[Congressional Record Volume 140, Number 6 (Tuesday, February 1, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]
[Congressional Record: February 1, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]
OREGON'S HOSPITALS ARE AMONG THE MOST EFFICIENT IN THE NATION
Mr. HATFIELD. Mr. President, the Nation has turned its hearts and
minds towards health care reform. President Clinton has rightfully
identified a crisis in our society and it is now up to the policy
makers of our country to provide solutions to this epidemic. In
addition, the Nation's Governors are meeting this week to discuss a
number of important issues including health care reform. One of the
issues highlighted in Sunday's Washington Post was the desire of the
States to retain flexibility in implementing comprehensive reform. As
we focus on national health care reform, a few lessons can be learned
from the State of Oregon.
As my colleagues know, Oregon is one of the States that is out in
front in enacting and implementing health care reform. In fact, today
Oregon's innovative Medicaid expansion goes into effect to bring basic
health care coverage to an additional 120,000 Oregonians. But, Oregon
is progressive in the private sector of health care as well. I was
reminded of this when I met with representatives from the Oregon
Association of Hospitals earlier today. That is why I come before the
Senate now.
In a recent study, HCIA Inc., a firm that analyzes the hospital
industry, examined 5,600 hospitals around the Nation and ranked the 100
best performers. Oregon led the Nation with 11 out of the 100 top
performers--more than any other State. The efficiency rankings of
independently-owned acute care hospitals were based on first,
shortening lengths of stay, second, reducing mortality and morbidity
rates, and third, improving facilities.
In addition to the HCIA report, data collected in 1992 by the
American Hospital association indicates that despite its high
percentage of population over 65: Oregon has the shortest average
length of hospital stay in the nation--5.05 days versus 7.12 days
national average; Oregon ranks among the lowest in hospital inpatient
days in the Nation--502.4/1000 versus 866.6/1000 national average;
Oregon ranks 36th in adjusted expenses per hospital admission--$682
lower than the national average; and Oregon ranks 42d in hospital
expenses per capita--21 percent below the national average.
This phenomenal success can be attributed to the State of Oregon's
local control over health care. Oregon has decided not to regulate the
cost of health care and the hospitals have responded by working hard
with business to cut costs. To put Oregon's experience in perspective--
the data indicates that if the U.S. average hospital expenditures per
capita had been the same as Oregon's in 1992, the Nation would have
saved over $50 billion of its $248 billion in hospital expenditures
that year.
Mr. President, it would be tragedy if national health care reform
would suppress the tremendous reforms that are proceeding at a rapid
pace in Oregon and other States around the Nation. The States need to
be allowed to forge their own reforms to ensure positive change in the
event that the Federal Government fails to act.
There is no doubt that health care reform is needed at the national
level to achieve universal access to health care for all Americans. I
am a strong believer, however, in the flexibility of States to enact
innovative and creative programs to accomplish this and to help the
Federal Government develop its database to enact needed Federal
reforms. I expect to work with my colleagues in the Senate as the
debate on health care reform continues to ensure that the States
maintain flexibility and localized control in health care.
Mr. President, at this time I would like to ask unanimous consent
that a copy of an article from the Oregonian highlighting the HCIA,
Inc. rankings be inserted in the Record following my remarks.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the Oregonian, Jan. 14, 1994]
State Hospitals Top U.S. Efficiency List
(By Vince Kohler)
Oregon's hospitals are the most efficient in the nation,
according to a report released Thursday.
The report ranked 11 hospitals in Oregon--more than any
other state--and five in Washington among the nation's 100
best performers.
The annual report by HCIA Inc. of Baltimore, a firm that
analyzes the hospital industry, is considered among the most
definitive in the health care sector.
The study said that at least $14 billion--and maybe as much
as $28 billion--could be saved if the U.S. hospital system
improved its clinical and financial efficiency. HCIA said
money could be saved in part by emulating the 100 most
efficient hospitals.
Oregon had the most hospitals on the top-100 list, followed
by Wisconsin with nine. California and Michigan tied for
third place, each with eight hospitals. Washington, Ohio
and Indiana were in fourth place, each with five on the
list.
The William M. Mercer Inc. analyst firm processed numbers
for the study, which analyzed 1992 federal Medicare data from
5,600 hospitals nationwide to arrive at the rankings.
Lowell E. Lichtenberg, a principal in Mercer's Portland
office, said hospitals that made the top 100 were notified
Wednesday and Thursday. The list was made public Thursday
morning. It listed the hospitals alphabetically and did not
give specific rankings.
Making the list will be a boost for administrators planning
for national health care reform, likely attracting business
to those institutions classed as the nation's most efficient,
Lichtenberg said.
``One hundred hospitals in 33 states made the list, and 16
percent of them were in Oregon and Washington,'' Lichtenberg
said. ``It's phenomenal, really.''
Lichtenberg said HCIA's study was confined to independently
administered acute-care hospitals.
Publicly funded or controlled hospitals and chain-owned
hospitals under centralized administration were not included.
Specialty hospitals such as children's hospitals and
psychiatric hospitals also were not part of the study.
``Investor-owned hospitals have a different measure of
debt,'' Lichtenberg explained. ``And in states such as New
York, where they regulate hospital spending,'' costs are
``artificially controlled.''
Oregon does not regulate hospital costs.
Washington regulates them to some degree but not to the
extent of New York and a number of other eastern states, he
said.
The 100 hospitals charge their customers significantly less
than average--as much as 21.2 percent less, depending on the
type of hospital.
Mortality was from 9.3 percent to 14.6 percent lower than
average and length of patient stay was from 10.6 percent to
26 percent shorter than average, according to the report.
The top 100 hospitals also are relatively profitable, the
report said.
Keys to efficiency included: Shortening length of stay;
reducing mortality and morbidity rates; improving facilities.
Oregon hospitals have taken steps such as these, as the
state's big health care networks jockey for business by
cutting costs.
``I guess we won a contest we didn't know we were in,''
said James E. May, president and chief executive officer of
Legacy Portland Hospitals, which owns Good Samaritan Hospital
& Medical Center, one of the listed hospitals.
``We have worked real hard over the last three to four
years on the cost side of the equation. . . . I'm pleased to
see that our efforts are paying off.''
Larry Dodds, president and chief executive officer of
Portland Adventist Medical Center, said the staff of the 302-
bed hospital had worked for years to cut costs while keeping
up the quality of medical care.
``I think that Oregon has led the nation in terms of
managed care, attention to costs,'' he said.
``As a state, we rank among the lowest for cost of medical
care,'' Dodds said.
The report broke the 5,600 hospitals studied into groups,
including academic medical centers, other teaching hospitals
with more than 250 beds, nonteaching hospitals with more than
250 beds, urban hospitals with fewer than 250 beds and rural
hospitals with fewer than 250 beds.
It then analyzed Medicare cost reports and patient
discharge data, adjusting for severity of illness and
geographic differences.
These Northwest hospitals are among the 100 most efficient
in America.
oregon
Good Samaritan Hospital & Medical Center, Portland; Good
Samaritan Hospital, Corvallis; Grande Ronde Hospital, La
Grande; Josephine Memorial Hospital, Grants Pass; Lebanon
Community Hospital; Portland Adventist Medical Center;
Providence Medical Center, Portland; Sacred Heart General
Hospital, Eugene; St. Charles Medical Center, Bend; St.
Vincent Hospital and Medical Center, Portland; Willamette
Falls Hospital, Oregon City.
washington
Washington hospitals on the list were: Deaconess Medical
Center, Spokane; General Hospital Medical Center, Everett;
St. John's Medical Center, Longview; St. Mary Medical Center,
Walla Walla; University of Washington Medical Center,
Seattle.
Idaho
Madison Memorial Hospital in Rexburg, Idaho.
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