Oregon Gets Good Marks on Medicare Spending

An analysis shows Oregon's average Medicare enrollee expenditure is among the lowest in the nation, thanks to an effective network of home-based health care for seniors.Helping senior citizens remain in their homes is given credit for holding down per enrollee Medicare spending in Oregon.

Oregon's $8,247 per Medicare enrollee average is among the lowest in the nation and far below the $10,365 average expenditure nationwide. Washington's average is slightly higher at $8,497 and Idaho's is lower at $7,880, according to data compiled by the Kaiser Family Foundation.

The Portland Business Journal reported on the findings in its online edition this week, citing a study by the Institute of Medicine that concluded post-hospital services account for most of the variation in Medicare spending. The study pointed to uneven spending on nursing homes, long-term care hospitals, home health care and inpatient rehabilitation as responsible for 73 percent of the variability in average Medicare spending state-by-state.

The PBJ quoted a medical consultant as saying that up until now hospitals have looked for where to send Medicare patients after their release, often without considering the cost or the best interests of the patient.

Oregon has fought hard to maintain a home health care system that is patient friendly and more economical, which is reflected in its Medicare spending average. This approach may be emulated more widely elsewhere as Medicare officials experiment with outcome-based payment methods.

But it will take more than a snap of fingers to create an effective network to support home-based health care for seniors.