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 November 2024

OHSU and Legacy Health have filed for regulatory review of the integrated, full-service public university health system to ensure compliance with all relevant laws.  

Work is underway to ensure successful integration once regulatory approval has been given. More information on the integration work will be available soon.  

While a lot is happening 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. 

Health Care Market Oversight Program

On Sept. 26, 2024, OHSU filed a notice of material change transaction application with the Oregon Health Authority’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 look forward to the process ahead as work continues to become one integrated public university health system. The state’s oversight is one of the most rigorous and robust in the nation and requires entities to file for approval at least 180 days prior to closing to allow time for a thorough review. OHSU and Legacy Health hope to complete the transaction by spring 2025.  

On Nov. 4, the Oregon Health Authority issued a Preliminary Review Report formally advancing OHSU’s proposal for an integrated public university health system to Comprehensive Review. OHSU and Legacy Health appreciate the Oregon Health Authority’s timely review during the preliminary phase of the review and look forward to a robust and thorough Comprehensive Review including a Community Review Board. OHA confirmed receipt of a complete Notice of Material Change Transaction on Oct. 4.

The Oregon Health Authority issued the Preliminary Review Report based on information included in OHSU’s Notice of Material Change Transaction for the integration with Legacy Health. OHSU looks forward to responding to requests for information from the Oregon Health Authority during the Comprehensive Review phase to demonstrate the significant health access, equity, quality, and cost benefits for people in Oregon. 

OHSU continues to robustly engage in good faith with the HCMO program. On Nov. 21, OHSU responded to a request for supplemental information from OHA as part of the comprehensive review. OHSU responded within the 15-day window OHA requested. OHSU is making the questions and responses available to the public.

In response to OHA's request for other documents and sensitive business records, OHSU provided about 47,000 pages for OHA to review in full as part of its HCMO review. All redacted information shared with the public has been submitted unredacted to OHA.

OHSU and Legacy continue to be committed to a transparent Health Care Market Oversight review process. OHSU will continue to post information about the review process, including responses to any requests for information from the Oregon Health Authority, to this webpage so that everyone can stay informed about the review process during the 180-day review. 

All public filings related to this process will be shared here and are also available on Oregon Health Authority’s website. 

As Oregon’s public academic health center, we will ensure everyone can access information about the OHSU integration of Legacy Health. OHSU provides help for people to access information in different formats. If you would like translation or format help, or have questions, comments or feedback, OHSU is here to help. Please contact, HCMO@OHSU.edu.  

Communications received by OHSU may be subject to public disclosure under Oregon public records law. 

OHSU and Legacy news

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.