Financial Health of Oregon Hospitals

Hospitals are essential community institutions and their finances affect access, affordability, and the future of care across Oregon. This report examines statewide hospital finances from 2013–2023, focusing on two measures that best describe sustainability and financial strength: net income (profit/loss) and net assets (financial position). We emphasize long-term trends using consistent, publicly available data.

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Results are presented by health system, individual facility, and hospital category, using the most reliable public financial sources available. FamilyCare does not own hospitals or healthcare providers and has no financial stake in their performance. Our role is to serve as a neutral, evidence-based resource, informed by decades of work building a better health care system for all Oregonians.

Updated Findings Based on 2024 Data

An update examining 2024 hospital financial data shows that statewide hospital margins in 2024 remained essentially in line with 2023, while also highlighting variation at the individual hospital level, including which hospitals improved, which moved into negative territory, and how 2023 and 2024 results compare across the state.

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Key Insights From Hospital Financial Data Submissions

What this Report Covers

This Hospital Transparency Report provides a statewide view of Oregon hospital finances over time. It is designed to support public understanding and policy evaluation by applying a consistent approach across hospitals and emphasizing long-term trends rather than single-year headlines.

What We Measure

• Net income: We use net income/loss because it is the most complete annual measure of financial sustainability. It reflects both operating results and non-operating income (including items like investment gains/losses), which can meaningfully affect a hospital’s overall financial performance.
• Net assets: We track net assets (assets minus liabilities) as a measure of overall financial position. Net assets capture long-term financial strength, including buildings, equipment, and investments—so they are broader than cash on hand.
• Trends over time: Hospital finances can swing year-to-year due to one-time events or market changes. This report focuses on 2013–2023 patterns to provide a clearer view of direction and durability.

Our Methodology

To prepare the figures in this report, FamilyCare used the most reliable public financial records available and applied a consistent method across all Oregon hospitals. For most nonprofit hospitals, this meant using revenue, expenses, net income, and net assets from IRS Form 990 filings. For hospitals that do not file a Form 990 (such as for-profit hospitals, system-owned hospitals, or health districts we used audited financial statements or FR-3 forms submitted to the Oregon Health Authority and extracted comparable data fields.

Because hospitals operate on different fiscal calendars, we strived to standardize reporting periods to improve comparability and focused on trends over time rather than direct hospital-to-hospital comparisons. We also excluded affiliated charitable foundations (hospital-related 501(c)(3) organizations).

• Primary source: IRS Form 990 filings for Oregon nonprofit hospitals (and Oregon DOJ Charitable Activities records)
• Secondary source: Audited financial statements and FR-3 filings with the Oregon Health Authority
• Standardization: Align fiscal years to a common calendar year where possible (March or April year-ends attributed to the prior calendar year)

To evaluate whether reporting differences materially affect statewide results, we compared Form 990 and FR-3 approaches and found that substituting FR-3 for Form 990s would result in statewide differences of −3% for revenue, −4% for expenses, and +2% for profit in 2023, suggesting statewide conclusions are not materially altered by source choice.

Our Methodology Details

Oregon’s hospital industry demonstrated remarkable resilience and financial growth between 2013 and 2023, despite facing unprecedented challenges such as the COVID-19 pandemic and escalating health care costs. The statewide aggregation of net assets and margins reveals that most hospitals and health systems strengthened their financial positions, with the industry doubling its collective net assets over the decade. Critical access hospitals outperformed the statewide average, underscoring how cost-based reimbursement helps rural hospitals continue delivering services.

However, the data also highlights significant disparities. While most hospitals achieved robust gains, a handful of important facilities experienced persistent financial distress, raising concerns about long-term viability and access to care in certain communities.

Transparency in hospital finances is essential for informed decision-making by policymakers, community stakeholders, and healthcare leaders when access to care is put at risk across Oregon. By providing a comprehensive view of industry trends over 11 years of significant industry change, this report serves as a foundation for future discussions on sustainability, accountability, and the alignment of financial health with community benefit.

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Questions About This Report

FamilyCare Health will update this report as additional hospital financial data become available.