Oregon hospitals lost more than $450 million on day-to-day operations in 2025, even as patients kept filling emergency rooms and inpatient beds. The shortfall is the latest sign that the state’s hospitals are being asked to do more care with a financial model that increasingly does not cover the cost.
The figures, reported Wednesday by KOIN, come from Oregon hospital financial data collected by the state. Becky Hultberg, president and CEO of the Hospital Association of Oregon, said there “isn’t a silver lining” in the numbers.
Hospital expenses climbed far faster than comfort levels
Operating expenses for Oregon hospitals surged 57.5% between 2020 and 2025, according to the analysis cited by KOIN. More than half of health care facilities statewide operated at a loss last year, while about 70% were facing significant financial challenges after their operating margins deteriorated.
The state’s latest quarterly report shows the mechanics behind the squeeze. In the fourth quarter of 2025, Oregon hospitals recorded $5.82 billion in operating expenses—$68.3 million more than their operating revenue—while payroll costs had risen 17% and medical supply expenses 24% since 2023, according to the Oregon Health Authority.
Hospitals are also treating more patients, not fewer. The Hospital Association of Oregon’s financial report said emergency-room visits reached a record 1.52 million in 2024, while inpatient discharges exceeded pre-pandemic levels; the group said the added demand has brought sicker, more complex patients through the system.
Medicaid pressure lands hardest on safety-net care
About 30.4% of Oregonians were enrolled in Medicaid, compared with a national average of 25.9%, according to the KOIN report. That makes reimbursement rates for the Oregon Health Plan especially consequential for hospitals that serve large numbers of low-income patients, particularly in rural and safety-net communities.
As OPB reported, Oregon hospital leaders have blamed a combination of labor costs, supply prices and Medicaid payments that do not cover the full cost of care. The Hospital Association of Oregon has also warned that the state’s regulatory requirements add expenses while making it harder for hospitals to preserve services.
Portland systems are already feeling the financial drag
The statewide problem is not confined to small-town hospitals. OPB previously reported that Providence had lost roughly $100 million on its Oregon operations in each of four years, while Portland-based OHSU and Legacy Health were also struggling with their finances.
That pressure is arriving alongside another potential hit to the Oregon Health Plan. Earlier this month, Hoodline reported that state advisers were weighing 46 possible Medicaid changes after new federal rules threatened to create an estimated $421 million hole in Oregon’s budget.
Hospitals warn the next cuts could reach patients
Oregon hospitals have lost more than $1.25 billion caring for patients since federal CARES Act funding expired in 2021, according to KOIN. The Hospital Association of Oregon says the consequences could include fewer services, reduced capacity, more partnerships between systems and, in the most severe cases, hospital closures.
The Oregon Health Authority maintains annual audited financial records from hospitals and health systems, giving lawmakers and the public a continuing view of the industry’s condition. For patients, the concern is less abstract: sustained losses can eventually show up as longer waits, fewer specialists, delayed appointments and emergency departments with nowhere left to put the next person through the door.
