HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

May 06, 2003 Hearing Room 50

3:15 PM Tapes107 - 108

 

MEMBERS PRESENT:††††††††††† Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

 

MEMBERS EXCUSED:††††††††††† Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

 

GUEST MEMBERS:†† ††††††††††† Rep. Mitch Greenlick

††††††††††††††††††††††† ††††††††††† ††††††††††† Rep. Laurie Monnes Anderson

 

STAFF PRESENT:††††† ††††††††††† Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD: Informational Meeting

††††††††††††††††††††††††††††††††††††††††††††††† OHP reimbursement policies:

†††††††††††††††††††††††††††††††††††††††††††† ††††††††Quantifying the cost to other purchasers

Kevin Earls, Oregon Association of Hospitals and Health Systems

 

These minutes are in compliance with Senate and House Rules.Only text enclosed in quotation marks reports a speakerís exact words.For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 107, A

003

Chair Westlund

Calls the meeting to order and opens the information meeting.

INFORMATIONAL MEETING

025

Kevin Earls

Oregon Association of Hospitals and Health Systems, presents testimony and begins presentation. (EXHIBIT A)

134

Rep. Greenlick

Asks in terms of your sense of the hydraulic effect, does it really matter that this 3rd category is really a lot more complex than that.

144

Earls

Comments from a policy level it is best to look at it at the 30,000 ft. level and elaborates and continues presentation.

290

Rep. Kruse

Asks if A and Bís are suppose to be true cost reimbursement, why arenít they.

293

Earls

Comments about A and B Hospitals.

301

Rep. Greenlick

Asks question on the out-patient expenses jump in two years from 59 million to 89 million.

319

Earls

Comments that the result of what happened was migration and continues.

339

Rep. Greenlick

Makes comments about that the hospital costs went up 30 % in two years, that just seems like a lot.

360

Earls

Gives an explanation of why the cost were so high, and continues presentation.

365

Rep. Greenlick

In the large hospitals the cost went up roughly thirty percent in those two years.

375

Earls

Comments that hospitals received a pretty significant bump in their component of the Managed Care rate during that time period, comments that he canít break it down at this point.Continues presentation.

418

Rep. Greenlick

That means the cost on the fee for service side went up sixty million.

422

Earls

The number you are looking at is utilization driven we are not talking about an increase in the rate, we are talking about an increase in expenditures.

430

Rep. Greenlick

That is a sixty percent increase in expenditures for the Medicaid fee for service hospital costs in a two year period.

437

Earls

That is a dramatic increase in utilization, but qualified it by saying when you are a hospital and you are being paid seventy one percent of your costs on units of service your working hard to try to limit utilization and lengths of says in order to manage your loses.Continues presentation.

476

Rep. Bates

Asks if the Medicaid allowable any where close to your true costs.

478

Earls

It is close, but it is lower.

TAPE 108, A

029

Rep. Bates

Asks if he would put that at ninety or ninety five percent of the cost, what is close.

032

Earls

Comment he has no idea and makes a guess that it is two percent, but it will vary from facility to facility.

036

Rep. Bates

Asks if he has any idea what has driven the costs so high for hospitals and plus utilization.

047

Earls

Comments about the point he is trying to make and state that it has to be utilization.

063

Chair Westlund

State what he thinks Kevin is trying to show.

070

Earls

Continues presentation

101

Berkobien

Asks did you break out long term care and acute care.

105

Earls

It is what is recorded and is not sure, comments about how HICVA reports it.

125

Rep. Monnes Anderson

When we are talking about costs and other states you say they pay higher, asks are you comparing the actual costs that it takes, are we comparing apples to apples.

140

Earls

Agrees and comments that it does not take in account cost of living and elaborates.

155

Chair Westlund

Makes comments about what other states are spending on long term care verses Oregon.

172

Earls

Will find out the answer to that question.

175

Rep. Greenlick

Asks if we rank about the same with Medicare spending as well.

180

Earls

Answers and continues presentation.

185

Rep. Bates

Made comments about reimbursing providers.

190

Earls

Responds yes that is right.

193

Rep. Greenlick

Comments that Medicare is not an issue of control it is an issue of our utilization patterns because the expenditure estimates are the same and its just that we use less care per enrollee in Medicare than other states use.

211

Rep. Bates

Disagrees and comments why.

217

Rep. Greenlick

Comments that you are talking about the Managed Care component of AAPC, but that is based on the fee for service utilization and explains.

223

Rep. Bates

Would argue that that was inappropriate at that time and still thinks it is inappropriate.

229

Earls

Adds to the conversation.

232

Rep. Greenlick

States that the fact is historically, that we have used hospital rates as you know twenty to twenty five percent on the average, because we chose to, not because the Government told us to.

275

Earls

Makes comments and continues presentation.

330

Chair Westlund

Comments that the slide leaves the uninsured out of the conversation.

336

Earls

Responds yes.

338

Rep. Merkley

Comments that he missed what the conversion is that we are discussing.

360

Earls

Answers and makes a couple comments in closing.

415

Chair Westlund

Makes his closing comments calls meeting to a close and adjourns 4:25 pm

 

 

EXHIBIT SUMMARY

 

A Ė Informational, prepared testimony, Kevin Earls, 3 pp