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Oregon 350 Winter St Department of Consumer and Business Services Workers’ Compensation Division Oregon 350 Winter St. NE John A. Kitzhaber, MD, Governor P.O. Box 14480 Salem, OR 97309-0405 1-800-452-0288, 503-947-7810 www.wcd.oregon.gov BULLETIN NO. 290 (Revised) March 7, 2013 TO: Workers’ compensation insurers and Oregon hospitals SUBJECT: Hospital fee schedule — adjusted cost/charge ratios for Oregon hospitals This bulletin provides updated adjusted cost/charge ratios. Apply these ratios to hospital inpatient and outpatient services according to ORS 656.248 and OAR 436-009-0020. This bulletin replaces Bulletin 290 issued Sept. 19, 2012. The following are adjusted cost/charge ratios for the Oregon hospitals: Adjusted Adjusted Adjusted Adjusted cost/charge cost/charge cost/charge cost/charge Hospital name ratio ratio ratio ratio 4/1/13 – Notes 10/1/12 – Notes 4/1/12 - Notes 10/1/11 - Notes 9/30/2013 3/31/2013 9/30/2012 3/31/2012 Adventist Medical Center *Adventist Health System/West 0.405 0.411 0.452 0.456 Formerly Portland Adventist Ashland Community Healthcare 1.000 1 1.000 1 1.000 1 0.544 Services Bay Area Hospital 0.445 0.470 0.470 0.463 *Bay Area Health District Blue Mountain Hospital District 1.000 1 1.000 1 1.000 1 1.000 1 (CAH) Columbia Memorial Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 Coquille Valley Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 Cottage Grove Community Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *PeaceHealth Curry General Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Curry Health District Good Samaritan Regional Medical Center *Samaritan Health Services, Inc. 0.554 0.557 0.544 0.547 Formerly Good Samaritan Regional Hospital Corvallis Good Shepherd Medical Center (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Good Shepherd Health Care System Grande Ronde Hospital, Inc. (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 Harney District Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 Kaiser Sunnyside 0.494 0.501 0.490 0.496 *Kaiser Foundation Hospitals Bulletin 290 Page 2 Adjusted Adjusted Adjusted Adjusted cost/charge cost/charge cost/charge cost/charge Hospital name ratio ratio ratio ratio 4/1/13 – Notes 10/1/12 – Notes 4/1/12 - Notes 10/1/11 - Notes 9/30/2013 3/31/2013 9/30/2012 3/31/2012 Lake District Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Lake Health District Legacy Emanuel Hospital and Health Center 0.537 0.535 0.535 0.542 *Legacy Health System Formerly Emanuel Hospital Legacy Good Samaritan Hospital and Medical Center 0.458 0.471 0.471 0.478 *Legacy Health System Formerly Good Samaritan Portland Legacy Meridian Park Hospital *Legacy Health System 0.422 0.422 0.422 0.445 Formerly Meridian Park Legacy Mount Hood Medical Center *Legacy Health System 0.408 0.405 0.405 0.422 Formerly Mt. Hood Medical Center Lower Umpqua Hospital District 1.000 1 1.000 1 1.000 1 1.000 1 (CAH) McKenzie-Willamette Medical Center 0.333 0.334 0.344 0.344 Formerly McKenzie-Willamette Hospital Mercy Medical Center, Inc. 0.327 0.339 0.339 0.349 Mid Columbia Medical Center 0.524 0.527 0.520 0.522 Mountain View Hospital District 1.000 1 1.000 1 1.000 1 1.000 1 (CAH) Oregon Health Sciences University 0.519 0.507 0.507 0.528 Peace Harbor Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *PeaceHealth Pioneer Memorial Hospital – Heppner (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Morrow County Health District Pioneer Memorial Hospital – 1.000 1 1.000 1 1.000 1 1.000 1 Prineville (CAH) Providence Hood River Memorial Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 * Providence Health System – Oregon Formerly Hood River Memorial Providence Medford Medical Center 0.390 0.395 0.396 0.400 *Providence Health System – Oregon Providence Milwaukie Hospital 0.499 0.505 0.496 0.500 * Providence Health System – Oregon Providence Newberg Hospital 0.506 0.518 0.488 0.493 * Providence Health System – Oregon Providence Portland Medical Center 0.497 0.503 0.476 0.480 * Providence Health System – Oregon Providence Seaside Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 * Providence Health System – Oregon Bulletin 290 Page 3 Adjusted Adjusted Adjusted Adjusted cost/charge cost/charge cost/charge cost/charge Hospital name ratio ratio ratio ratio 4/1/13 – Notes 10/1/12 – Notes 4/1/12 - Notes 10/1/11 - Notes 9/30/2013 3/31/2013 9/30/2012 3/31/2012 Providence St. Vincent Hospital and Medical Center 0.486 0.494 0.477 0.485 * Providence Health System – Oregon Formerly St. Vincent Hospital Providence Willamette Falls Hospital * Providence Health System – Oregon 0.566 0.567 0.527 0.529 Formerly Willamette Falls Hospital Rogue Valley Medical Center & Medford Clinic PC 0.415 0.419 0.431 0.434 *Asante Health System Sacred Heart Medical Center at Riverbend 0.517 0.538 0.538 0.563 *PeaceHealth Sacred Heart Medical Center, University District 0.517 0.538 0.538 0.563 *PeaceHealth Salem Hospital 0.526 0.535 0.558 0.564 Samaritan Albany General Hospital *Samaritan Health Services, Inc. 0.586 0.594 0.583 0.588 Formerly Albany General Hospital Samaritan Lebanon Community Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Samaritan Health Services, Inc. Formerly Lebanon Community Hospital Samaritan North Lincoln (CAH) *Samaritan Health Services, Inc. 1.000 1 1.000 1 1.000 1 1.000 1 Formerly North Lincoln Hospital Samaritan Pacific Communities Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 * Samaritan Health Services, Inc. Santiam Memorial Hospital 0.544 0.553 0.578 0.584 Silverton Hospital 0.539 0.544 0.534 0.537 Sky Lakes Medical Center Formerly Merle West Medical Center, 0.434 0.439 0.470 0.474 Inc. Southern Coos Health District (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 St. Alphonsus Medical Center – Baker City (CAH) * Trinity Health 1.000 1 1.000 1 1.000 1 1.000 1 Formerly St. Elizabeth Health Services, Inc. St. Alphonsus Medical Center – Ontario 0.510 0.478 0.478 0.454 * Trinity Health Formerly Holy Rosary Medical Center St. Anthony Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Catholic Health Initiatives Bulletin 290 Page 4 Adjusted Adjusted Adjusted Adjusted cost/charge cost/charge cost/charge cost/charge Hospital name ratio ratio ratio ratio 4/1/13 – Notes 10/1/12 – Notes 4/1/12 - Notes 10/1/11 - Notes 9/30/2013 3/31/2013 9/30/2012 3/31/2012 St. Charles Medical Center – Bend *Cascade Healthcare Community, Inc. 0.495 0.502 0.512 0.518 Formerly St. Charles Medical Center St. Charles Medical Center – Redmond *Cascade Healthcare Community, Inc. 1.000 1 1.000 1 1.000 1 1.000 1 Formerly Central Oregon Community Hospital Three Rivers Community Hospital and Health Center 0.363 0.366 0.398 0.401 *Asante Health System Tillamook County General Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Adventist Health System/West Tuality Community Hospital 0.462 0.466 0.474 0.476 *Tuality Healthcare, Inc. Wallowa Memorial Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 *Wallowa County Health Care District West Valley Hospital (CAH) 1.000 1 1.000 1 1.000 1 1.000 1 Formerly Valley Community Hospital Willamette Valley Medical Center, 0.262 0.269 0.275 0.280 Inc. * Corporate name (CAH) Critical Access Hospital ¹ This is a rural hospital excluded from the adjusted cost/charge ratio as defined in OAR 436-009-0020. If you have questions about how the adjusted cost/charge ratios are calculated, contact the Information Technology and Research Section at 503-947-7975. If you have questions about how to apply the adjusted cost/charge ratios, contact the Medical Resolution Team at 503-947-7606. /s/ John L. Shilts John L. Shilts, Administrator Workers’ Compensation Division Distribution: WCD-OH, LY, E-mail lists .
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