Legacy Health Integration

Gradient color block with OHSU plus Legacy

Expanding care, accelerating impact

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Oregon Health & Science University and Legacy Health have announced their intention to integrate under OHSU Health. They will create a comprehensive, expanded health system that will offer high-quality, essential health care services to patients throughout Oregon, Southwest Washington and beyond.

OHSU and Legacy’s complementary expertise will create a high-impact health care system driven by a mission of public service.

  • OHSU brings experience serving complex patient needs, administering statewide health care training and education programs, and conducting leading-edge research.
  • Legacy brings deep roots in providing high-quality, community-based care through its comprehensive system of hospitals, primary and specialty clinics, and outpatient facilities.

What’s next?

Updated May 2024

In the coming months, OHSU and Legacy Health will file regulatory documents for the expanded health system to be reviewed to ensure compliance with all relevant laws. Both organizations will also begin the extensive work to ensure successful integration once approval has been given.

While a lot of work will happen behind the scenes to prepare for the systems to integrate, there will not be an immediate impact to how patients receive care or how employees do their work. OHSU and Legacy Health will provide regular updates as the systems work through the process, answering questions to minimize any confusion.

Read current questions and answers.

Health Care Market Oversight Program

One step in receiving approval for the integration is review through the State of Oregon’s Health Care Market Oversight program.

This program, established by House Bill 2362 (2021), “reviews proposed business deals to make sure they will help and not hurt Oregon's shared goals of health equity, lower consumer costs, increased access and better care. The program applies to mergers, acquisitions, and other business deals that involve health care entities and meet certain criteria.”

OHSU and Legacy Health anticipate filing with HCMO this summer. All public filings related to this process will be shared here and on the Oregon Health Authority’s website.

How to stay updated

OHSU looks forward to hearing from you and sharing more in the coming weeks and months.

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Questions and answers

OHSU is facing financial challenges. How can you afford to do this?

OHSU has built up its capital capacity over the past 15 years in order to be able to borrow the funds to make such a large, generational acquisition/investment.

The commitment we’re making under the definitive agreement is a 10-year capital commitment. This means that the funds will be used on buildings, technology and equipment and represent an investment that will further support our health system’s growth and ability to serve patients. We intend to borrow most of that money over time through bonds.

Investments in capital are financed differently from the way we pay people; we can’t borrow to pay wages. In the long run, we believe that by serving the people of Oregon better, we’ll be in a stronger position and better able to support our people.

What will integration planning look like? Who will be involved?

After the HCMO application is filed, the state regulatory review process will begin.

During that time, leaders of both organizations will continue to work with their members to ensure a smooth transition and effective planning for operational integration, pending regulatory approval.

After that point, we will set up a leadership integration structure. More information will be provided in the coming weeks.

When will you file the application with the Health Care Market Oversight program?

How long will the regulatory review process take?

We anticipate OHSU and Legacy Health will submit an application this summer to the State of Oregon’s Healthcare Marketplace Oversight, or HCMO, Program.

While the process can be as short as 180 days, we anticipate a transaction of this size will require significant review. We hope to complete the transaction by spring of 2025. The HCMO review is a complex regulatory process and is difficult to predict.

Are there any immediate impacts to patients and employees?

While a lot of work will happen behind the scenes to prepare for the systems to integrate, there will not be an immediate impact to how patients receive care or how employees do their work. OHSU and Legacy Health will provide regular updates as the systems work through the process, answering questions to minimize any confusion.

In the Letter of Intent, there was a reference to a community focused foundation. Do you have any updates on this?

Following the completion of the transaction, a Legacy community foundation independent of OHSU will receive funds equal to Legacy Health's cash less its debt and a negotiated withhold, for making grants in support of health, health care and health equity in our communities.

Both OHSU and Legacy have fundraising foundations, what will happen to those?

OHSU and Legacy foundations will continue to fundraise in support of the combined system’s missions of patient care, education and research and hold funds entrusted to them by donors and will honor donor intent with respect to those gifts.

How will clinical research programs be merged?

That is something we’ll be looking at in the transition plan – how those programs can come together and can best be managed.

How will this impact OHSU’s education programs?

The integrated system will support expanded clinical placement options for students, residents and fellows through Legacy’s clinical sites, delivering critical training and research resources to enhance Oregon and Southwest Washington’s health care workforce.

Both organizations bring complementary expertise that will support the next generation of health care professionals as we create a pathway for research and education for future scientists, advanced practice providers, nurses, physicians and health care professionals.

Who will lead the combined organization?

Our integrated system will be governed under a unified governance structure (the OHSU Board which is appointed by the Governor of Oregon), with management of each division reporting to a single Health System Chief Executive Officer. The CEO will be appointed by OHSU’s president.

Over the coming months, a dedicated team including leaders from both Legacy and OHSU will establish a Transition and Integration Management Office (“TIMO”) to design our integration plans. We will share more information about leadership structure as appropriate.

Will there be any facility closures as the systems combine?

Will there be any cuts to the services, care or programs you provide?

Legacy’s broad footprint of hospitals and care facilities will remain essential to the long-term success of the integrated health system.

OHSU has committed to maintaining all physician positions and there will be no changes to our physician structure or patient arrangements.

Over the coming months, a dedicated team comprising leaders from both Legacy and OHSU will be established at closing, all Legacy facilities, sites and services will remain intact as direct or indirect subsidiaries of OHSU.