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The Impact – Steep Financial Losses for Hospitals and the Long-term Care Shortage

Mike McClanahan profile by Mike McClanahan
  • This week we look at why hospitals are hemorrhaging money as health care costs skyrocket and the consequences for access to medical treatment in Washington.  Then we focus on why the shortage of beds at nursing homes and assisted living facilities, as well as the financial challenges facing that industry. We also explore the debate over consolidation in both industries. Guests: Cassie Sauer, President and CEO of the Washington State Hospital Association and Carma Matti-Jackson, Washington Health Care Association

The surging cost of healthcare isn’t just a headline grabbing heated political issue, it’s built into the price of every bag of groceries. Medical services and insurance premiums are so expensive, they affect virtually every slice of society. Expensive procedures and hospital visits may strain personal savings for individuals and families, employers may struggle to offer workplace health benefits, and publicly funded programs such as Medicaid that cover people who can’t afford insurance are a huge expense for state and federal governments.

According to the state insurance commissioner’s office: insurance premiums for individuals went up nearly 50% over the last decade and deductibles increased by nearly 80% between 2010 and 2020. 

Meanwhile, hospitals are not immune to the rising costs of healthcare. According to the Washington State Hospital Association, hospitals in Washington experienced huge losses again last year, $1.74  Billion in lost revenue for 2023, following even steeper losses in 2022. 

What can we expect if the trend continues?

“I think the biggest thing is a loss of access to care. We have seen, for example, a loss of multiple rural maternity centers that are almost exclusively Medicaid patients. They just can’t make ends meet. To deliver a baby, you have to have a doctor who delivers a baby. You have a nurse. You need to have an anesthesiologist. You need to have a surgeon. You need to have a crash pediatric team. It’s a pretty complex group that you need to have there. They just can’t. They can’t afford it. And so those services are closing. We’ve seen closure of mental health services. We’ve just seen curtailing of services in general. I suspect if any of your viewers have tried to get health care in a hospital recently, it’s a challenge. It’s hard to get in,” said Cassie Sauer, President and CEO of the Washington State Hospital Association. 

Another major expense for many people later in life is long-term care. For some families that takes the form of an in-home care provider, but for others it involves nursing homes or assisted living facilities. The financial pressures facing those facilities has pushed many out of business. Meanwhile, the demand for long-term care is projected to grow sharply in the years ahead.

Why is there a shortage of available beds at long-term care facilities when demand has never been greater?

“It’s predominantly due to our staffing issues. We have beds. We just can’t find enough staff to make sure that we have the care for our residents that we need,” said Carma Matti-Jackson, CEO of the Washington Health Care Association which represents nursing homes and assisted living facilities. “I think competition is one of those things. We have high Medicaid providers that, don’t receive a lot in rates, which makes it very difficult to keep up with the wages that we have in our state. We have a very progressive state in terms of wages. We have annual inflation that takes place with our minimum wages. And, it’s just really hard to get the staff in, especially when Amazon and McDonald’s and Starbucks are able to pay equal in a lot of places to what we would pay for some very, very difficult, difficult care.”