The success of the Affordable Care Act has had an enormous impact on hospitals' charity care expenditures across the state. This anticipated outcome is also why Congress cut $155 billion from planned Medicare expenditures over 10 years to help pay for the ACA. At the same time, we must also acknowledge that Oregon hospitals' net operating margins have gone in the other direction. While we don't believe that these improved margins will hold over the next few years, the decrease in charity care and the increase in net income make hospitals a potential target for lawmakers on a variety of fronts.
As a result, in February 2015, the OAHHS Board of Trustees approved a Community Benefit Policy Package, comprised of two policies chosen from a slate of five. The full slate was developed over the course of a year by the Community Benefit Task Force, with significant member input. The voluntary policy package applies to all nonprofit hospitals. The board-adopted policy provisions recommended for implementation at all Oregon hospitals are as follows:
- A floor of 200% of the federal poverty level for free care.
- Hospitals commit to maintain or increase current community benefit levels in aggregate (relative to multi-year average).
Although not every hospital has been able to implement each of these policies to-date, a large majority of Oregon's hospitals and health systems have done so. To this end, the Association's Board believes that telling our story around your community benefit commitments and programs is of utmost importance given current political realities.
Other policy provisions that were not adopted as part of the board action, but are now advised as beneficial are:
- Oregon hospitals will achieve 21 days for patient notification of financial assistance determination.
- Maximum collection limit of 20% of a family's annual household income.
- Hospitals' community benefit to meet or exceed their estimated property tax liability.
Additional Materials - FOR INTERNAL HOSPITAL USE
Below you will find tools and resources to help tell your hospital's story around community benefit as part of this broader statewide rollout.