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These hospital systems have a relatively small presence in Oregon compared to their national expansion, yet are a major force in the state’s economy.

Medicare and Medicaid add up to more than two thirds of hospital charges in the most recent figures, with small coastal hospitals Peace Harbor and Lower Umpqua Hospital most reliant on these programs

The increased money to coordinated care organizations will go for higher general health care costs plus more treatment of addictions.

Public-owned hospitals such as Bay Area, Blue Mountain, Coquille Valley, Curry General, Harney District, Lake District, Lower Umpqua, Pioneer Memorial, Southern Coos and Wallowa Memorial struggle to remain independent.