Oregon Public Broadcasting

Oregon is well known for providing high-quality health care for a relatively low cost, compared with other states. But even here, there are variations in the cost and quality of care.

There's no single reliable way to measure those differences in the state. One benchmark, though, is Medicare spending - since seniors interact with the health care system frequently.

Today, we bring you the stories of two counties: one with slightly higher Medicare reimbursement rates than the other.

OPB's Kristian Foden-Vencil went to Hood River , among the low cost areas in the state by this one measure, but first let’s start with April Baer, in Lane County, on the higher end.

Kim Kelly knew about Oregon's excellent reputation when she and her husband moved here from Texas.  Kelly’s a pretty savvy consumer, since she works as a broker of long-term care insurance plans.

Kim Kelly: “When you’re aging, you want to know you’ve got the health care.”

And she was especially impressed with how elderly patients were treated.

Kim Kelly  “I’ll never forget we were in Reedsport, and we drove up to a bluff overlooking the ocean, and it was cold, it was February, and there were elderly people who’d been brought from a nursing home or assisted living, and they were all bundled up and they were sitting out overlooking the ocean. And that imagine in my mind, I was just like, (laughs) WOW this never happens in Texas!”

Kelly lives in Eugene, where some Medicare programs are reimbursed at an monthly average rate of $836 per patient.

The community is served by two major hospital groups: McKenzie-Willamette, and PeaceHealth.  PeaceHealth operates four hospitals in Lane County, along with some smaller facilities. And keeping its focus on quality care is not an easy task, says CEO Mel Pyne.

His company has chosen to do this by changing to a more collaborative culture, one specialty at a time.

Mel Pyne   “You know, you have the ambulatory care, which is primarily in an outpatient setting, and that’s where most care is delivered, but then you get into an acute care setting, into the hospital setting, then you need to organize that around centers of excellence.”

Pyne says  that by changing its culture slowly, the hospital has avoided the worst excesses of hospital systems that that try to do too much. Another key strategy: figuring out when to transport patients to other hospitals that have the expertise to treat them. 

PeaceHealth  opened a relatively new hospital in Springfield, River Bend, one year ago.

Its construction budget burgeoned to nearly $550 million -- seven times pricier than Eugene’s designer federal courthouse. Its private rooms overlooking the Willamette River would be the envy of some local hoteliers.

The native wood fixtures of the graceful lobby recall the Timberline Lodge, and a volunteer serenades incoming patients on a baby grand.

One spending choice PeaceHealth made was putting serious money into IT, a move hospital officials say will save money in the long run. River Bend has more computer terminals in more useful places for staff, patient and staff tracking systems.

PeaceHealth director of Quality Steve Gordon says they’re not just bells and whistles.

Steve Gordon “You’re anurse, and you’re with a patient in the room, and particularly in and you need help, So what are your choices, you can leave the patient, you can signal for help, but if you havethe technology you’re much more likely to be able to get that help faster without leaving the bedside."

But what kind of patients will the beautiful surroundings and high tech equipment attract? Under the current system, no hospital can survive without  bringing in patients that are fully insured.

Hospital officials say RiverBend has treated more patients than expected in its  first year. About 36 percent of those coming through the emergency room were uninsured.

This story was produced with help form OPB’s PublicInsight Network. To learn more – or to share your experiences, go to opb.org/public insight .