Matt Altman

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Kittitas Valley Healthcare (KVH) has been a fixture in this community for decades. It seems normal to us to have an independent, community hospital provide the healthcare services we need. My work as a commissioner for Hospital District 1 and with the American Hospital Association has made me aware of the challenges facing rural hospitals throughout the United States. I’ve discovered that what we think of as normal is actually pretty unusual, and becoming more so.

Rural hospitals confront unique financial challenges that big-city systems do not, including lower patient volume, higher drug costs, and a reliance on government payers (where we’re usually reimbursed less than the cost of treatment). In addition, rural health care systems also have trouble recruiting caregivers. Nonetheless, rural hospitals have largely the same regulatory burdens as larger systems do, along with the associated costs.

These challenges are having a dramatic impact on access to care in rural communities. According to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, 180 rural hospitals in the U.S. have closed since 2005. Many others have merged with or been acquired by larger health care systems. As a result, they become little more than waystations for patients to be immediately transferred to the nearest big city so that they can get less personalized care at a “more efficient” system owned by the parent company.

Despite all these national trends, KVH remains an independent, rural hospital whose mission is to serve the people of Kittitas County, not to provide a revenue stream for investors elsewhere. KVH does an excellent job of providing high-quality care locally. The current Board and the CEO share a commitment to increasing access through additional service lines. That, along with sound fiscal management, has made KVH financially strong even as many other rural hospitals struggle.

There are many advantages to living in a rural community with an independent health care system that has its own hospital and clinics. For example, over the past few years KVH has been adding specialty services so that patients can get treatment where they live, right here in the valley. New services include neurology, vascular surgery, otorhinolaryngology (ENT), workplace health, wound care, and dermatology, among many others. We’ve also improved existing services, such as adding a 24-hour pharmacy, expanding physical therapy, and offering state-of-the-art digital mammography. Having to transfer a patient can take a KVFR ambulance and crew out of the county for several hours. Keeping care local allows them to stay here and provide emergency services to people who need them.

As an independent, rural hospital, KVH has close relationships with community partners. The distribution of COVID vaccines in Kittitas County has been so efficient and successful because it has been overseen by the Kittitas County Incident Management Team, with members from the Public Health Department, Kittitas County Sheriff’s Office, Kittitas Valley Fire & Rescue, KVH, and many others. The ability of these different local organizations to work together has gained us attention in national media outlets and has made us the envy of other counties in the state.

KVH is also the second biggest employer in Kittitas County, which means that the people working there are your friends and neighbors. Studies have shown that rural hospital closures result in a per capita reduction in income and a long-term increase in the local unemployment rate. In other words, there are economic benefits, in addition to health benefits, from keeping care local.

As a community member, I know that there are many things make Kittitas County special. As a commissioner, I know that having an independent, rural healthcare provider is one of them.

Matt Altman is Secretary of the KVH Board of Commissioners and a professor at Central Washington University.

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