Before this week, every county in Wyoming had a hospital – except Sublette County. But as of this week, that’s changed.
On Monday morning, the doors to the Sublette County Hospital unlocked.
“So, 8 a.m. the first patient started arriving,” said Kari DeWitt, public relations director for the Sublette County Hospital District. “We've already had people in the emergency room and people in X-ray, MRI, mammogram.”
Before, it was at least an 80-mile drive to get a lot of that care, often in Jackson or Rock Springs.
The new hospital also has eight emergency beds and a blood bank.
“Without being a hospital, we couldn't have the complex laboratories, we didn't have any blood bank,” DeWitt said. “So if you were in an accident or a trauma or something pregnancy related, we were really far from care.”
While there was an emergency room at the Pinedale Medical Clinic before the hospital, it made billing insurance companies tricky.
“As a doctor's office, essentially, you're not able to bill for those hospital services,” said Gregory Brickner, the interim CEO of Sublette County Health. “So that's really what drove that need to open this hospital, and also you're getting a much higher and more sustainable level of care for the community.”
Brickner said the clinic sometimes gave hospital-level care to stabilize a patient in emergencies. But because they weren’t a hospital, they couldn’t bill insurance and Medicaid in the same way. Meaning, less reimbursement money.
But Pres. Trump’s One Big Beautiful Bill Act has raised concern across the country about the funding model for rural hospitals, as they rely heavily on Medicaid reimbursements. However, Brickner said because Wyoming didn’t expand Medicaid, it’s a smaller budget hit.
“It’s more of an administrative burden in recertifying the Medicaid patients and making sure that they stay certified,” he said.
But Brickner said he’s generally concerned about people being able to get necessary healthcare. The American Hospital Association (AHA) estimates about one-third of those with Affordable Care Act (ACA) insurance subsidies will lose them at the end of the year when enhanced premium tax credits expire. In Wyoming, where about 8% of the population is enrolled in the Marketplace, monthly costs for plans could rise up to 194% on average.
“So then those patients end up back in the uninsured category within our operations, and now we're trying to figure out if that patient qualifies for charity care, or trying to figure out that self-pay payer status,” he said.
Brickner added the ACA helped reduce the number of people in self-pay healthcare status in the state.
“The loss of those subsidies for some individuals is going to be pretty challenging,” he said. “That's a lot of your self-employed individuals – your small business employers that were getting the higher subsidy level.”
Brickner said the bigger cash-flow hit to the hospital project has been another pot of funds. Recent changes to county payouts from oil and gas taxes has been a hit to the group. As a result, the hospital had to take out a $10 million short term loan.
Changes to property taxes in Wyoming will also likely hit county-supported groups like medical clinics and hospitals, schools and special districts. WyoFile reported that hospitals like Sublette County’s will be “at risk” from the state-approved cuts.
All in all, it was a $73.8 million project. Funding sources included federal grants, Sublette County, Pinedale, Sublette County School District and local mill levies.
The hospital also has a new long-term senior care facility. Residents will be moved there in September.
There will be an official ribbon cutting ceremony for the entire hospital facility Sept. 25 at 2 p.m.
