FAQs

The Frequently Asked Questions (FAQ) page provides clear answers to common questions. It brings together essential information in one place so you can quickly find factual information. Each section is organized by topic.

July 20, 2026 CEO Update

Read CEO Update - Checking the facts

Q: As the hospital has discussed the systemic challenges facing healthcare in southern Oregon, union leadership has characterized these facts as “egregious” and “outrageous”^[1] - is this actually about pay and benefits?
A: That would be a question for union leaders to answer. We encourage discussion grounded in facts, data, and constructive problem-solving. A few facts that may provide additional context:

• When adjusted for cost of living, bedside registered nurse pay in Oregon ranks highest in the nation.^[2] At Asante, bedside RNs earn significantly more than the national average with average annual pay for a full-time Asante nurse of $157,000.^[3] This compares to the national base of $101,420.^[4] For a new graduate nurse at Asante, the starting base pay (before any incentives, overtime or other premium pay) is $112,000, higher than the national average for experienced nurses.^[5]
• At the end of last year’s strike against Providence in Medford, ONA union leaders proclaimed publicly (and quoted) that wages are now aligned with other health systems.^[6] Given that Asante is the only other health system in Medford, this indicates wage parity already exists in the local market. This should be particularly true considering Asante nurses have had another wage increase since striking nurses at Providence ratified a new contract last year.
• Asante offers the most comprehensive benefits of any large employer in southern Oregon. On average, Asante invests $37,340 in benefits for every full-time employee.^[7]

Q: Beyond pay and benefits, what about working conditions and safe staffing? How are working conditions at Asante?

A:

• In 2025, Asante had a turnover rate for nursing of only 11%, which is 50% below the national average among hospitals.^[18]
• Asante currently has a vacancy rate for nursing of only 5%; the national RN vacancy benchmark is 8.6%.^[19]
• Asante has greatly reduced the number of traveling nurses by more than 90% since 2023 as a result of successful recruitment efforts; 153 additional employed nurses have been added in the last 18 months.^[20]
• Oregon is one of only several states with enforceable nurse-to-patient staffing ratios, and has the strictest statutory staffing ratios in the nation.^[21] Many other states do not have enforceable patient-to-nurse ratios or have more flexible nursing standards. Asante complies with Oregon’s statutory staffing ratios, as explained in the FAQs accompanying the May 4 memo found here.
• Asante hired 104 new graduating nurses from RCC and SOU/OHSU this past year, in great partnership with our local university and college.^[22]
• Oregon was recently named fourth best in the nation for working environment for nurses.^[23] According to Oxfam, Oregon has the strongest worker protection laws in the entire country.^[24]
• Asante has invested in processes and equipment to modernize our Workplace Violence Prevention program focused on staff and patient safety, with frontline staff - including nurses - playing a key role through active participation in program workgroups.^[25]
• We continue to invest in maintaining high quality working conditions. Thanks in part to generous donations and support from our community, RRMC is a state-of-the-art facility with equipment and space to care for complex patients close to home.^[26] These outstanding facilities and well-equipped clinical spaces have been a large part of recent success in record recruiting years for physicians and nurses.
• Asante has adopted a clear position statement on the use of AI.^[27] AI is already used extensively at Asante as part of our industry-leading state-the-art electronic health record our clinicians use every day. Like it is used today, AI should be an enablement tool for our clinicians to assist them in an increasingly complex and information-heavy environment. AI can help leverage the expertise of our clinicians, but cannot take the place of the compassion that only human hearts, hands and minds can provide.

Q: Union leaders have accused Asante leadership of causing the problems described in the May 4 CEO Update letter to employees and medical staff.^[28] Is this true?
A: The accusations are mystifying and offered without evidence. The rhetoric seems intentionally inflammatory to create discord. The May 4 CEO Update was very transparent and detailed in the challenges we face, including:

• National (and international) inflationary increases in supplies, pharmaceuticals, utilities and other costs.^[29]
• New state laws and burdensome, unfunded regulations coming from Salem affecting all health care providers across Oregon.^[30]
• The federal One Big Beautiful Bill Act (OBBBA), which will dramatically reduce Medicaid funding in Oregon and across the nation.^[31]
• Chronic underfunding of Medicare and Medicaid that reimburse less than the cost of providing health care services.^[32]
• A loss of private sector jobs across the state, but especially in southern Oregon; Oregon’s unemployment rate is almost 20% higher than the national average (5.2% versus 4.3%).^[33]
• The loss of jobs and a shrinking economy in Oregon mean less people having commercial insurance. For Asante, only 14%-15% of patients in 2026 are commercially insured – a steady decline from around 20% since 2017, and half of what exists in the Portland Metro area.^[34] For hospitals, commercial insurance is the only payer that covers the full cost of healthcare.^[35]
• Struggling organizations here in the valley, with many of our high-profile employers reducing jobs and cutting costs, or worse, leaving the region altogether.^[36]
• A Hospital Staffing Law that was grossly misinterpreted by the Oregon Health Authority, that goes well beyond safe staffing ratios agreed to by all parties in 2023.^[37] This needs a legislative fix to get back to the intent of the law.^[38]
• Increasing financial support of both physicians and mid-level providers of independent groups to retain our current medical staff and recruit more to the valley to address access challenges for our community.^[39]
• Oregon dropping to 39^th in the nation for business environment – a 22-spot drop between 2017 and 2025; Oregon fell another three spots, down to 42^nd, in the recently released 2026 rankings.^[40]

Q: In the May 4 CEO update, it was reported that Asante had lost money from operations? Has the financial picture improved since then?
A: In short, No. In the May 4 letter, we reported that Asante has suffered operating losses of $16 million in the first 6 months of fiscal year 2026, including a $12 million loss in March alone. For the 9-month period ended June 30, our operating losses have grown to $25 million. This disturbing trend is why the cost reduction and overhead efficiency work is so important, especially before the Medicaid funding cuts we expect in 2027 and beyond from the federal One Big Beautiful Bill. We are in the middle of implementing those action plans in our efforts to better match our expenses to our revenue. Hundreds of roles have been eliminated since May 4, and with our physician leaders we are evaluating service line consolidations. And as discussed in our June 17 update, we are still investing in expanding clinical services and physician recruitment to serve our community’s health care needs.

Q: Is Rogue Regional Medical Center (RRMC) still utilizing a lot of traveling nurses like in 2023?
A: No, the use of traveling nurses has dropped dramatically.

For context, the pandemic response all over the country from 2020-2023 saw a huge increase in the use of travel nurses in every state. In addition, the hourly rates for those temporary nurses were driven by national market demand, often approaching $225 per hour for the staffing agency sending them at the height of the pandemic. Since 2023, the vacancy rates, turnover rates, and therefore the use of travel nurses has fallen in most places across the country, including right here in Oregon. Today, the rates for travel nurses are less than half the cost of what was experienced during the peak of COVID-driven demand.

Southern Oregon has followed those same national trends of decreasing need and use of travel nurses. In fiscal year 2023, RRMC was using 200 travel nurses to fill gaps in the schedule. As of June 30 last month, that number has dropped to just 9. As mentioned, we are at a multi-year low in the number of travel nurses. Combined with lower than national average vacancy rates, turnover rates, and successful recruitment, the workforce issues are not the same as they were just 3 years ago. While we will likely have some small number of contract employees reflecting a short-term need to fill certain longer-to-recruit roles, pandemic-era crisis staffing issues are well behind us.

One more note: this summer, Asante received employment applications from more than 290 new graduating nurses for just 53 available positions in our hospitals. 2026 is a lot different than 2023, in many ways.

June 17, 2026 CEO Update

Q: What is the Asante Board of Directors and what is their role?
A: The Board of Directors is comprised of local community members who all live in southern Oregon. They are unpaid volunteers who donate their time and expertise to governing our organization. The board nominates candidates and elects members to 3-year terms, who can then serve a maximum of 3 terms.

Read CEO Update - Growth is the point

The board is made up of physicians both retired and active, former nurses, business leaders, and other community leaders with a deep love of Asante and our Mission to serve southern Oregon and northern California. They are responsible for overall governance in alignment with our Mission and our strategic priorities, for overall quality and safety of care, for credentialing medical staff to work in our facilities, for hiring and evaluation of the Asante CEO, for financial stewardship of our resources and assets, and to  ensure we remain sustainable  to serve the health needs of our communities. The current board priorities are Culture, Quality & Safety, Financial Sustainability, and Growth.

Q: Who profits from Asante?
A: No one – that is just divisive propaganda. Asante is a private not-for-profit tax-exempt charitable organization chartered in Oregon as a public benefit corporation and classified as a Federal 501(c)3 tax-exempt organization by the Internal Revenue Service (IRS). We have no shareholders, no stock, no private equity investors, and no out-of-state owners. Our Board of Directors (except for the one seat held by the CEO) are volunteers and are not compensated for their roles.

Asante is the largest charitable organization in southern Oregon. “Not-for-profit” does NOT mean we need no bottom line – any revenues remaining after expenses is what allows us to invest in new or expanded clinical service lines, to buy new or replace outdated equipment, renovate buildings when needed, and fix expensive infrastructure like boilers when broken. With no bottom line, the ability to re-invest locally in healthcare goes away. We don’t need a big bottom line – we have no shareholders – but our operating margin needs to be 1-3% per year for long term viability. So far this year, we are operating at a loss. That is not sustainable.

By being good stewards of resources and investing in clinical care as a priority, we can ensure our community profits with better access to care closer to home.

Q: It is mentioned several times that Asante is the largest employer in southern Oregon – what does that mean?
A: With over 6,000 employees, Asante is not just the region’s leading healthcare organization - it is an economic engine for the valley. Asante’s annual payroll and benefits for employees are $840 million per year, and up 8.6% since 2025. For a long time the trend line is always upward – same with supplies, utilities and other expenses. We need to bend that curve to more closely track the small gains and future reductions in government payments and insurance challenges. We will continue to prioritize investments in our people – it is all of you who care for our community. But that rate of growth is not matched by the underpayments from Medicare, Medicaid, and what little private insurance we have left in the valley. We will be good stewards and adjust or prioritize our spending accordingly.

Q: The union continues to speak about greedy Asante executives and their outrageous paychecks. How are executives paid, and is it fair? 
A: First, it’s important to note that Asante is an Oregon nonprofit public benefit corporation and a federally recognized 501(c)(3) charitable organization. Like all nonprofits, we are permitted to pay competitive, reasonable compensation for leadership, but we must follow strict IRS standards designed to prevent excess benefit. Our compensation decisions are guided by established IRS safeguards to ensure they are appropriate and independently validated.

The Board of Directors establishes and oversees the compensation philosophy and plan for senior leaders. To ensure compliance with IRS expectations of a not-for-profit organization, each year the board engages independent, national compensation experts that evaluate national and regional data and trends and advises the board on executive compensation. Compensation decisions are reviewed and approved by a Board committee comprised of members without conflicts of interest, consistent with IRS governance standards.

The philosophy the Board has adopted for many years dictates a pay between the 25^th and 50^th percentile for base salary aligned with experience in role, with pay held back and at-risk for meeting annual strategic priorities. The effective salaries of Asante senior leaders average the 43^rd percentile, with no individual above the 50^th percentile (50^th percentile is the national median or “average”). At-risk pay, if eligible, can result in total wages between the 50^th and 75^th percentile but is never guaranteed and is tied specifically to meeting performance expectations. Some years the at-risk pay is forfeited entirely – 2023 was such a year.

For comparison, the effective pay for Asante nurses (union or non-union) is over the 90^th percentile nationally. For all other non-management roles at Asante – clinical or support roles – we target the 50^th percentile or better based on west coast wage data, which is routinely higher than national data. We offer competitive pay to attract and retain the best talent to care for our patients and their families. Our turnover rates for clinical staff are 50% lower than national averages for health care. We provide the best comprehensive benefit plan of any large employer in southern Oregon. All employees including leadership have access to the same health, dental and other plan options. We invest 70% of all expenditures in our employees and physicians, and rightfully so – our staff is what drives forward our Mission of caring for patients.

So no, there is no “back room” of executives lining their own pockets – such rhetoric is intentionally divisive.

Q: The memo states that recruitment is underway to add physicians and mid-levels in many medical specialties – can we see a list of which specialties are being recruited?
A: We are currently recruiting for physicians, nurse practitioners and physician associates in the following areas:

May 4, 2026 CEO Update FAQ

Read CEO Update

Health care services 

Q: Much of this announcement seems focused on cost control and reductions. Are there plans to grow and improve access or clinical services, or is this only about shrinking?    
A: Yes. We are committed to strengthening our medical group’s influence and visibility, and growing key clinical services to address community need. As part of this, continuing to recruit physicians, nurse practitioners and physician assistants will help us continue meeting the health care needs of our region. We have 17 new physicians and mid-level providers joining Asante this summer and anticipate this will continue increasing.

Asante had a record recruitment year in 2025, and we need to keep recruiting to serve more people.

Q: Will there be changes to Asante’s Emergency Departments and Immediate Care locations?
A: No. There are no plans to change these services. Our emergency care remains core to how we support our communities. All three campuses in Ashland, Medford and Grants Pass continue to operate full‑service Emergency Departments, and we also operate two Immediate Care locations in Medford and Grants Pass.

• Emergency Departments, open 24/7 
• Immediate Care, open every day, 8 a.m. to 8 p.m.
  • Medford: 555 Black Oak Dr., Medford, OR 97504
  • Grants Pass: 537 Union Ave., Grants Pass, OR 97527

Q: Is Asante going to sell or close?
A: No. Our three campuses will remain open, and we are not selling or merging with anyone. We believe being locally led and governed is important to ensure decisions made about health care access in the valley are made close to home. In support of advancing access to safe high-quality care, one of our four strategic priorities is Financial Sustainability, ensuring we remain independent, prosperous and positioned for long‑term success. Since the mid‑1900s, we’ve taken pride in our tradition of being locally owned and governed. Preserving that legacy is central to our Mission. Achieving this requires us to make bold — and at times difficult — decisions so we can continue providing reliable access to care for our patients amid the significant challenges facing health care today at the local, state and federal levels. Not making changes like this would jeopardize long-term viability.

Q: You are eliminating inpatient services in Ashland – is Rogue Regional or Three Rivers next?
A: No. Elimination of acute inpatient services on those campuses is not planned at this time. We are focusing on all non-clinical areas for reductions, and it’s likely several clinical service areas will be reduced. Some services with multiple locations may be consolidated. We have an obligation to evaluate all services in all locations with an eye toward maintaining availability of core services in the region.

Q: Why are expenses outpacing revenue?
A: Simply put – we do not receive adequate reimbursement to cover our costs. Commercial insurance covers the cost of patient care; government programs like Medicare and Medicaid do not. We do not differentiate care based on the coverage of an individual patient, but as fewer people in the valley have commercial insurance and more rely on government programs (one in three Oregonians are on the state’s Medicaid program, the “Oregon Health Plan,” for example) we see expenses outpacing the growth in patient care reimbursement.

Q: Will any services be cut?
A: Some services will likely be impacted, but we hope to avoid mass service reductions. Over the coming months we will continue to work with our clinicians to evaluate patient services across our three campuses and many outpatient clinics. We are committed to preserving the core clinical services that comprise the safety net for southern Oregon.

Q: How is the organization ensuring continuity of care during the transition?
A: This work will be thoughtful and not needlessly rushed, but actions need to begin. Any clinical services impacted, just like in Ashland, will have prior notice and substantial lead time for communication to patients and employees.

Workforce

Q: Are there layoffs occurring?
A: Yes. Over the past six months, Asante’s expenses are greater than our revenue (and worsening in March), and no organization can survive and prosper that way. As it should be, we invest almost 70% of our collected revenue back into the salaries and benefits for our employees and community-based physicians. Our people are the power behind our patient care. However, we cannot ignore the size and magnitude of payroll for an organization of our size.

Our focus will be heavily on non-clinical roles, as it was over two years ago when we eliminated around 400 roles. However, more work needs to be done. We are fighting hard to keep resources directly serving our patients in our clinics and hospitals, but some clinical areas will be impacted. We anticipate this will impact 300 or more people in fiscal year 2026, which represents 5-6% of our workforce.

Q: Will individuals who are affected by layoffs have support from Asante?
A: Yes. We are committed to supporting impacted employees through this transition by providing severance and separation benefits, as well as outplacement support for those who qualify.

Q: What kind of job placement support will impacted employees receive?
A: In partnership with Rogue Workforce Partnership, a job fair will be held June 18 from 10 a.m. to 2 p.m. in the pavilion at the Jackson County Fairgrounds. Asante’s outplacement services will be on site to assist impacted employees.

Q: Were alternatives to layoffs considered?
A: Yes. Our goal is always to find efficiencies elsewhere first. Unfortunately, in our current operating environment, we must find more efficiencies in how work is accomplished and minimize overhead expenses. Investments in our people comprise almost 70 cents of every dollar of revenue we collect.

Q: Is Asante also decreasing corporate and leadership roles?
A: Yes. Since 2023, corporate building staffing has been cut by 67%. This is justified in the interest of preserving patient care. In that same time period, leadership roles were reduced by 23% across the entire organization, and more needs to be done. It is likely we will close the corporate building permanently since most of the space is unoccupied and convert it to physician clinic space. Overhead must be bare-bones to keep as many resources as we can dedicated to patient care.

Q: How much money does this really save?
A: We estimate that, to break even in 2027, we need to identify $50 million or more in savings in 2026. And due to inflation and planned federal cuts to Medicaid, we will need to keep finding savings each year thereafter. This will be ongoing work.

Q: Is there a hiring freeze?
A: Yes, in some cases. We are pausing most non-clinical hiring. However, we will continue recruiting physicians and advanced practice providers, nurses and other clinical roles.

Q: What other measures, besides layoffs, are you implementing to cut costs?
A: There are many initiatives we are implementing, including but not limited to: Freezing most non-clinical job postings and new vendor contracts, evaluating and reducing services (i.e. cleaning, office supplies), consolidating leased and owned spaces, implementing new processes for insurance coding and billing, reducing technology equipment, review of supply utilization and cost per unit of supply and more.

Q: Will employees’ benefits change?
A: Too early to know. Asante offers some of the most comprehensive and supportive benefits of any large employer in southern Oregon. Even so, to be good stewards, every option should be evaluated and may not lead to changes in every circumstance. Any suggested changes to benefits will not be sudden and will be communicated and discussed well in advance.

Q: Why are layoffs occurring again after 2024? Did Asante hire again after those cuts?
A: No. We reduced approximately 400 roles in early 2024 and have maintained that lower staffing level, especially in business support areas. Even after hiring many more clinical roles and recruiting more physicians, we have remained leaner in overhead. But inflation of costs has continued in the healthcare industry, and the minor revenue increases from Medicare and Medicaid are too low. The regulatory burden in Oregon has worsened since then. As the operating environment worsens in the state and federal cuts loom, we must keep adapting to stay viable.

Headwinds

Q: How will the Affordable Care Act (ACA) tax credit loss impact patients?
A: Individuals above 400% of the Federal Poverty Level are among those most impacted because many no longer qualify for financial assistance that had previously reduced premium costs. This will have cascading effects on hospitals with an increase in uninsured patient populations. We are experiencing this in Oregon and southern Oregon. OHA estimated that more than 2,400 people in Jackson and Josephine Counties will lose these credits (source). In January, it was reported that Oregon experienced one of the largest enrollment drops in the nation (source). 

Q: Do Medicare and Medicaid cover the cost of delivering care?
A: No. In 2024, Medicare reimbursed hospitals just 83 cents on the dollar, according to national data from the American Hospital Association. At Asante, those rates are even lower — Medicare reimbursed at 79 cents on each dollar of our expense (i.e. 79 cents coming in for each dollar spent going out) and Medicaid was at 67 cents in fiscal year 2025. Medicare and Medicaid and other government-covered patients are ~75% of Asante’s patient population, and that percentage is growing.

Q: Who decides how much Medicare and Medicaid pay hospitals and doctors?
A: Medicare and Medicaid rates are set by the government, not by hospitals.

• Medicare rates are set by the federal government, specifically the Centers for Medicare & Medicaid Services (CMS). CMS uses national formulas to decide how much hospitals and clinics get paid for each service. These formulas rarely reflect the true cost of care in high‑cost or rural areas.
• Medicaid rates are set by each state, within federal guidelines. That means Oregon decides how much it will pay hospitals for Medicaid patients, and those rates are much lower than Medicare or commercial insurance.

Health care organizations cannot negotiate these rates the way they can with private insurance companies.

Q. What is presumptive charity?
A: Presumptive charity in Oregon is a legal requirement (HB 3320/HB 4040) for hospitals to screen patients for financial assistance, without their consent, before they receive a bill. Due to the shortcomings of the screening tools, this process initially resulted in a number of high-income individuals receiving charity care, as well as many complaints from members of the community due to the requirement that hospitals presumptively screen, regardless of consent or active participation in the process.

The existing screening tools are unreliable, forcing a manual process, and there is no OHA offset for an unfunded mandate.

Q: Are layoffs happening because of the One Big Beautiful Bill Act (H.R. 1)? Has Asante been preparing for this?
A: There are many contributing factors, including the OBBBA. There have been shifts in demographics in the local community that have impacted local health care. In addition, proposed cuts to Medicaid at the federal and state level are expected over the next several years. Even prior to the anticipated funding reductions in OBBBA, the regulatory burden on hospitals in the state of Oregon is untenable. Oregon hospitals are three-times more regulated than other hospitals in the country, adding unnecessary administrative costs without associated funding. As stewards of invaluable health care resources in the region, Asante aims to keep pace with these challenges and not wait to act. OBBBA funding cuts will be severe.

Q: Are other industries facing headwinds in Oregon?
A: Yes. Pressures today reflect very real shifts happening across Oregon’s business landscape, and health care is disproportionately at the mercy of these shifts. Oregon Business & Industry (OBI) has declared an economic state of emergency.

Read more:

• Oregon’s economic crossroads - AsanteIMPACT
• Health care’s economic influence deserves more attention - AsanteIMPACT

Q: What regulatory changes have contributed to this current state?
A: Non-profit health care organizations in Oregon face a dual burden of significant federal cuts, as well as a number of recent unfunded mandates from the Oregon State Legislature and Oregon Health Authority that have required health care systems to reexamine operations in order to remain independent and financially sustainable.

These following changes will impact Asante:

State

• Hospital Staffing Law – the 2023 Hospital Staffing Law has resulted in Asante incurring significantly increased administrative costs and fees, exacerbating the financial strain on hospitals. This will likely increase due to the penalties and the administrative burden of responding to investigatory demands by the Oregon Health Authority (OHA). The law continues to carry a high financial cost to health care systems – without any offset from the legislature to account for lost operating revenue.
• Presumptive Charity Care – despite known implementation concerns, particularly around the efficacy of the available screening tools, the legislature passed a bill that now requires health care systems to implement presumptive financial screening for charity care.
  
  Due to the shortcomings of the screening tools, this process initially resulted in a number of high-income individuals receiving charity care, as well as many complaints from members of the community due to the requirement that hospitals presumptively screen, regardless of consent or active participation in the process.
• Labor shortages due to refusal to join Compact – Oregon is one of only eight states that is not a member of the Nurse Licensure Compact, which discourages out-of-state nurses from taking roles in Oregon by delaying licensure approvals, leading to a persistent labor shortage and increased labor costs.
• Health Care Market Oversight and corporate practice of medicine laws – Oregon has some of the most restrictive laws on the books that place significant limits on what types of transactions, and with whom, health care systems can engage. This acts to prevent many common ownership and financing structures that otherwise can provide lifelines to strained physician practices and other business owned by physicians. The HCMO process itself is unnecessarily invasive and complicated, and the State’s costs of the programs are paid directly by the organizations being reviewed. Other structures that could potentially have been explored have been ruled out due, in part, to these regulatory hurdles. In a recent example, the burdensome HCMO process prevented Asante from purchasing a struggling surgery center (Southern Center of Southern Oregon) after engaging in good faith in the process since August of 2025. It is regrettable and very disappointing that Oregon Health Authority withheld approval, with the end result being the closure of an important surgical access point for the residents of southern Oregon.
• Hospital licensing fees – despite significant financial pressures on health care systems, the Oregon legislature passed legislation increasing hospital licensing fees by 400% in 2025.
• Cost Growth Target – Oregon’s Cost Growth Target places unrealistic cost increase limits on health care organizations, while imposing administratively burdensome performance improvement plans and stiff financial penalties for failure to meet such goals, despite health care organizations having little-to-no control over the price of goods and labor. This law overlooks the economic realities of the industry and forces health care organizations to divert critical resources toward documenting and defending broad, industry-wide trends—resources that should be focused on patient care.

Federal

• The One Big Beautiful Bill Act (OBBBA) particularly impacts the state of Oregon, as the state has chronically underfunded the Medicaid program. One in three Oregonians currently rely on Medicaid for health insurance coverage.
  • Reduction of Medicaid eligible patients will result in a substantial increase in uninsured patients and uncompensated care.
  • The OBBBA decreases federal matching funds that are used to fund Oregon’s Medicaid program.
• Continued impacts of Medicare sequestration.
• Reduction in Disproportionate Share Hospital payments, which are used to help cover the cost of treating vulnerable patients.
• Reduction of State Directed Payments through our CCOs.
• Expiration of ACA Tax Credits – the expiration of tax credits will lead to an increase in premiums and more uninsured patients.
• Tariff impacts on supply costs.
• Pharmaceutical impacts, through changes to 340B and overall cost specifically in cancer care.

Q: What can I do to help? Are there actions that make a difference?
A: Stay informed and be an advocate. Please continue referencing the FAQ page on our website for factual and updated information and share it with your colleagues, families and friends. Also, visit and bookmark AsanteIMPACT for weekly updates on important information about advocacy, policy, regulatory and economic impacts.

If you have an interest supporting our advocacy efforts, please email PublicAffairs@Asante.org. There may be ways that you can help as we try to gain the attention of our state and federal legislators. We need all of us to preserve the safety net for health care in southern Oregon.

Q. Does Medicare Advantage help cover the cost of delivering care?
A: No. Medicare Advantage plans pay at traditional Medicare rates, and Medicare does not cover the cost of health care. In addition, Medicare Advantage plans are often slower to pay their bills and more difficult to get reimbursed for our care.

Q: This seems to be a national problem. Is it worse in Oregon and in southern Oregon?
A: Yes. Oregon hospitals are three times more regulated than the U.S. median. In southern Oregon, we also have a challenging funding problem with most of our patient population being Medicare or Medicaid. Our commercial payer mix, meaning people who have health care coverage through their employers, is the lowest it’s ever been so far in 2026. Hospitals in the Portland area typically average twice the percentage of commercial insurance patients (over 30%) compared to southern Oregon/Asante (14-15%). Just a decade ago, it was at 20%. Because of a declining business economy in southern Oregon, combined with the impending cuts to Medicaid, Asante needs to take action to ensure the sustainability of local health care in the future.

We are honored to care for any patient regardless of insurance coverage. But the fact remains, this tilted payer mix places a disproportionate strain on the economic conditions for southern Oregon hospitals and physicians. Eastern Oregon has similar issues.

Q: Would having a single health care payer for all settle these challenges?
A: Without details and a specific proposal presented – and how it would be funded – this is not possible to answer.

Q: Are other health systems facing the same challenges?
A: Yes, especially in Oregon.

Q: What is the difference between Medicaid (OHP) and commercial insurance?
A: Medicaid is a government‑funded health insurance program. Oregon has expanded this program more significantly than other states; one in three Oregonians are currently on OHP. Commercial insurance is private coverage (i.e. what employees receive as a benefit through their employers) and covers more toward the cost of health care services.

The two differ in how much they cost and how they pay health care providers. At Asante, Medicaid currently covers 67 cents per dollar we spend to provide care, which clearly does not cover the cost of delivering care. Hospitals with a weak commercial payer base—such as rural or safety‑net hospitals—are at higher risk because they cannot generate enough commercial revenue to balance losses from Medicaid, Medicare and uninsured care. Hospitals with a strong commercial payer mix, like markets in Eugene, Salem and Portland, can maintain healthier margins even when government reimbursement falls short.

Q: Can Asante grow its commercial payer mix?
A: This is directly dependent on our state and local economy. When businesses reduce their size, leave the region or their employees retire, commercial payers decrease. As the largest employer and health care provider in the region, we are working hard to advocate for local businesses and legislation to support our economy.

Q: Why is Asante being penalized if it meets staffing ratios?
A: Asante unequivocally supports safe staffing and ratios, both philosophically and in practice. While the Hospital Staffing Law (HB 2697) set forth a framework for hospital staffing supported by a coalition of stakeholders, the implementation of that framework by Oregon Health Authority (OHA) has failed the shared vision. The implementation of the law has been tone-deaf to current realities in Oregon and over-reaching in its interpretation. It emphasizes complex procedural requirements that place disproportionate burdens on hospitals, without offering any clear benefit to patients. This is resulting in millions in unhelpful expenses and capricious penalties – dollars that will leave our community.

Q. What is Medicare proposing for an increase in 2027?
A: CMS has not yet released the proposed 2027 Medicare outpatient payment rates — those are expected in July. However, CMS did publish the proposed 2027 inpatient payment update in April, and it is only a 2.4% increase. This proposed adjustment is far below the actual inflation hospitals are experiencing for supplies, pharmaceuticals, labor and other essential operating costs, meaning Medicare reimbursement is not keeping pace with real inflationary pressures.

Q: If Asante had a positive margin for years before 2020, how can current losses be understood in today’s health care environment?
A: Past performance does not shield any hospital from today’s dramatically higher operating costs, post‑pandemic patient trends, reimbursement challenges or increasing regulatory and legislative burdens. The landscape has fundamentally changed since 2019. It has even worsened since 2025. 

Other topics

Q: What does safety-net hospital mean?
A: A safety‑net hospital treats patients regardless of insurance status, income or ability to pay. These hospitals maintain an open‑door policy, meaning they do not turn patients away due to financial barriers. Like Asante, they care for disproportionately high numbers of uninsured, Medicaid, Medicare and other vulnerable populations. They are hallmarked by offering high-level complex services that are not offered elsewhere in the community.

Q: How can Asante acquire practices such as Gastroenterology Consultants if there are financial challenges?
A: Capital acquisitions – like purchasing buildings and equipment – are long term investments, not daily consumable expenses. Capital acquisitions have the benefit of actual physical assets which can then be used long-term for clinical services. Daily expenditures like wages, utilities and supplies are daily operating expenses which should be covered by daily revenue. Asante makes strategic decisions around our partnerships and acquisitions based on our four strategic priorities: Culture, Quality & Safety, Strategy & Growth, and Financial Sustainability. We heavily prioritize the preservation of key services in our community and the safety net that we offer. Our region was at significant risk of losing GI services altogether. Partnerships like this underscore how collaboration is essential as health care organizations face increasing economic and regulatory pressures, and physician offices are not immune to these challenges. By joining forces, we’re able to maintain both inpatient and outpatient GI services for our communities and strengthen our ability to recruit specialists.

Q: Is the pending criminal case involving a former employee at Rogue Regional and civil case settlements reasons for this?
A: No, that case is unrelated to this decision and other current challenges. 

Q: Why are we continuing renovations at Rogue Regional Medical Center if we have financial concerns?
A: Like strategic acquisitions of patient care organizations, renovations and major equipment are funded through a separate long-term capital plan and not the day‑to‑day operating budget. Expanding access to services at our system’s tertiary regional referral center is essential to meeting our community’s needs, and this work has been planned for many years.

Many of these projects are made possible through the generosity of our community. Philanthropic support through the Asante Foundation plays a significant role in bringing these expansions to life. We are grateful for the continued support of our donors.

Q: Why can’t Asante Foundation help cover more of our losses?
A: Philanthropy supports strategic capital projects and programs that help transform health care in southern Oregon. While this generosity is central to our Mission and strengthens our ability to serve the region, philanthropic dollars are not intended to — and should not — cover operating costs. Relying on donor funds for ongoing expenses is not sustainable, and our approach to philanthropy is to partner with donors to enhance the services provided by Asante.

Oregon Headwinds FAQ

Q: Are the challenges and headwinds unique to Asante? How are other hospitals doing in Oregon?
A: No, these challenges are not unique to Asante, but the impact is more significant in a rural area like ours. One of the key findings of the Hospital Association of Oregon’s (HAO) ‘A fraying safety net: Oregon hospitals in crisis’ report is that these challenges are occurring across the state. At its core, this report is a warning: hospitals are the safety net for the communities, but that safety net is fraying. 

Q: How are hospitals being affected statewide?
A: While specific impacts vary by community, hospitals across the state are facing common challenges, including rising costs, workforce shortages, increasing demand for services and reimbursement pressures. These factors can affect access to care and hospitals’ ability to invest in services for their communities. Here are key findings from HAO’s report:

• Oregon hospitals lost $450 million caring for patients in 2025, bringing cumulative losses to more than $1.25 billion since 2022.
• More than 80% of hospital beds in Oregon are located in hospitals operating with unsustainable margins.
• In the past three years, Oregon lost three community hospitals, including Ashland Community Hospital, which closed its hospital license and transitioned to a satellite campus.

The report reinforces the importance of the work we are doing to strengthen Asante for the future while continuing to advocate for policies that protect patient access.

Q: Where can I learn more and stay updated?
A: More information is available on AsanteIMPACT and you can subscribe for weekly email updates here: https://impact.asante.org/subscribe/. HAO’s report can also be downloaded here: https://oregonhospitals.org/wp-content/uploads/2026/07/2025-Oregon-Hospital-Utilization-and-Financial-Analysis_A-fraying-safety-net-Oregon-hospitals-in-crisis-5.pdf.  

Outpatient Rehab FAQ 

Please find below FAQs about Outpatient Rehabilitation services. Rehab services at Asante include occupational therapy, physical therapy and speech therapy.

Q: Why is Asante discontinuing outpatient rehab services?
A: As shared in our May 4 letter, we must pursue every opportunity to ensure system-wide sustainability and preserve the core clinical services our community relies on as we face ongoing headwinds in this resource-constrained environment. As part of that effort, we continually evaluate our services, patient demand and community needs to make thoughtful, strategic decisions based on what only Asante can offer and what is available in our community, and to do so with services that we can sustain.

There are community-based independent, experienced rehabilitation providers that already serve both Jackson and Josephine counties. After evaluating our outpatient physical therapy and rehabilitation services, we have made the difficult decision to discontinue these services and refer future patients to other organizations.

We will pursue every cost-saving opportunity available to us to protect our core clinical services for the community. We are the safety net for health care in the valley, and that safety net must be preserved.

Q: How many locations are closing and when?
A: Two locations - one in Grants Pass and one in Medford - will close. Those locations will remain open for services until August 28, 2026.

Q: How is Asante supporting patients who are receiving outpatient rehab services?
A: We will continue to support patients in their current treatment plans until August 28, 2026. From there, we will help each patient transition their care with another community provider as needed.

Q: Will inpatient physical therapy continue to be available?
A: Yes, inpatient physical therapy will continue in our hospitals.

Q: How will employees be impacted in these clinics?
A: We are working with our community partners to help match open roles with employees being impacted through this transition. In addition, we are committed to supporting affected employees by providing severance and separation benefits, as well as outplacement support for those who qualify. Employees are also eligible to apply for other open roles within the organization.

Q: Is Asante planning to discontinue or reduce any other service lines?
A: As noted above, Asante is continuously evaluating our services, patient demand and community needs. As the largest employer and convener of physicians, nurses, health professionals and support staff – by far – in southern Oregon, we anticipate both opportunities for growth in some areas, and further reductions in other areas over the course of the next few years.

Pediatric Outpatient Infusion FAQ

Please find below an FAQ about the Pediatric Outpatient Infusion clinic at Rogue Regional Medical Center. 

Has there been a physician change within the Pediatric Outpatient Infusion clinic?

Our long-serving hematology-oncology physician, Dr. Plummer, is relocating and joining another organization outside of the region this summer. We’re grateful for her years of dedicated care to the southern Oregon community. Dr. Plummer will continue seeing patients and providing care through July 16, 2026.

Asante has been recruiting for an additional hematology-oncology physician position for this unit for several years with no success. This is a highly specialized service and limited across the country. The role remains open and is still posted on our careers website.

How does this impact services moving forward? 

This Unit serves patients for several different infusion therapy needs including chronic disease management, hematology and oncology. Following Dr. Plummer’s departure, community infusion patients with non‑oncologic conditions may continue receiving treatment in the Unit under physician oversight and with appropriate medical orders.

For years, Pediatric Outpatient Infusion has worked closely with physicians at specialized programs such as Doernbecher Children’s Hospital (an Oregon Health & Science University facility) in Portland, and other hospitals, to manage patients’ care plans. We are working with these physicians and Dr. Plummer to develop a near-term plan for the infusion services offered in the clinic.

We will work closely with each patient and family to understand their individual circumstances and plan for the future. Our priority is to ensure that all current patients continue to receive uninterrupted care and consistent support.

Who can I contact with questions? 

For general inquiries, please email communicationsrequest@asante.org.

Ashland Community Hospital FAQ

Please find below an FAQ about the changes for Ashland Community Hospital. 

What is the current status of Ashland Community Hospital? 

We are open! The campus remains open and is offering many services unchanged. The small inpatient part of the hospital closed its license and transitioned to become Asante Ashland, a satellite campus of Rogue Regional effective May 22, 2026.  

What services does Asante Ashland offer? 

Services that continue at Asante Ashland include:

• 24/7 Emergency Department
• Imaging (X-ray, ultrasound, mammography, MRI and CT scan)
• Cardiopulmonary Services
• Lab Services
• Outpatient surgeries

Nearby outpatient clinics:

There are several outpatient clinics surrounding the Asante Ashland campus. Those include:

• Obstetrics physicians and midwives maintain their outpatient clinic in Ashland, in addition to a new office in Medford, and have delivery privileges at Rogue Regional.
• Asante Multispecialty clinic: Family Medicine and Obstetrics; Internal Medicine, Endocrinology and General Surgery
• Asante Family Medicine – Main St.

What will happen if I go to Asante Ashland for an emergency or surgery and need to be admitted? Will I get to choose where to go? 

We have a dedicated regional Transfer Admit Center that helps facilitate transfers across the region and will help transfer patients to another facility that can address more acute inpatient or specialty needs.

How will Asante and the City of Ashland resolve the Affiliation Agreement? 

Asante and the City of Ashland plan to mutually terminate the prior Affiliation Agreement, after which time Asante pays the City of Ashland $4 million or before June 18, 2026. The parties are working collaboratively on the details of this plan. We are committed to continual collaboration on sustainable health care in southern Oregon.

Neonatal Intensive Care Unit (NICU) FAQ

Please find below an FAQ about the Neonatal Intensive Care Unit (NICU) at Rogue Regional Medical Center.

Is the NICU at Rogue Regional Medical Center closing? 

No. This is a critical service line that we are committed to growing to better serve the families across the many counties who rely on Rogue Regional Medical Center for this specialty care.

Are the nine neonatologists still employed with Asante?  

No, the nine neonatologists were employed until their contracts expired on July 1, 2026. All physicians previously employed in the program were eligible to apply for positions within the new care model.

What are the plans for the NICU after July 2026? 

We are actively recruiting physicians and nurse practitioners and exploring clinical partnerships with academic and other regional providers who share our vision of expanding neonatal access and capability for our health system and region.

Who is covering the NICU while recruitment continues? 

Highly qualified and experienced Locum tenens (i.e. “traveling” physicians) and neonatal Nurse Practitioners (NNPs) are covering the NICU alongside our very talented nursing team. A locum tenens clinician is a doctor or nurse practitioner who works on a short-term temporary basis to fill in for regular staff due to vacancies or leave. Locums physicians are vetted and approved by the RRMC medical staff, including credentials, education, experience, licensure, quality and safety, and fitness to serve. These locums physicians are temporary until recruitment is completed into the new fully employed model within Asante Medical Group.

Why are we making this change? 

We want to expand access to keep more neonates in our region, closer to families. This includes extending neonatology specialist coverage to Three Rivers Medical Center in Grants Pass.

Hospitalists FAQ

Please find below an FAQ about hospitalists at Rogue Regional Medical Center (RRMC).

Are hospitalists working at Rogue Regional Medical Center (RRMC)? 

Yes, inpatient services remain covered and uninterrupted. Individual hospitalists are not employed by RRMC, they are employed by a private company (Southern Oregon Hospitalists, PC) that provides contracted services to RRMC. Consistent with the terms of an existing professional services agreement, we provided a one-year notice to Southern Oregon Hospitalists, PC.

Why is Asante making this change?  

We directly employ hospitalists at our other facilities through Asante Physician Partners. Transitioning to a single systemwide employed hospitalist model will ensure sustainable and aligned inpatient coverage for our communities.

Once the contract expires with Southern Oregon Hospitalists, PC, current hospitalists will have the opportunity to become Asante employees.

Will there still be coverage for inpatient care at RRMC?

Yes, 24/7 inpatient care continues, and current staffing is expected to remain the same.