Brad Boner sits in a reclining chair in St. John’s Health oncology clinic. Small partitions separate five adjacent bays where patients – some talk on the phone or type on laptops, trying to work – receive intravenous infusions.
“I look like Professor Xavier,” he said, referencing the Marvel Comics character while removing the beanie that keeps his newly buzzed head warm.
Last year, liposarcoma, a rare cancer that develops in fatty tissue, manifested as a five-pound tumor the size of a football near his stomach. After surgery, the longtime Jackson Hole News & Guide photographer is down to one kidney.
“My doctors,” he said, “their biggest concern is just to maintain that kidney function and make sure it stays healthy.”
The father of two used to drive just 10 minutes from his house in Victor, Idaho, for a sodium chloride hydration infusion up to three times a week on his off-weeks from chemotherapy.
Then, Teton Valley Health Care (TVHC) in eastern Idaho suddenly closed its infusion clinic and laid off 26 people. An anonymous donor recently stepped in to save the hospital from closing altogether.
That’s why Boner is here in Jackson, an hour’s drive in icy conditions.
Kenedee Hill was a nurse with the clinic when it closed after three years. She’d been there almost from the start, watching patient volume grow from just a few daily infusions to over 10.
“It was actually pretty heartbreaking,” she said of the closure. “It was kind of my baby that we started out.”
The difficult decision came down to costs, TVHC spokesperson Nancy Osmundson told KHOL. One infusion visit can cost up to $30,000.
Teton Valley Health faced a perfect storm: soaring health care costs, slashed federal reimbursements, low patient volume and high rates of uncompensated care.
“We were facing bankruptcy a few weeks ago,” she said in mid-February. “We were looking at closing our doors.”
Just over half of the hospital’s patients are on Medicare and Medicaid. And those costs could go unreimbursed for a year, Osmundson said.
Once the clinic closed, most patients had to choose between driving much longer — an hour and a half to Idaho Falls — or across state lines to Jackson. Most aren’t in Boner’s position, whose work-sponsored insurance grants him access to Wyoming insurance providers.
“You have to decide between driving to Rexburg or Idaho Falls in a snowstorm, or drive over Teton Pass in a snowstorm,” Boner said. “Neither one of those are appetizing options to me.”
TVHC is not on its own as a struggling rural hospital.
Even before recent political events, the lack of a sustainable financial model has left hospitals in less-populated areas struggling to keep up with rising health care costs. Last year’s federal policies have only made things worse, according to national analyses.
Last year, Congress passed the Trump administration’s One Big Beautiful Bill, which included Medicaid cuts. Some lawmakers supported that bill because of the last-minute addition of the Rural Health Transformation Program. The federal government awarded almost $186 million for Idaho over the first five years and $205 million for Wyoming.
But strict usage requirements and delayed timelines mean Osmundson is losing hope. She thought federal money would make it through the Idaho legislature by this spring, but now is eyeing late October, if at all.
“I don’t think that we will ever see that funding,” she said, “that is not something that we’re planning for.”
It’s hard to tell just how many people like Boner have been impacted by the infusion clinic’s closure. Osmundson said at least 750 procedures took place from October through the end of last year.
Hill estimates the clinic – which also treated wounds – would see about 150 to 200 visits a month, but some would be repeat patients.
That means about 90 active infusion patients could be left to search for care.
About 20 of Hill’s former hospital patients now get infusions in their home through Vital Care of Eastern Idaho, where Hill now works, treating issues from Crohn’s disease to rheumatoid arthritis or osteoporosis.
Most cancer patients, Hill says, have followed the oncologist to Idaho Falls or Rexburg. In an email, St. John’s Health Chief Communications Officer Karen Connelly wrote the Jackson hospital does have the capacity to take some of eastern Idaho’s infusion patients.
Though chemo is also usually delivered via IV, that has to happen in a hospital.
Boner’s employer-sponsored insurance is in Wyoming, making his infusion trips to Jackson somewhat unique for east Idaho residents. Others in a similar spot could also go to Frontier Infusion in Jackson.
The latter is run by Hannah Pollat, who takes calls on breaks from the operating room as a full-time nurse at St. John’s to squeeze in patients for treatment on her off days. She doesn’t have much capacity now to take on more customers at her private clinic, unaffiliated with St. John’s, let alone with new patients from Driggs.
“It’s quite incredible how many people are just totally dependent on these medications [otherwise] they would just be suffering,” she said. “And they really are just at the whim of insurance.”
After the anonymous donor stepped in to save Teton Valley Health Care from closing its doors and filing for bankruptcy, there is a chance the Idaho infusion clinic will open again.
But Osmundson said operating independently is no longer feasible, and philanthropy is not a long-term solution.
While the Driggs hospital looks for more tax revenue or partnering with a larger hospital group, people like Boner are left making the trek wherever they can find help.
“It’s just one more thing,” he said. “You’re already dealing with enough when you get a cancer diagnosis.”
