Legacy’s Track Record Should Give Partners Pause
Current and potential partners should consider all of the information before partnering with Legacy Health.
GoHealth: 10 Years Later, Investment in Urgent Care Expansion Hasn’t Paid Off
Legacy’s 2015 venture with a private equity–backed firm GoHealth was designed to rapidly expand urgent care access and funnel patients into its broader care network. The health system invested only a minority stake (10%) in Phase I of the partnership with GoHealth, but a 50% stake in Phase II. At first, the system grew quickly, reaching 18 Legacy-GoHealth clinics across the Portland–Vancouver area by late 2016.
Despite this early expansion, the model has not sustained its scale. As of 2026, only 8 clinics remain—less than half of the peak footprint.
While Legacy’s urgent care venture contracted, a different health system-owned urgent care venture in the area flourished. PeaceHealth purchased urgent care chain ZoomCare in 2018; it has since expanded from 37 to 47 locations. This stark contrast raises questions about why PeaceHealth’s urgent care expansion succeeded while Legacy’s did not.
Silverton: Financial Performance Worsened Under Legacy’s Watch
Legacy acquired Silverton Hospital in summer 2016, integrating the previously independent facility into its system and renaming it Legacy Silverton Medical Center. As part of the transaction, Legacy committed to invest $57.6 million.
The hospital was financially challenged prior to the acquisition and presumably sought out the partnership of a larger health system to gain greater financial stability. Unfortunately, its financial performance has deteriorated further under Legacy’s ownership; total margin declined from -0.72% in 2015 to -6.83% by 2025, with operating margins following a similar downward trend.
However, not all Oregon hospitals followed this trajectory. The vast majority of Legacy Silverton’s peers (other Type B hospitals—Oregon hospitals with 50 or fewer beds that are within 30 miles of another hospital) in the state realized profit margin improvements over the same period.
Silverton is an example of a partnership with Legacy that has underperformed profit-wise relative to its peers.
Paid More, Ended Up with Less: Legacy’s PacificSource Outcome
In 2016, Legacy spent $247.5 million to purchase a 50% stake in one of Oregon’s few domestic insurers, PacificSource. The acquisition was promoted as a way to create an integrated approach that would reduce costs and improve quality, population health, and access. Ten years later, it is worth examining how PacificSource has performed under this arrangement.
Legacy Employees Bore the Cost:
Legacy’s investment in PacificSource was expected to deliver meaningful benefits—both through significant capital infusion and by strengthening relationships with providers in key regions. It also resulted in PacificSource gaining a new, large self-funded client: Legacy’s own employee health plan.
Following the acquisition, Legacy transitioned all employee medical plan offerings to PacificSource, becoming one of the insurer’s largest self-funded accounts. PacificSource coverage for Legacy employees began on January 1, 2017. In effect, Legacy was partially negotiating with itself over employees’ benefits, given that they were both purchasing the insurance as an employer and part owner of the insurance carrier.
Following this transition, however, employees experienced steep health premium cost increases. An analysis of Legacy health insurance plan summary documents shows that over the next five years (2017-2021), employee health premiums increased by more than 36%—roughly three times the average increase experienced by employees in the healthcare industry in the Western United States during the same time period.*
Service Reductions and Layoffs:
In 2025, PacificSource announced it would withdraw its Medicaid plans from Lane County and the Portland area, effective January 1, 2026. This decision left Lane County—the fourth most populous county in Oregon—with just one coordinated care organization serving Medicaid enrollees.
Media coverage has characterized PacificSource as “in retreat,” citing both its contraction in services and substantial workforce reductions. In 2025, the company laid off hundreds of employees—nearly one-fifth of its workforce—with additional layoffs announced in 2026.
Taken together, these outcomes point to a troubling pattern: a partnership promoted as a path to progress, including cost management and market expansion, instead appears to have produced the opposite result. Under Legacy’s involvement, employees paid more for their healthcare coverage, communities lost insurance options, and PacificSource itself grew less stable—turning what was supposed to be an advantage into a liability.
*The average increase in employee health premiums experienced by employees in the healthcare industry in the Western United States was 11.5%. Source: 2025 KFF Annual Employer Health Benefits Survey | KFF.Results were filtered to show healthcare employers in the West region only (AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY)