Community Benefit is “a program or activity that provides treatment or promotes health and healing, addresses health disparities or addresses the social determinants of health in response to an identified community need." (Oregon Revised Statute 442.601).
Community benefit is comprised of unreimbursed care, such as charity care and Medicaid losses; and proactive, direct spending on services, such as supporting community health improvement projects or donating money or equipment to community groups. Annually, roughly 80% of all community benefit spending is on unreimbursed care.
The Oregon Hospital Community Benefit Dashboard is updated annually and accompanies the
Oregon Hospital Community Benefit Data Brief. The newest dashboard update and data brief include data through 2023.
DashboardDefinitions and TerminologyRead the Data Profile
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The Dashboard
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Definitions and Terminology
DRG Hospitals DRG hospitals are typically large, urban hospitals that receive payments based on the Diagnosis-Related Group system. Oregon's DRG hospitals are heavily concentrated in major population centers on the Interstate 5 corridor. DRG hospitals frequently serve as both local hospitals and regional medical centers and often participate in research.
Type A HospitalsType A hospitals are small (fewer than 50 beds) and are located more than 30 miles away from another hospital. Oregon's Type A hospitals are mostly located in eastern Oregon and largely serve small agricultural communities. Type A hospitals play a critical role in providing core health care services to communities that are often far from one another and far from other health care facilities.
Type B HospitalsType B hospitals are small (fewer than 50 beds) and are located less than 30 miles away from another hospital. Oregon's Type B hospitals are primarily located in the agricultural communities of the Willamette Valley, central Oregon, and along the coast. Type B hospitals tend to work as regional hubs, serving multiple small to medium sized communities.
Total Community Benefit
The sum of all community benefit categories listed in this dashboard. Community benefits are reported as costs, however not all community benefit categories are directly reportable expenses. For example, charity care cannot be considered an expense for accounting purposes.
Social Determinants of Health (SDOH)
The social, economic, and environmental conditions in which people are born, grow, work, live and age. These conditions are impacted by the distribution of money, power, and resources (at local, national and global levels), institutional bias, discrimination, and racism, along with other unlisted factors.
Cost-to-charge ratio (CCR)
The CCR describes, on average, how much expense the hospital incurs for every dollar it charges. It is the ratio of operating expenses to total charges. The closer the CCR is to 1, the smaller the difference between what the hospital charges and what it costs the hospital to provide services.
Unreimbursed Cost of Care
The sum of all unreimbursed cost of care expenses, including unreimbursed Medicaid, charity care, subsidized health services, and other public programs:
- Unreimbursed Medicaid
An estimate of costs that are not reimbursed to the hospital for providing Medicaid services. A hospital may have unreimbursed costs when the amount received for providing a service is less than expenses the hospital incurred, or because Medicaid denied payment to the hospital. In most cases, these costs are estimated using a cost-to-charge ratio.
- Charity Care
Costs of services provided to people who qualify for charity care based on the hospital's published policies. Like unreimbursed costs from public payers, charity care costs are most commonly estimated using a cost-to-charge ratio.
- Subsidized Health Services
Expenses incurred from hospital clinical services that are provided at a financial loss because they meet an identified community need and for which it is reasonable to conclude that if the service was no longer offered, it would not be available from another source in the community or the service would then become the responsibility of the government or other tax-exempt organization. Examples are 24-hour emergency departments at rural hospitals and home health services.
- Other Public Programs
Costs incurred supporting other public programs such as CHAMPUS, TRICARE, Veterans Health Administration, Indian Health Service and other federal, state, or local programs. These programs exclude Medicare and Medicaid. Any offsetting revenue must be deducted from cost calculations.
Direct Spending
The sum of all direct spending, including research, health professional education, community building, community benefit operations, community health improvement, and cash and in-kind contributions:
- Health Professions Education
Expenses incurred providing educational programs that result in a degree, certificate, or other training necessary to be licensed to practice as a health professional. It does not include education or training programs available exclusively to the organization's employees. Costs, including stipends, benefits or scholarships for medical residents or interns, can be included even if such people can be considered employees for W-2 tax reporting purposes. - Research
Expenses incurred conducting any study or investigation in which the goal is to increase generalizable knowledge available to the public. These costs may include salary and benefits for research staff as well as costs for equipment, facilities, computers, biosafety, accreditation, and any number of other expenses. Hospitals may include costs incurred conducting research that is funded by tax-exempt or government entities, but not research conducted on behalf of an individual or organization that is not tax-exempt. - Community Health Improvement
Costs incurred from activities or programs subsidized by the hospital that are carried out for the express purpose of improving community health. Such activities cannot be counted if they are primarily for marketing purposes or for the purpose of increasing referrals to affiliated organizations. Such activities must all fill an established or documented need in the community. - Cash and In-Kind
Direct donations of funds, or donation of supplies, space, and employee time to other individual or community organizations where the hospital is not the primary sponsor or organizer. Generally, such donations should be consistent with the hospital's goals and mission. Donations of money, supplies, or time must be representative of the hospital; individual activities performed by employees on their own time may not be counted. - Community Building
Expenses associated with activities or programs that address root causes of health problems in the community that are not directly related to providing health services. Such activities could address poverty, homelessness or environmental issues. Examples include supporting economic development, coalition-building, workforce development, and improving the physical environment in which people live. - Community Benefit Operations
Costs associated with staffing and coordinating hospital community benefit initiatives. These costs include staffing and supply costs to manage or oversee community benefit program activities, as well as the costs to perform community needs assessments and strategic implementation plans.
About the Data
Oregon's acute care hospitals report their community benefit spending directly to Oregon Health Authority (OHA). Oregon's two for-profit hospitals are not obligated to provide community benefit, but must report any community benefit spending activities they choose to engage in.
This dashboard does not include the current year’s data because Oregon Revised Statutes 442.601 and 442.602 require hospitals to report their yearly community benefit costs within 90 days of filing a Medicare cost report, which is generally 240 days after the close of their fiscal year. Fiscal years vary between hospitals/health systems.
As a result of the passage of HB 3076 in 2019, OHA no longer recognizes the unreimbursed cost of providing Medicare services as a category of community benefit spending. For this reason, this dashboard's "Total Community Benefit" and "Unreimbursed Care" figures - which do not include unreimbursed Medicare spending - should not be compared to those in previous reports.
For more information, see
Oregon Revised Statute 442.
Note on Subsidized health services:
On January 1, 2020, unreimbursed Medicare was removed as a category of community benefit (HB3076, 2019). This allowed Medicare to be included in subsidized health services calculations, since it could no longer be accounted for in its own category. The large growth in subsidized health services in 2020 can be attributed to this change.
Subsidized health services are health care services a hospital provides at a loss in response to identified community need. Currently, when calculating subsidized health service amounts, hospitals must remove revenue and expenses related to charity care and Medicaid, because these services have their own community benefit categories. Community benefits may only be counted in one category and double counting is not allowed.
In previous years, hospitals were also required to remove Medicare revenue and expenses from their calculations of subsidized health services because unreimbursed Medicare was an eligible category of community benefit. Medicare can now be included in subsidized health services without being double-counted, which accounts for the large growth in subsidized health services in 2020.
February 2025
• The dashboard was updated to include fiscal year 2023 data.
• PeaceHealth Sacred Heart Medical Center - University District ceased hospital operations on 12/01/2023.
January 2024
• The dashboard was updated to include fiscal year 2022 community benefit data.
• Fiscal year 2022 was the first year minimum spending floor data was collected (HB3076, 2019). This data can be found in the spending floor tab on the main page.
January 2023
• Updated dashboard with fiscal year 2021 community benefit data.
• Fiscal year 2021 predates HB3076 and has no minimum spending floor associated with it. The first data that will take the minimum spending floor into consideration will be fiscal year 2022.
January 2022
• Updated dashboard with fiscal year 2020 community benefit data
• Fiscal year 2020 predates HB3076 and has no minimum spending floor associated with it. The first data that will take the minimum spending floor into consideration will be fiscal year 2022.
General Information
OHA welcomes all data consumers. This dashboard will be made available in an accessible alternative format upon request. Please contact the OHA Hospital Reporting Program at HDD.Admin@odhsoha.oregon.gov for requests or questions.