Oregon hospitals fight legislation allowing lower-cost stays at ambulatory care centers

Several states have adopted rules allowing patients to recover from outpatient surgery in “extended stay” centers, but most Oregon hospitals don’t like the idea. They are fighting legislation that would allow for up to 16 pilot projects.

House Bill 2664 would allow as many as 16 ambulatory surgery centers in Oregon to increase the maximum stay for patients from 24 hours to 52 hours after arthroscopy, having a broken bone set or other outpatient procedures. It is modeled after a Colorado law.

Providence Health & Services is the only hospital system on record in “strong support” of the bill. Other supporters include the Oregon Ambulatory Surgery Center Association, the Oregon Association of Orthopaedic Surgeons and the Oregon Medical Association. These groups say giving patients more time to recover in an outpatient surgical facility dramatically lowers costs, cuts infection rates and leads to better patient satisfaction. For example, a fact sheet provided to Oregon state lawmakers, cites the cost of a knee or hip replacement: $23,000 if the patient spends up to 52 hours post-surgery in an outpatient surgical center  vs. $46,000 to $80,000 for in-patient, hospital care.

The Oregon Legislature began discussing extended stays at ambulatory care centers at least four years ago. Lawmakers convened a work group to study the concept in 2015. A 2016 bill was debated but not passed. This year House Bill 2664 took a detour to the Ways & Means Committee after the Oregon Hospital Association and hospital CEOs testified that it needs more study.

House Health Committee Chairman Mitch Greenlick, D-Portland, questioned whether opponents were using stall tactics to keep the bill from ever passing.

“This is frustrating to us,” Greenlick said during a March committee meeting.

The fate of House Bill 2664 may be decided on Friday, April 14, during a scheduled Ways & Means Committee work session.

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