Post-pandemic, our work is far from over

Perspective on Oregon Health Care

by Becky Hultberg

It’s hard to believe this month marks four years since the World Health Organization declared the COVID-19 outbreak a pandemic. I remember the day when it felt like the world changed.  

I had been in my new role as president and CEO of the hospital association for two short months when the Oregon Health Authority announced the state’s first presumptive case of COVID-19 on Feb. 28, 2020. Hospitals responded, serving as anchors in their communities, providing trusted information, and taking care of patients in challenging and previously unimaginable circumstances.  

The day-to-day world inside a hospital is never quite “routine,” but compared to the height of the pandemic, the work is back to a more recognizable rhythm.  

But while the pandemic is behind us, it ushered in a new normal for hospitals that makes me concerned for the future of health care access in Oregon. An urgent health care workforce shortage is prompting some hospitals to shutter or reduce services. Patients are staying in hospitals longer, in part because hospitals are still struggling to find them spots in places like skilled nursing or behavioral health facilities. And labor and supply costs continue to rise dramatically, while what hospitals are getting paid to care for patients has not kept pace.  

New Apprise Health Insights data released this week shows hospitals posted a sobering –1.3% median operating margin in 2023, the second consecutive year that hospitals as a group lost money. Without federal CARES Act funds propping up hospitals in 2020 and 2021, last year would have marked the fourth straight year hospitals experienced significant financial losses providing care.  

Oregonians depend on hospitals to be there when they need them most, but year after year of tough financial conditions have made it increasingly difficult for hospitals to maintain some services in their communities. If we want strong, stable hospitals that provide access to care, we must tackle the underlying issues causing financial instability for hospitals. This includes addressing how hospitals are supported for the care they provide, especially for the most vulnerable in our state. 

With the 2024 legislative session behind us, we’re reflecting on the progress we’ve made — and the work we still need to do. As the collective voice for our state’s 61 hospitals, the hospital association continues to work at advancing policies that address hospitals’ current and long-term needs to sustain a health care system generation of Oregonians can rely on.  

Ensuring that every Oregonian can access high-quality care is going to take all of us working together to help our hospitals withstand today’s challenges and prepare for the future. Together, as a community and with the support of policymakers, our state leaders and other groups, we’re committed to advocating for policy reforms that help put hospitals back on stable footing.