Arrow-right Camera
The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

State Senate approves bill to increase Astria Toppenish Hospital funding

The Astria Sunnyside Hospital in Sunnyside, Wash.  (Amanda Ray/Yakima Herald-Republic)
By Santiago Ochoa Yakima Herald-Republic

Astria Toppenish Hospital is one step closer to having its Medicaid reimbursement rates increased, which could help solve many of its financial woes.

Astria Health has spent most of the time it has owned Toppenish Hospital – almost six years – working with state lawmakers to raise the hospital’s reimbursement rates. Now, a bill sponsored by Sen. Curtis King, a Yakima Republican, could raise Toppenish Hospital’s Medicaid reimbursement rates to as high as 200% under certain conditions.

Astria Toppensh Hospital closed its Family Maternity Center in December, citing a low Medicaid reimbursement rate, rising operational costs and staffing issues. Earlier this week, Jane Winslow, an Astria Health spokesperson, said the hospital’s financial condition had stabilized since the center closed.

A bill that passed the state Senate this week would increase reimbursement rates for hospitals that are not currently designated as critical access hospitals and do not meet the criteria for eligibility, have Medicaid inpatient days greater than 50% of all hospital inpatient days, and are on the land of a federally recognized Indian tribe.

Astria Toppenish Hospital is the only hospital in the state to meet those requirements.

The bill, now before the House Health Care and Wellness Committee, would separate reimbursement rates for the hospital based on inpatient and outpatient services.

Inpatient services provided by the hospital regardless of their managed care enrollment status would be reimbursed at 120% of the hospital’s fee-for-service rates. Outpatient service rates would be raised to 200%. This means the hospital would receive the enhanced reimbursement rate for treating anyone eligible for Medicaid.

In 2021, Astria Toppenish Hospital’s revenue was made up of 75% outpatient services and 25% inpatient services, according to a year-end report submitted by Astria Health to the Washington Department of Health.

The new rates would be implemented Jan. 1, 2024, and end Dec. 31, 2028.

This is not the first time Astria Toppenish Hospital, whose leadership met with state lawmakers last week and advocated for King’s bill, has pushed for legislation to raise its Medicaid reimbursement.

In 2020, Astria Toppenish was one of three hospitals to receive funds from the state’s supplemental budget for a short-term reimbursement raise. From summer 2020 to summer 2021, the hospital’s reimbursement rate rose to 150%, putting it in line with the rates for nearby critical access hospitals like Kittitas Valley Healthcare and Prosser Memorial Health.

Astria Toppenish does meet the requirements to be categorized as a critical access hospital because of its size. Critical access hospitals are required to have 25 licensed hospital beds or less. Astria Toppenish has 63.

“This bill is critical to this small rural hospital in the lower Yakima Valley,” King said in a press release. “It is a hospital so valued and needed by the Yakama Tribe, by our Hispanic community and by all of the citizens who live in the lower Yakima Valley. Without this extra funding, the hospital is at risk of closing. I’m so very glad the Senate passed this important bill.”

Other community leaders like District 3 Yakima County Commissioner LaDon Linde and Dr. Rex Quaempts, medical director of Yakama Indian Health Services, spoke in favor of the bill during a public hearing.