State regulators are taking more time to review a proposed merger between Salem Health and Santiam Hospital Clinics to consider how the deal could impact patient access and affect competing healthcare providers.  The Oregon Health Authority’s decision for an extended review came down Tuesday, May 5, almost two weeks earlier than the deadline. The agency oversees hospital mergers in the state, evaluating how they could affect the affordability, quality and availability of the healthcare Oregonians receive.  The state now has up to 155 days to decide to either approve the deal, require changes or scrap it altogether.  READ IT: Oregon Health Authority preliminary review Regulators began an initial 30-day review on April 16, where they looked at the scope of the work the hospitals are doing in the community. They determined the merger did not meet any of the criteria that would have yielded an early approval. Those criteria include whether a transaction is necessary to keep a hospital open, if it’s unlikely to reduce access to affordable healthcare and if it will not substantially alter the delivery of healthcare. The health authority wrapped the initial review early to allow more time for a deeper look.  “Because the transaction has the potential to have substantial impacts on healthcare in Marion County, it became clear that this review requires complex analyses that can’t be completed in just 30 days,” health authority spokeswoman Franny White told Salem Reporter in an email. “As a result, OHA decided to complete its preliminary review before the 30-day deadline and begin its comprehensive review.” Hospital leaders previously expressed optimism about the state’s future decision, pointing to their shared missions as nonprofit hospital systems. They hope for the state’s approval by Sept. 30. A final decision could come as late as October, though the review clock could pause at any point if officials ask the hospitals for more information.  The Oregon Health Authority is accepting public comment on the proposed hospital deal. Comments can be made by email to [email protected], voicemail at 503-945-6161 or through an online public comment form. Santiam officials expressed disappointment with the state’s decision.  “Moving into comprehensive review was not the outcome Santiam Hospital Clinics was seeking, as it significantly extends an already urgent timeline for our organization and the community we serve,” Santiam spokeswoman Melissa Baurer said.  Santiam has positioned the merger as necessary to invest in infrastructure, including a new electronic record system, and hospital services to support the population it serves. It cannot afford to invest in the upgrades on its own.  “Santiam is operating with limited financial reserves and facing increasing costs that challenge our ability to sustain and grow services over time. Prolonged uncertainty only adds to that strain and impacts our ability to make the investments necessary to maintain access to care locally,” Baurer said in an email. The extended deadline will give the health authority more time to assess how the deal could affect the quality, cost and availability of healthcare locally, and evaluate the potential anti-competitive impacts of combining two of the three hospitals in Marion County.  Santiam, based in Stayton, serves some 60,000 patients each year through its hospital and 13 Santiam Canyon clinics. Its system provides critical care access for several rural communities, including Stayton, Mill City, Gates, Idanha, Gates and more.  “Residents have few options for care and would need to travel long distances to get care if not for Santiam,” the report said. Salem Hospital, meanwhile, has one of the busiest emergency departments on the West Coast and 644 hospital beds – the most of any Oregon hospital. Salem Health also operates 27 outpatient clinics in Marion and Polk counties. The system has continued to grow in recent years, recently absorbing Hope Orthopedics in 2023 and Willamette Urology in 2024. The growth has garnered concern from patients. The health authority has received over 100 public comments since December, most opposing the merger. Many expressed concern over consolidation by Salem Health and insurance coverage. Regulators are reviewing how the merger could affect healthcare access. Data cited in the report showed that two out of three residents in Marion and Polk County have experienced a barrier in accessing healthcare, including difficulty getting an appointment quickly, finding providers accepting new patients and high out-of-pocket expenses.  “Some public comments have also raised concerns that the transaction could worsen existing access issues, including lack of appointments, long emergency department wait times and inadequate staffing to serve patients,” the report said.  Commenters also raised concern over Regence BlueCross BlueShield insurance coverage. Regence is out-of-network at Salem Health, but in-network at Santiam until at least June 2027. The insurer authored a letter to the state in late April, asking it to ax the deal. A healthcare market already concentrated If approved, Santiam would become Salem Health’s third hospital, taking on its name to become, “Santiam Hospital, Salem Health Hospitals Clinics.” Salem Health also operates West Valley Hospital in Dallas.  State reviewers said the merger could further concentrate healthcare in Marion County. According to the report, Salem Health already holds 89% of market share in the Salem area, based on hospital discharge data. Santiam also has a stronghold on its market in the Santiam Canyon, data showed.  “These publicly-available findings indicate that Salem Health and Santiam already operate in highly concentrated markets,” the report said. “But more in-depth analyses are needed to fully understand the potential impacts of the proposed transaction.” The report also cited research showing that hospital consolidation can raise prices for patients, decrease or not affect quality of care and slow wage growth for employees.   Spokeswomen for the two hospitals said the merger would reduce the cost of care for patients by combining administrative services, implementing Salem Health’s lean management system and increasing the amount of patients Santiam serves.  By pooling resources and combining patients under one system, the merger would improve quality of care, they said. “Together, this allows more patients to receive care close to home while benefiting from improved continuity of care through a connected health record and the support of a larger, Oregon-based nonprofit health system,” Baurer said. Santiam’s employees would be moved to the Salem Health pay scale.  “Salem Health will continue to pay market wages to all its staff to ensure it has the workforce to serve our community,” Salem Health spokeswoman Megan Allison said in an email. Have a news tip? Contact reporter Hailey Cook: [email protected] . SIGN UP: “Your work helps hold leaders accountable and gives citizens a voice.” Independent reporting gives Salem a stronger voice on issues from homelessness to health care. Be part of that work. Subscribe today. The post State regulators will take longer to review potential patient impacts of Salem Health-Santiam merger appeared first on Salem Reporter. ...read more read less