The budget approved this week by the U.S. House and Senate may lead to fewer dollars going to rural hospitals that care for patients on Medicaid. Some small towns have aging populations with high percentages of people on subsidized care.
Shane McGuire, the chief executive of the Columbia County Hospital District, based in Dayton, worries any decrease in reimbursements will force facilities like his to reduce services.
Shane McGuire: When they say we're not cutting care for beneficiaries, that's probably a true statement. I don't think the beneficiaries were necessarily the target. But because Medicaid only covers a portion of the cost to deliver care, a lot of reliance on these other programs, these direct-funded programs, to sort of close that gap between the cost of care and what we're being paid, it's kind of crucial to survival. It's crucial to maintaining access for those beneficiaries. And so what I believe is being targeted mostly in these bills are those sort of supplemental Medicaid programs. And so when these funds go away, it's going to push a lot of us into the deep red, where we're going to be losing and we're going to have to be looking at ways to cut expenses even more.
McGuire says his hospital, Dayton General, is one of six in Washington that’s close enough to the financial red line that closure is not out of the question. Columbia County is a public hospital district, which means it could ask its customers to increase its taxes to pay for more services. McGuire doesn’t think that’s a realistic option.
Shane McGuire: We tend to be a less affluent population. We tend to be an older population on fixed incomes. And so the thought of them having to pay additional taxes to make up for this, I just don't think it's a reality.
McGuire says changes at the federal level would add to cuts implemented by the state. He and his staff and board have been working for months to find ways to be more efficient and trim expenses. If they’re not able to keep the system afloat, it means people in Dayton and Waitsburg and nearby towns will have to go elsewhere for care.
Shane McGuire: I do want to be a little careful and not just say the sky's falling, we're doomed. I did see that they put that hospital, that rural hospital fund in place. They at least have a sense that this is disproportionately bad for rural and that they needed to do something about it. I mean, that tells me that there's an awareness, right? And I think there's an opportunity for the AHA and WSHA and others to probably use that to say this is the reality if you implement it as designed.
McGuire says, even if the bill passes as is, Dayton General Hospital still has time to figure out what’s next.
Shane McGuire: We are probably going to be okay this year. Most of these implementations are gonna sort of slide in over the next few years. Most of us would be remiss to not be taking action or at least doing some pretty strong contingency planning right now. But it's not like I'm gonna move to close my inpatient services tomorrow, right? And I do think there needs to be some room for us to talk to our community because I don't like the idea of being a bigger burden on them.
