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Washington state hospital system ‘very fragile’ after two years of losses

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2 years ago

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Washington state hospital system ‘very fragile’ after two years of losses


Hospitals in Washington state continue to deal with daunting financial difficulties.

While hospitals generally fared a bit better in 2023 than in 2022, most hospitals are continuing to lose money, according to a survey by the Washington State Hospital Association. Some are cutting services and reducing beds.

During a media call Tuesday, Washington hospital leaders say some organizations are on the brink, and some aren’t poised to handle more financial pressures. Cassie Sauer, president and CEO of the Washington State Hospital Association, also pointed to financial difficulties from the Change Healthcare cyberattack, which has affected hospitals and healthcare providers nationwide.

“What we really see is that the state of Washington’s hospital system remains very fragile after experiencing more than two years of significant losses,” Sauer said. “And these losses are now being compounded by delayed payments from insurers and the impact of the cyber attack on Change Healthcare.”

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‘Unprecedented, unsustainable’

Cumulatively, the state’s hospitals lost $3.8 billion in 2022 and 2023, said Eric Lewis, chief financial officer of the Washington State Hospital Association.

“These losses are unprecedented, unsustainable, and represent a huge-post COVID financial challenge,” Lewis said.

In 2023, the state’s hospitals had a -5.2% operating margin, which actually represents a bit of improvement from 2022, when the margin was -7%. Lewis said 85% of the state’s hospitals are losing money.

The state’s hospitals ran in the red during the first half of 2023, and the losses mounted as the year progressed. Washington’s hospitals took in more revenue in 2023, but the revenues were outpaced by higher expenses.

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The net operating losses for Washington’s hospitals totaled $1.7 billion in 2023, compared to $2.1 billion in 2022.“The losses, though not as massive, continued,” Lewis said. He noted that the state’s hospitals have seen significant losses for eight consecutive quarters. 

Adding to the difficulties, more residents in Washington are relying on Medicare and Medicaid, Sauer noted. Fewer people are using commercial insurance, which typically provides better reimbursements to hospitals.

“That piece of the pie that’s commercial has really diminished quite a lot,” she said.

‘A large hole’

Ettore Palazzo is the CEO of EvergreenHealth, a community-owned, two-hospital system based in Kirkland. He said, “These terms, unprecedented and unsustainable, are absolutely true. And there are other adjectives that we’re trying to come up with because it almost doesn’t seem like those words are really appropriate anymore.”

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EvergreenHealth has lost $158 million over the past two years, he said.

To cut expenses, EvergreenHealth has had to reduce some positions, including some non-clinical positions and an executive role, Palazzo said. Some services have had to be cut, including a “helpline,” where residents could call nurses with health questions. The helpline had been operated for 30 years.

While EvergreenHealth has made some headway in reducing losses, Palazzo said the system still faces a difficult road.

“We have a large hole to climb out of,” Palazzo said. “And the thought of any other disruption, whether it be self-imposed, or as a result of another pandemic, or anything that changes the current, really delicate balance of how healthcare finances work now, could put all that in jeopardy. And I do worry about how hospitals will be addressing their capital needs as they work towards improvements.”

Closing delivery services

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Cathy Bambrick, administrator of Astria Toppenish Hospital, a 63-bed community hospital, outlined some of the sober challenges her organization has faced. The hospital lost nearly $8 million in 2023, after losing $7.3 million in 2022.

The hospital serves one of Washington’s most impoverished and ethnically diverse regions, including a large Native American population. The hospital is the only one in the state located on a reservation.

Lawmakers are working with the hospital to sustain emergency and acute care services, but Bambrick said some services have had to be cut.

In December 2022, the hospital closed its labor and delivery unit, leaving local women with a drive of more than 30 minutes, even in good weather. “And you know, in eastern Washington, we have very difficult driving conditions in the winter,” Bambrick said.

The hospital typically delivered a baby a day, she said.

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“We couldn’t have felt worse about closing that delivery unit,” she said.

In 2023, the hospital had to close its MRI service. “We are one of two hospitals in the state that doesn’t offer MRI services to its patients,” she said.

Needing a long-term remedy

Elise Cutter, CEO of Island Health in Anacortes, an independent, public hospital district, including a 43-bed facility, along with primary and specialty care clinics. Island Health is at a -12% margin over the past two years, she said.

“Over the past two years, we’ve seen an unprecedented increase in costs, yet have not seen corresponding increases in the payment for care,” Cutter said.

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Even though Island Health operates a small hospital, Cutter noted that it’s “too big” for enhanced funding for rural providers from the federal government.

Despite the financial hurdles, Island Health’s hospital has received a 5-star rating from the Centers for Medicare & Medicaid Services for the past two years, she says.

“We need to find a long-term solution to ensure that independent, rural public hospital districts like Island Health can continue to be the safety net for our community, and provide 5-star care close to home,” Cutter said.

‘Heartbreaking decisions’

In addition to the losses, Sauer pointed to the gut-wrenching decisions some hospitals have had to make to reduce services in order to stay afloat. Even seemingly minor decisions, such as reducing a couple of beds, matters to people who are seeking care, she said.

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“Over the course of the last year, we’ve seen hospitals make both what seemed like mundane, but also heartbreaking decisions, about service reductions and closures that are done to preserve access to other hospital services,” Sauer said.

And some of those decisions mean patients are waiting longer for the care they need, whether it’s closing a unit or even a couple of beds, she said.

“If you’re someone who’s looking for care, it can be a really big deal that your hospital now has less capacity,” Sauer said.



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Washington

Inside Woodlawn Cemetery’s mission to preserve history

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1 hour ago

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June 24, 2026

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Inside Woodlawn Cemetery’s mission to preserve history


The iron gate to Woodlawn Cemetery is almost always locked shut, but Toni White-Richardson was more than happy to let News4 inside.

As president of the Woodlawn Cemetery Perpetual Care Association, she was excited to talk about what makes this resting place so special.

“It is major D.C. history, first. Then it’s also major Black history, second,” White-Richardson said.

More than 30,000 people, mostly African Americans, are buried among the 22 acres of Woodlawn Cemetery, which opened in Southeast D.C. in 1895. And like so many cemeteries that date back to the 1800s, particularly African American cemeteries, this one has fallen into disrepair, is overgrown and has headstones tumbled over, like those of Wilhelmina and her husband James, and Eliza Spencer, a mother who died in 1887.

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“Let me do a very upfront disclaimer,” White-Richardson said. “We have no idea where these stones go. And when we looked at the grid, it became even clear as mud, it became less clear as to where these stones should really go. Unfortunately, when we look back, we can tell there was a plan, but we could see we never got totally completed. Even back then, there are no markers saying this is Section H or this is Section G or this is 102 and this is, none of that.”

One of the most notable Washingtonians laid to rest here is John Mercer Langston, Virginia’s first Black congressman.

“Langston University came one year because they had a grand reunion in D.C., and we arranged for them to come to see […] John Mercer Langston, the university that was named after this man,” White-Richardson said.

And Blance Bruce, the first Black U.S. senator to serve a full term and register of the treasury, is also buried in the cemetery.

“He’s the signature on our dollar bill, you know, back in the late 1800s,” White-Richardson said. “So, oh, it’s history. It’s capital letters. No getting around it.”

Woodlawn is also the resting place of several of the original founders of two of the country’s most prominent Black sororities, Alpha Kappa Alpha and Delta Sigma Theta. Both organizations volunteer to help with clean ups.

The Perpetual Care Association recently received a grant from the D.C. Office of Planning to help with upkeep of the grounds and preserving the history here.

“These are important individuals who’ve made contributions to the District a century ago, but today still their history and their stories reverberate and really influence the trajectory of our city,” said Anita Cozart, director of the D.C. Office of Planning.

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The cemetery tucked away off Benning Road is only open to the public five days a year, but groups can request tours anytime. The next chance to visit Woodlawn when it will be open to the public is Labor Day.

They’re always looking for volunteers and donors to help with the upkeep of this sacred ground.



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Washington

Parsing Trump’s claims about Washington’s reflecting pool

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11 hours ago

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June 24, 2026

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Parsing Trump’s claims about Washington’s reflecting pool


US President Donald Trump wanted to mark the US’s 250th birthday with a renovated Lincoln Memorial Reflecting Pool on the National Mall.

The makeover, including a new coat of “American Flag blue,” cost taxpayers $16 million (€14.1 million).

But the water is covered in green algae. The blue paint is already peeling. Trump has blamed vandals, while his critics question the project’s transparency and cost.

DW’s Brent Goff and Washington correspondent Janelle Dumalaon unpack the whole fiasco.

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Washington

Social media reacts to former BYU star AJ Dybantsa going No. 1 in 2026 NBA draft

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22 hours ago

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June 23, 2026

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Social media reacts to former BYU star AJ Dybantsa going No. 1 in 2026 NBA draft


Former BYU basketball star AJ Dybantsa fulfilled his dream of going No. 1 overall in the 2026 NBA draft.

The Washington Wizards selected Dybantsa with the first pick.

Immediately after the pick, reactions poured in on social media about the Wizards drafting Dybantsa.

Social media reactions to the Washington Wizards selecting BYU star AJ Dybantsa

Mitch Harper is a BYU Insider for KSL and hosts the Cougar Tracks Podcast daily on KSL Sports YouTube and KSL NewsRadio (SUBSCRIBE). Harper also co-hosts Cougar Sports Saturday (12–3 p.m.) on KSL NewsRadio.

Follow Mitch’s coverage of BYU athletics in the Big 12 Conference on X (formerly Twitter) and Instagram: @Mitch_Harper.

Want more coverage of BYU sports? Take us with you wherever you go.

Download the new and improved KSL Sports app from Utah’s sports leader. Allows you to stream live radio and video, keeping you up to date on all your favorite teams.

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