Wyoming’s rural hospitals provide medical treatment to rural communities across the Cowboy State. But many of them are experiencing difficulties in providing care to patients. Sixteen of the state's 27 hospitals are listed as critical access ones. This means that they receive additional funding from the federal government that helps to keep them operating.
“They've emerged from the pandemic in pretty poor financial shape in a lot of circumstances,” said Eric Boley, president of the Wyoming Hospital Association. “And many of them are struggling a great deal.”
Short-term federal COVID-19 funds have helped with some of the costs associated with care, but more is needed. This has left several hospitals dangerously low on funds.
“I would say we have a handful of our hospitals that are under 10 days cash on hand at this point,” Boley said. “That's one financial indicator that we use in the industry to judge the financial strength of hospitals. Prior to the pandemic, we probably had two, maybe three that were right around 10 days cash on hand, but we [since then] we've doubled that number.”
Boley said that a better situation for a small hospital would be to have at least 160 days cash on hand.
Despite being a politically charged topic, Medicaid expansion has been touted as a way to help these small facilities. While a majority of Wyomingites have come to support expansion, the legislature failed to do so this session. Many advocates say it would help with the $130 million debt load that hospitals currently hold across the state. Boley added that expansion has proven beneficial for small hospitals in surrounding states, including Colorado, Montana, and Idaho.
“We estimate conservatively that if we were to expand Medicaid, we'd see a decrease of about 20 percent in uncompensated care,” he said. “So, it's a significant amount of money when you look at $130 million annually.”
The pandemic has taken a toll on Memorial Hospital of Carbon County in Rawlins.
Ken Harmon, CEO of the Memorial Hospital of Carbon County in Rawlins, said they’ve lost $11 million during the pandemic. They also ceased providing maternity and obstetrics in Rawlins, instead contracting with Ivanson Memorial Hospital in Laramie where many patients from Carbon County were already seeking these services.
“As you have volumes decrease, two things occur: the cost doesn't change because for us, you still have to have OB GYNs, you still have to have two nurses on at all time[s], you still have to have a CRNA to provide epidurals, and so we have this significant cost and the number of deliveries going down,” he said. “Our cost per delivery was skyrocketing.”
Approximately 50 deliveries per year were taking place in Rawlins before these services were eliminated locally, which also occurred at South Lincoln Medical Center in Kemmerer. Small hospitals have increasingly turned towards partnering with larger hospitals or health care systems, such as UC Health, to stay afloat.
But even with the numerous challenges rural hospitals face, they will continue to be a lifeblood for small communities.
