The problem in public numbers

What the numbers show

Analysis. A regional hospital can be important to its community while its finances change from year to year. The question is whether the payment system supports the services the region needs over time. Answering that question requires clear definitions. A loss, a payment shortfall and a shortage of cash are different findings. They need different records.

Public record. Oregon's audited hospital financial dataset reports a fiscal 2025 operating margin of minus 10.42 percent for Bay Area Hospital, minus 3.34 percent for Sky Lakes Medical Center and plus 1.06 percent for Mercy Medical Center. Operating margin measures the relationship between operating income and operating revenue. It covers the hospital's operations as reported; it does not measure Medicaid alone. Bay Area and Mercy's reporting years end in June, while Sky Lakes' ends in September. Source: OHA audited financial data, FY 2025 hospital rows.

Public record. The three hospitals together reported approximately $945.1 million in net patient revenue for those fiscal years. Net patient revenue is a measure of patient-care revenue after the adjustments reflected in the reporting system. It is not the amount left after paying wages, supplies, buildings and other operating expenses. A large revenue number can therefore coexist with an operating loss.

Eleven years of audited operating margins

Public record. The same audited dataset shows each hospital's operating margin, in percent, for fiscal years 2015 through 2025. Values are rounded to one decimal place. Each hospital's fiscal year ends on the date shown; the figures are whole-hospital results, not Medicaid-only results.

• Bay Area Hospital (fiscal years ending June 30): 2015, 6.6; 2016, 4.4; 2017, 6.2; 2018, 5.4; 2019, 3.5; 2020, 0.1; 2021, −4.6; 2022, −33.2; 2023, −15.8; 2024, −2.8; 2025, −10.4.
• Mercy Medical Center (fiscal years ending June 30): 2015, 12.6; 2016, 13.3; 2017, 10.5; 2018, 7.8; 2019, 2.5; 2020, 9.5; 2021, 5.2; 2022, 7.5; 2023, 2.8; 2024, 5.6; 2025, 1.1.
• Sky Lakes Medical Center (fiscal years ending September 30): 2015, 9.5; 2016, 8.6; 2017, 3.3; 2018, 4.7; 2019, 4.2; 2020, 3.9; 2021, 1.6; 2022, 1.2; 2023, −0.9; 2024, 0.6; 2025, −3.3.

Analysis. A single year can mislead in either direction. The series shows the direction of each hospital's reported results without explaining their causes, which can include payment, volume, staffing, one-time items and accounting choices.

Why different reports can look different

Public record. OHA also publishes a monthly financial and utilization dataset, often called Databank. This is a different reporting product from audited financial statements. Using all twelve months of calendar 2025, a calculation from that public dataset finds negative operating margins at 30 of 59 hospital reporting entities. The unweighted median hospital margin is minus 0.45 percent. In this calendar-year series, all three hospitals described here had negative operating results. Mercy's positive audited fiscal-year result covers a different period and reporting basis. Source: OHA Hospital Reporting Program, financial and utilization workbook, October 19, 2026 release.

Analysis. These comparisons should never be blended into a single unlabeled trend. A statewide group includes hospitals with different sizes, services and payment rules. A national rural-hospital comparison may include small critical access hospitals that receive different payment treatment. A useful comparison identifies the year, the hospitals included, the definition of margin and whether emergency pandemic funding was included.

Coverage connects the hospital to the community

Public record. The Oregon Health Plan includes Medicaid coverage and other coverage pathways. The following counts are OHA's OHP physical-health enrollment measure, not a Medicaid-only population. OHA's September 2026 county data support rounded counts of about 24,700 members in Coos County, 43,900 in Douglas County and 29,800 in Klamath County. These figures describe enrolled county residents at the monthly snapshot. They do not count hospital admissions. Small cells in the public source are suppressed, and recent months can be revised. Source: OHA enrollment report, About and county worksheets.

Analysis. If residents lose coverage, hospitals may receive less payment for care that still must be delivered. The size of that effect depends on who loses coverage, what care they need, what other coverage they obtain and how hospitals are paid. Applying a statewide projected percentage to a county would be a sensitivity calculation, not a county forecast. This site does not present it as a known loss of patients or revenue.

What a payment proposal must establish

Analysis. A payment proposal needs more than a headline amount. It must identify the services covered, the payment hospitals receive today, the proposed benchmark, the lawful source of new nonfederal money and the treatment of existing supplements. A dollar of gross new payment may not be a dollar of net benefit if another payment is reduced or a hospital must contribute more toward financing.

Public record. Federal matching rates depend on the eligible expenditure. Oregon's regular federal Medicaid match for federal fiscal 2027 is 58.18 percent; qualifying expansion expenditures have a 90 percent match. Those rates help calculate financing after the spending category is identified. They do not establish whether a particular new payment is allowable. Sources: FY 2027 FMAP notice, Oregon row; 42 USC 1396d(y).

Analysis. The aim is to sustain regional care with a clear explanation of both the need and the limits of the evidence. These hospitals can be the lifeblood of their regions without having identical balance sheets. “Too big to be small, too rural to be big” describes the question the project is examining. It is not a substitute for the financial work needed to answer it.

Five questions

1. Are all three hospitals losing money? Two had negative audited fiscal 2025 operating margins; all three had negative calendar 2025 operating results in Databank. The dates and reporting bases differ.
2. Does a negative operating margin prove closure is imminent? No. Cash, debt terms, system support, capital needs and future operations also matter.
3. Does the dataset measure Medicaid losses? No. The audited operating margin is hospital-wide. Payer-specific costs and reconciled receipts are needed for a Medicaid shortfall.
4. Can the state coverage-loss estimate be multiplied by county enrollment? Only as a labeled hypothetical sensitivity, with explicit assumptions, never as an official county forecast.
5. Has the project calculated each hospital's gain? Not yet. The current payment baseline, lawful financing and treatment of overlapping supplements remain necessary inputs.

Public sources

• OHA audited hospital financial data
• OHA hospital reporting (Databank)
• OHA enrollment reports
• FY 2027 federal matching notice
• Federal expansion match statute, 42 USC 1396d(y)

Evidence date and scope

Circulation draft. Resource evidence date: November 7, 2026. Public facts link to their original public sources; analysis, project positions and open questions are labeled. A reference to a hospital or other organization describes public information and does not mean that it has joined this project or endorsed its proposals.