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Ag and Rural Caucus Call to Meeting, November 2022

Posted on November 17, 2022

Private insurance and Rural Hospital risk

Harold Miller judges that of Washington’s 39 rural hospitals, 13 are at risk of closing, one of which may be facing immediate closure. Harold heads up a national center that “facilitates improvements in healthcare payment and delivery systems.” Harold joins Shane McQuire, Columbia County Health System, Thursday evening  to help us understand the complicated finances of rural hospitals. 

These “complicated finances” are not just Medicaid reimbursement calculations. Harold points also to private insurance payment rules.

There are two different types of hospitals in America—large hospitals that make high profits on patients with private insurance, and small rural hospitals that lose money providing care to these patients,” Miller said. “Private insurers are paying too much for services at many large hospitals but they are paying too little to sustain essential services in rural areas.

Join the discussion.

Don
15 November 2022

Rural Hospitals. Essential. Viable?
Thursday 17 November 6:30 pm 
https://us02web.zoom.us/j/84093446627?pwd=VFJ3N2p3RUhRRUNFRDhYKzlTa01sQT09 
Meeting ID: 840 9344 6627 
Passcode: 148588
Shane McGuire
CEO
Columbia County Health System

Rural Hospitals. Essential. Viable?
Economic Driver

We started looking at rural hospitals from the selfish position of saving our lives, and those of our families. A less urgent but maybe no less selfish view is that health care is big business. And we in rural areas need the employment and property taxes.

Recall, too, that several months ago we talked about “gateway” communities and the unwanted housing, water and environment, and cost-of-living effects that come with being attractive communities. The Methow was our test case but the same holds for Omak, Chelan Leavenworth, Cle Elum, and Dayton, too.

We recognize the downsides of Puget Sound residents moving east to work remotely and recreate locally. We acknowledge, though, that they bring not only pressure on scarce housing but also purchasing power, tax revenues and innovative ideas. They bring dollars and culture.

Health care access is part of responsible planning for populations shifts, for folks moving into our communities. Access to good health care is a major factor for both young families with kids going to our schools and retirees converting their house equity to investment in our downtowns.

If “selfish” means planning for our own welfare, then we all should know about, care about, and do something about making our rural health care viable.

Join Shane McGuire in talking through these issues. Shane enjoys widespread respect in southeast Washington and has graciously agreed to help us understand what makes small hospitals work.

Don
13 November 2022

Rural Hospitals. Essential. Viable?
Who pays what?

Some years ago, ARC heard from Providence that their estimates of how the Affordable Care Act would work were thrown off by the greater than expected proportion of their patients that were on Medicaid. The expansion of Medicaid had the intended effect of increasing the number of previously uninsured residents who were seeking health care.

The statement then was that Medicaid paid less than private insurers. A current study of small rural hospitals turns that on its head. Private insurers short small rural hospitals relative to Medicaid and Medicare. What are the facts?

This quickly drops us down into the rabbit hole of health care finance. One shaky handhold is Critical Access Hospital (CAH) designation. (Here is what they are. And here is who they are in Washington.) It turns out that CAH’s are compensated differently than Sole Community Hospitals, for example. CAH status buys you compensation based on your cost of service. No other classification gets this privilege. Most hospitals are paid under Prospective Payment Systems – “pre-determined, fixed discharge payment”.

If CAH status is so good, then, why is there such a variation in payment? If Dayton’s 60 percent “weighted cost to charge” is good, then what about Pomeroy’s 553 percent? What does this mean?

FINAL CRITICAL ACCESS HOSPITAL (CAH)
 WEIGHTED COST TO CHARGE (WCC) RATES
 INPATIENT OUTPATIENT
 WCC WCC
Cascade Medical Center92.88% 48.29%
Columbia Basin Hospital155.03% 68.40%
Coulee Medical Center77.70% 55.86%
Dayton General Hospital59.70% 46.20%
East Adams Rural Hospital73.31% 56.79%
Ferry County Memorial Hospital125.46% 36.35%
Forks Community Hospital57.91% 39.68%
Garfield County Memorial Hospital553.75% 139.84%
Jefferson Healthcare Hospital70.58% 42.22%
Kittitas Valley Healthcare66.14% 41.31%
Klickitat Valley Hospital130.02% 50.56%
Lake Chelan Community Hospital47.31% 56.49%
Lincoln Hospital102.80% 71.33%
Lourdes Medical Center23.60% 21.10%
Mason General Hospital43.03% 31.79%
Mid-Valley Hospital72.62% 47.63%
Morton General Hospital83.89% 54.67%
Newport Community Hospital75.37% 54.10%
North Valley Hospital95.55% 56.20%
Ocean Beach Hospital107.28% 54.89%
Odessa Memorial Healthcare Center199.39% 107.98%
Othello Community Hospital61.12% 42.59%
PeaceHealth United General Medical Center38.77% 29.01%
Prosser Memorial Hospital Medical Center41.57% 28.72%
Providence Mount Carmel Hospital65.10% 40.53%
Providence St. Joseph’s Hospital100.02% 49.06%
Pullman Regional Hospital78.76% 44.73%
Quincy Valley Medical Center433.39% 74.33%
Skyline Hospital84.51% 73.16%
Snoqualmie Valley Hospital85.63% 80.87%
St. Elizabeth Hospital26.46% 17.63%
Summit Pacific Medical Center54.43% 36.62%
Sunnyside Community Hospital33.16% 21.44%
Three Rivers Hospital102.36% 73.57%
Tri-State Memorial Hospital43.84% 39.48%
Whidbey General Hospital73.20% 30.00%
Whitman Hospital & Medical Center62.22% 56.80%
Willapa Harbor Hospital102.47% 57.93%

Let’s ask Shane McGuire on the 17th, but don’t expect an easy route out of the rabbit hole.

Don
7 November 2022

Rural Hospitals. Essential. Viable?

It is commonplace that rural hospitals are important. Common, that is, until it is your father has a cardiac arrest at the Thanksgiving table, your wife wakes up in the middle of the night gasping for air, or your son catches his hand in the baler’s power take-off, working alone on the other side of the farm. Then your local hospital becomes essential.

Will your hospital be there for the next curve life throws at your family?

Is your rural hospital viable? The cost structure is simple enough: physicians, nurses, support staff, supplies…the lights. That is where the simplicity stops. What is the denominator? A rural hospital does not know from day to day who is going to present as an outpatient, inpatient.

The bigger complication is payment for services. What do you get paid for a patient? And who decides?

Join Shane McGuire, CEO of Columbia County Health System (Dayton), to get a feel for the ins and outs of managing a rural hospital.

Don
29 October 2022


Legacy News

The Lower Snake River dam system moves grain from the Palouse and the Camas Prairie to Portland. Replacing this capacity is a difficult issue. Solutionary Rail, an advocacy group, has done an exceptional job of mapping rail alternatives to the barges. 

Watch the slide show.
Read the Introduction pages 1-9


The Odessa Groundwater Replacement Project is widening irrigation mainlines to deliver increased quantities of Columbia River water to replace the groundwater extraction from the Odessa aquifer. A problem, though, is finding funds to replace the existing bridges.


The Methow Valley continues to attract population growth.


One of ARC's longest standing issue is the wolf-cattle issue in northeast Washington. It does not stop.
The 9th Circuit takes up wolf management

Copyright © 2022 Ag and Rural Caucus, All rights reserved.
Ag and Rural Caucus of State Democratic Central Committee
Our mailing address is:
Ag and Rural Caucus
2921 Mud Creek Rd
Waitsburg, WA 99361

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Mike Lindell Declares Victory After Crushing Trial DefeatStory by Nikki McCann Ramirez and Asawin Suebsaeng, Rolling StoneOn Monday evening, MyPillow CEO and Donald Trump ally Mike Lindell texted Rolling Stone: "Awesome win! MyPillow 100% innocent!!!!"It was an odd moment to be taking a victory lap. Moments earlier, a jury ruled that Lindell had defamed a former Dominion Voting Systems executive named Eric Coomer on two occasions, including by calling him a traitor, and ordered Lindell to fork over $2.3 million in damages. Why was Lindell reveling in supposed victory? Presumably because the jury damages awarded to Coomer were significantly less than the $26.7 million sought by his attorneys.In his text to Rolling Stone, Lindell added that he planned to appeal the ruling, declaring: "My fight to get rid of the machines will continue on stronger than ever!"As previously reported by Rolling Stone, Lindell had seemed almost giddy to make his case in court ahead of the trial. "Of course I'm gonna testify at my own trial!" he said earlier this month. "I have nothing to hide. I am a former crack addict; I've always been open about that. I've always been open about everything! I'm as transparent as they come." Lindell did testify in his own defense, telling the jury that he didn't knowingly defame Coomer when he accused the Dominion director of being a traitor, while boosting wild conspiracy theories insinuating that Coomer had been involved in efforts by his employer to rig the 2020 election against President Donald Trump. (There is no evidence of any such plot.)While Lindell may be celebrating only being slapped with a seven figure damages penalty in this case, Coomer's lawsuit is the first in a series of defamation claims against the MAGA pillow magnate, related to his claims about the 2020 election. Lindell has also been sued directly by Dominion and by Smartmatic, another election hardware and software company about which Lindell made wild claims.Dominion is seeking $1.3 billion in damages from Lindell, Smartmatic has left the amount up to the judge. But it's safe to say that Lindell is nowhere close to being out of the woods. ... See MoreSee Less

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Never normalize what the Trump regime is doing. They want us to think this is perfectly fine and they are trying to desensitize us. ... See MoreSee Less

Brad Lander, NYC comptroller and mayoral candidate, is arrested outside immigration court

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New York City comptroller and Democratic mayoral candidate Brad Lander has been arrested at a federal building in Manhattan after he linked arms with a person that authorities were attempting to detai...
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Indivisible Tri-Cities WA is once again organizing another local rally on July 17th! ... See MoreSee Less

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It's only the "living in an alternate reality" MAGA's that want to be taxed more. ... See MoreSee Less

Bad news for Trump's tax bill: Poll finds majority of Americans oppose it

www.usatoday.com

A poll found 64% of Americans have an unfavorable view of Trump's proposed tax bill that passed the House in May and is being revised in the Senate
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Party Calendar

June 2025

Sun Mon Tue Wed Thu Fri Sat
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  • TCD Democrats Protest Tuesday

    TCD Democrats Protest Tuesday

    June 3, 2025  3:45 PM - 5:45 PM
    John Dam Plaza, 815 George Washington Way, Richland, WA 99352, USA

    "Protest Tuesday" at John Dam Plaza on GWay in Richland from 3:45pm to 5:45PM. Bring your own sign or flag or one will be provided. Join our stalwarts and protest whatever is bothering you most that day.
    https://www.facebook.com/events/999996418325987/999996484992647/

    See more details

  • SOME CUTS DON'T HEAL

    SOME CUTS DON'T HEAL

    June 3, 2025  4:00 PM - 6:00 PM
    1301 N Columbia Center Blvd., Kennewick, WA Next to Arby’s/Use Burlington parking lot

    Greetings Indivisible TC! We are inviting you to join an action we haven’t organized but support called Some Cuts Don’t Heal - Hold Them Accountable! It’s sponsored by Central WA Families and SEIU775. Some of our Leadership team will be there wearing our Indivisible t-shirts. Here’s more:

    Come one, come all... bring your friends, neighbors, coworkers, children!! BECAUSE I know, we all know someone on Medicaid who will be impacted by these cuts. Please show up and support!!!! #SOMECUTSDONTHEAL
    #HoldThemAccountable #SEIU775

    ¡Vengan todos! ¡Traigan a sus amigos, vecinos, compañeros de trabajo e hijos! Porque sé que todos conocemos a alguien con Medicaid que se verá afectado por estos recortes, ¡por favor, vengan y apoyen!! #ALGUNOSRECORTESNOCURAN
    #HaganQueRindanCuenta #SEIU775

    See more details

  • Richland City Council

    Richland City Council

    June 3, 2025  7:30 PM - 8:30 PM
    Richland City Hall, 505 Swift Blvd, Richland, WA 99352, USA

    See more details

• • •
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  • North Richland Dems Picnic

    North Richland Dems Picnic

    June 4, 2025  4:00 PM - 8:00 PM
    Leslie Groves Park, 40 Park St, Richland, WA 99354, USA

    See more details

  • SOME CUTS DON'T HEAL

    SOME CUTS DON'T HEAL

    June 4, 2025  4:00 PM - 6:00 PM
    1301 N Columbia Center Blvd., Kennewick, WA Next to Arby’s/Use Burlington parking lot

    Greetings Indivisible TC! We are inviting you to join an action we haven’t organized but support called Some Cuts Don’t Heal - Hold Them Accountable! It’s sponsored by Central WA Families and SEIU775. Some of our Leadership team will be there wearing our Indivisible t-shirts. Here’s more:

    Come one, come all... bring your friends, neighbors, coworkers, children!! BECAUSE I know, we all know someone on Medicaid who will be impacted by these cuts. Please show up and support!!!! #SOMECUTSDONTHEAL
    🩸🤕⚰️🩺🪦🩹🩸
    #HoldThemAccountable #SEIU775

    ¡Vengan todos! ¡Traigan a sus amigos, vecinos, compañeros de trabajo e hijos! Porque sé que todos conocemos a alguien con Medicaid que se verá afectado por estos recortes, ¡por favor, vengan y apoyen!! #ALGUNOSRECORTESNOCURAN
    🩸🤕⚰️🩺🪦🩹🩸
    #HaganQueRindanCuenta #SEIU775

    See more details

• •
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  • Indivisible TC - Founder Hour, Thurs

    Indivisible TC - Founder Hour, Thurs

    June 5, 2025  12:00 PM - 1:00 PM
    https://zoom.us/j/94107976607?pwd=qZeb9jUuH9e3DwVvukrhqxuwrNTWvv.1

    Join in and ask questions, get updates or just say hi! Zoom link below, let me know if you need the mobile version. These are held every Thursday at 12pm and occasional weekends.

    See more details

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  • Benton County Executive Board

    Benton County Executive Board

    June 9, 2025  6:30 PM - 8:30 PM
    Meeting details will be provided over email from the Benton County Democrats Chair.

    See more details

•
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  • TCD Democrats Protest Tuesday

    TCD Democrats Protest Tuesday

    June 10, 2025  3:45 PM - 5:45 PM
    John Dam Plaza, 815 George Washington Way, Richland, WA 99352, USA

    "Protest Tuesday" at John Dam Plaza on GWay in Richland from 3:45pm to 5:45PM. Bring your own sign or flag or one will be provided. Join our stalwarts and protest whatever is bothering you most that day.
    https://www.facebook.com/events/999996418325987/999996484992647/

    See more details

  • Kennewick City Council Workshop

    Kennewick City Council Workshop

    June 10, 2025  6:30 PM - 8:00 PM

    See more details

• •
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  • Indivisible TC - Founder Hour, Thurs

    Indivisible TC - Founder Hour, Thurs

    June 12, 2025  12:00 PM - 1:00 PM
    https://zoom.us/j/94107976607?pwd=qZeb9jUuH9e3DwVvukrhqxuwrNTWvv.1

    Join in and ask questions, get updates or just say hi! Zoom link below, let me know if you need the mobile version. These are held every Thursday at 12pm and occasional weekends.

    See more details

  • 8th LD Democrats General Meeting - Thursday, June 12th

    8th LD Democrats General Meeting - Thursday, June 12th

    June 12, 2025  6:30 PM - 8:30 PM
    https://us02web.zoom.us/j/81281540363?pwd=yIVhkstb8G71OA79g8FD4hBUAOJzUI.1#success

    Meeting Details:

    This meeting is for all residents of the 8th Legislative District to attend as their time permits.

    We strongly encourage attendance by our PCOs and anyone who wishes to participate or contribute to the efforts of the 8th LD Democrats, as well as those seeking information on how they can help.

    Our June Meeting will be Zoom only due to constraints at available locations.

    Our July meeting is booked at the Kennewick Library and will also be on Zoom.

    See more details

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  • Tri-City Democrats Meeting/Potluck

    Tri-City Democrats Meeting/Potluck

    June 13, 2025  6:00 PM - 8:00 PM
    4501 W Lattin Ct West Richland WA 99353 USA

    See more details

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  • NO KINGS Tri-Cities WA

    NO KINGS Tri-Cities WA

    June 14, 2025  11:00 AM - 1:00 PM
    1321 N Columbia Center Blvd We will be on the sidewalk in front of the mall Kennewick, WA

    In America, we don’t put up with would-be kings. NO KINGS is a national day of action and mass mobilization in response to increasing authoritarian excesses and corruption from Trump and his allies. We’ve watched as they’ve cracked down on free speech, detained people for their political views, threatened to deport American citizens, and defied the courts. They’ve done this all while continuing to serve and enrich their billionaire allies.

    🚨On Saturday, June 14, we’re taking to the streets nationwide. We’re not gathering to feed his ego. We’re building a movement that leaves him behind.🚨
    RSVP at: https://www.mobilize.us/indivisible/event/787085/

    See more details

  • No Kings: National Day of Defiance

    No Kings: National Day of Defiance

    June 14, 2025  12:00 PM - 1:00 PM
    Walla Walla County Superior 315 W Main St Walla Walla, WA 99362

    In America, we don’t put up with would-be kings. NO KINGS is a national day of action and mass mobilization in response to increasing authoritarian excesses and corruption from Trump and his allies. We’ve watched as they’ve cracked down on free speech, detained people for their political views, threatened to deport American citizens, and defied the courts. They’ve done this all while continuing to serve and enrich their billionaire allies.

    🚨On Saturday, June 14, we’re taking to the streets nationwide. We’re not gathering to feed his ego. We’re building a movement that leaves him behind.🚨

    The flag doesn’t belong to Donald Trump. It belongs to us. We’re not watching history happen. We’re making it.

    On June 14th, we’re showing up everywhere he isn’t—to say no thrones, no crowns, no kings. Check out nokings.org for more information.

    A core principle behind all No Kings events is a commitment to nonviolent action. We expect all participants to seek to de-escalate any potential confrontation with those who disagree with our values.

    See more details

  • No Kings: National Day of Defiance

    No Kings: National Day of Defiance

    June 14, 2025  2:00 PM - 4:00 PM
    John Dam Plaza 815 George Washington Way Richland, WA

    They’ve defied our courts, deported Americans, disappeared people off the streets, attacked our civil rights, and slashed our services. The corruption has gone too. far. No thrones. No crowns. No kings.

    See more details

• • •
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  • TCD Democrats Protest Tuesday

    TCD Democrats Protest Tuesday

    June 17, 2025  3:45 PM - 5:45 PM
    John Dam Plaza, 815 George Washington Way, Richland, WA 99352, USA

    "Protest Tuesday" at John Dam Plaza on GWay in Richland from 3:45pm to 5:45PM. Bring your own sign or flag or one will be provided. Join our stalwarts and protest whatever is bothering you most that day.
    https://www.facebook.com/events/999996418325987/999996484992647/

    See more details

  • Richland City Council

    Richland City Council

    June 17, 2025  7:30 PM - 8:30 PM
    Richland City Hall, 505 Swift Blvd, Richland, WA 99352, USA

    See more details

• •
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  • Indivisible TC - Founder Hour, Thurs

    Indivisible TC - Founder Hour, Thurs

    June 19, 2025  12:00 PM - 1:00 PM
    https://zoom.us/j/94107976607?pwd=qZeb9jUuH9e3DwVvukrhqxuwrNTWvv.1

    Join in and ask questions, get updates or just say hi! Zoom link below, let me know if you need the mobile version. These are held every Thursday at 12pm and occasional weekends.

    See more details

•
20
  • Indivisible Tri-Cities Potluck/Strategy Session

    Indivisible Tri-Cities Potluck/Strategy Session

    June 20, 2025  5:00 PM - 7:30 PM
    Mid-Columbia Libraries - Kennewick Branch Located in: Highlands Grange Park Address: 1620 S Union St, Kennewick, WA

    What: bring a food item to share, we will be planning for next month and continue our work on community building and education. We hope you can join in.

    See more details

  • World Refugee Day Celebration

    World Refugee Day Celebration

    June 20, 2025  6:00 PM - 8:30 PM
    BOY AND GIRLS CLUB - KENNEWICK CLUB HOUSE 910 W 7th, Kennewick

    Join B5 in celebration of World Refugee Day on Friday, June 20! This is an evening to learn more about our refugee neighbors, see cultural performances, and enjoy a meal while supplies lasts. The event starts at 6pm and will take place on the Boys & Girls Club lawn.

    See you there!

    See more details

• •
21
  • WA Immigrant Support Network - Latino Pride

    WA Immigrant Support Network - Latino Pride

    June 21, 2025  2:00 PM - 7:00 PM
    327 W. Lewis St. Pasco, WA

    WAISN is proud to join the first Latino PRIDE in Tri Cities, Washington! Come celebrate with us on Saturday, June 21, from 2–7 p.m. in Pasco. We’ll be tabling alongside local organizations, sharing resources, and honoring the resilience, joy, and leadership of our queer Latinx communities. Stop by to connect, celebrate, and build power together!

    See more details

•
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  • TCD Democrats Protest Tuesday

    TCD Democrats Protest Tuesday

    June 24, 2025  3:45 PM - 5:45 PM
    John Dam Plaza, 815 George Washington Way, Richland, WA 99352, USA

    "Protest Tuesday" at John Dam Plaza on GWay in Richland from 3:45pm to 5:45PM. Bring your own sign or flag or one will be provided. Join our stalwarts and protest whatever is bothering you most that day.
    https://www.facebook.com/events/999996418325987/999996484992647/

    See more details

  • Richland City Council Workshop

    Richland City Council Workshop

    June 24, 2025  6:00 PM - 8:00 PM
    Richland City Hall, 505 Swift Blvd, Richland, WA 99352, USA

    See more details

• •
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  • Indivisible TC - Founder Hour, Thurs

    Indivisible TC - Founder Hour, Thurs

    June 26, 2025  12:00 PM - 1:00 PM
    https://zoom.us/j/94107976607?pwd=qZeb9jUuH9e3DwVvukrhqxuwrNTWvv.1

    Join in and ask questions, get updates or just say hi! Zoom link below, let me know if you need the mobile version. These are held every Thursday at 12pm and occasional weekends.

    See more details

  • BCDCC General Public Meeting

    BCDCC General Public Meeting

    June 26, 2025  6:30 PM - 8:30 PM
    Richland Public Library, Conference Rms A & B, 955 Northgate Dr, Richland, WA 99352, USA

    See more details

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