hard sell this session with the state of
Oregon facing a $1.6 billion budget gap
this biennium and projected budget
issues for the next several years due to
unsustainable state workforce costs from
steadily rising wages, health care and
pension costs, and mandates for spending
from the voters and federal government.
If Medicaid rates fail to keep pace with
the rising costs of providing care, we will
lose this opportunity to raise wages for
caregivers without increasing employee
turnover rates and diluting the earnings
of workers above minimum wage. We
also risk providers opting out of serving
Medicaid beneficiaries as the differential
between private pay and Medicaid rates
further widens, and we could even
lose smaller providers serving mostly
Medicaid residents as their costs simply
outstrip reimbursement rates. Losing
providers in the mostly rural parts of
the state could eliminate long-term care
options in these communities.
With these issues in mind, OHCA will
continue to urge Oregon lawmakers to
be mindful that achieving the goals we
all share of providing higher wages for
our hardworking caregivers and a more
stable, qualified workforce serving our
seniors, includes a financial commitment
from the state to keep care affordable. 
Phil Bentley, J.D., is the Senior VP for Government Relations
at OHCA.