Legacy Health

Legacy provides administrative services for the System in the areas of general administration, finance, legal services, human resources, information management, patient billing, quality and patient safety, and marketing and also oversees and supports health education and community wellness programs throughout the System's service area. Legacy is the sole corporate member of six nonprofit corporations: Legacy Emanuel Hospital & Health Center (LEHHC), Legacy Good Samaritan Hospital and Medical Center (LGSHMC), Legacy Meridian Park Hospital (LMPH), Legacy Mount Hood Medical Center (LMHMC), Legacy Salmon Creek Hospital(LSCH), Silverton Health (SH) and Legacy Visiting Nurse Association (LVNA). While there is investment in a variety of community-based activities and programs as a part of its non-profit status, an overwhelming majority of Legacy community benefit comes in the form of providing uncompensated care. Legacy's policy of providing care regardless of the ability to pay makes it one of the region's largest providers of uncompensated care in the four-county metropolitan area. Legacy, collectively provided over $46 million, $327 million, $273 million, and $12 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2023. In addition, Legacy provided over $29 million in other community benefit activities during fiscal year 2023.In support of its mission, Legacy voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. The criteria for charity care is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for services provided. Specifically, Legacy provides an uninsured discount of 35% to patients. Additional discounts, on a sliding scale, are available to patients whose household income is less than 400% of the federal poverty level. For patients whose household income is at or below 300% of the federal poverty level, a full subsidy is available. In addition to the household income criteria, the patients' qualified assets (e.g., 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility for charity care.During 2023, Legacy provided charity care on 51,545 patient accounts, representing 5,071 inpatient accounts, and 46,474 outpatient accounts. In 2023, 12% of the patients receiving charity care received a full subsidy representing roughly 21% of the total charity provided. The top five services provided to patients qualifying for charity care were emergency/trauma, surgery, cardiovascular, pediatrics, and general acute care.In addition to charity care, Legacy provides services under various states' Medicaid programs for low-income patients, to Medicare beneficiaries, and to beneficiaries under other government programs(such as Tricare). The cost of providing services to these beneficiaries generally exceeds the reimbursement from these programs.Legacy also employs financial counselors and social workers, who assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, and public assistance programs such as Medicaid. This program assists many patients in obtaining coverage through a third party, reducing the patients' financial responsibility.

As the health needs of communities surrounding our hospitals are frequently changing, Legacy continues to identify investments for underserved populations. Legacy collaborates with other health delivery systems and community-based organizations to improve the health of the community. One example of a collaboration addressing Access to Care, is Project Access Now (PANOW). PANOW provides innovative, integrated support for patients and healthcare providers across the tri-county region. Through shared investments, the monthly cost of premiums and out-of-pocket expenses are covered for patients who cannot afford to make those payments on their own. Additionally, PANOW connects uninsured and low-income individuals with donated primary and specialty care. Recognizing that health professions are lacking in diversity, Legacy established the Health Occupation Profession and Education program (HOPE, formerly Youth Employment in Summer). Each year between 5-15 students of ethnically diverse communities have access to paid summer employment in departments where they work with health professionals. Students are paid between $15-18 per hour and may work up to 400 hours over the summer. HOPE students also receive college scholarships between $3,000 and $10,000 annually. Students remain in the program if they remain in school and pursue health careers. Some students remain in the program as long as seven years and graduate with a range of degrees from imaging technician to Bachelor of Science in nursing to medical doctor. Most students are the first in their family to go to college. Legacy encourages and supports employee volunteerism. Legacy donates $100 to nonprofit health, human service or education organizations in honor of employees who volunteer on personal time 50 hours a year. Employees may receive paid time when volunteering in one or two week time periods in local nonprofit organizations through Legacy's community service leave program.Non-cash donations of resources include clinical and non-clinical services and items (e.g., screenings and support services, internships, information and referral services and health fairs). Legacy's warehouse is available to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space and other infrastructure services are made available to local nonprofits for a variety of uses.In FY23 Legacy Health contributed system-wide over $689M in community benefit across all reportable categories, including financial assistance. Of the $689M total community benefit, $913K was allocated through strategic investments and grant making to community-based organizations to address access to health care, chronic conditions, and health equity.