“My goal today is not to make health care partisan,” Joe Theine, CEO of Southwest Health System, said to a group of Montezuma County locals who gathered at the Dolores Public Library Saturday morning.
Although Theine presented a nonpartisan take on health care, the main focus of the day was a set of partisan cuts to federal Medicaid spending that could change the lives of every day Coloradoans.
This weekend, about three dozen people attended the meeting, organized by the League of Women Voters in Montezuma County for an in-depth conversation on rural access to health care. Saturday’s meeting, led by CEO Theine, came as potential cuts to Medicaid worked their way through the Senate that very morning, proffering large scale impacts on the vital medical resources of rural counties like Montezuma and possibly threatening to disrupt the necessary funds that allow Southwest Memorial Hospital to stay afloat.
Nationwide, based on the latest numbers from 2023, Medicaid accounts for about a fifth of all spending on hospitals. Hospitals that serve rural communities tend to be even more reliant on Medicaid.
Closer to home, that spending includes Southwest Memorial Hospital, which employs the third largest workforce in Montezuma County, right behind the Ute Mountain Ute Tribe and Montezuma Cortez School District RE1, according to a 2024 Region 9 report.
The overarching Southwest Health System – including not just the hospital on North Mildred Road, but also a clinic in Mancos and one in Montezuma-Cortez High School – clocked a volume of tens of thousands of patient visits last year, their latest annual report shows.
With uncertainty in the air, Theine did not always guarantee concrete answers at Saturday’s meeting.
“I can't predict what the future will be,” Theine said. “That crystal ball isn't gonna work anytime we're together today.”
Instead, throughout the meeting Theine offered insights on the federal bill’s progress, Southwest’s finances and future directions and a commitment to serving the community’s needs to the best of his ability.
Theine emphasized that as of Saturday morning, the Senate’s latest version of the budget reconciliation bill would be harmful to “people who live in rural communities, if not the health care system as a whole.”
While the bill includes a rural health care relief fund of $25 billion allotted over a five years, the sweeping cuts to Medicaid would be more permanent, Theine said.
Because of Colorado’s Taxpayer's Bill of Rights and a state budget deficit from last year, cuts to federal spending means the state cannot simply swoop in to provide funds lost, he said.
That means less money for hospitals and health care providers, he said.
An important, central feature of the cuts centers around the lowering of provider taxes that helps determine how much money thee federal government matches states to pay for Medicaid.
The 900-plus page, Trump-backed bill is slated for a July 4 deadline.
But the next area of uncertainty is the choices that Colorado will make on how it finances the health care of its residents, Theine said.
Amid concerns about federal funding, Theine described signs of financial well-being for Southwest which he largely attributed to the community members seated in front of him.
“Last year, we actually had more revenues coming in than we had expenses going out from operations,” Theine said, presenting a slide of graphs to the attendees.
The hospital anticipates about $85 million collected for services this year, which Theine said they use for all of their expenses, leaving roughly $1 million left to reinvest in the hospital.
“Our success over the last 18 months isn’t because we reduced expenses,” he said. “It’s because more of your said ‘when I need health care, i’m going to come to my local hospital.’”
By May, Theine said, the hospital finished the month with 109 days of cash available on hand. Some of that money is needed for repairs on the building and reserves for bond debt to maintain a good credit standing.
As a result, whatever happens federally, the hospital is in good financial standing, he said.
But the future was still uncertain, he said multiple times during the meeting.
Another common concern for rural health care has been hiring medical staff, such as doctors.
Oftentimes, medical staff may have to take on bigger workloads when the health care workforce is more limited in a rural region, Theine said.
Recently, Southwest is in the process of recruiting a new cardiologist that could live and work in the community, he said.
During the meeting, Theine and the attendees emphasized that fostering a vibrant community – with good schools and friendly neighbors – would help attract medical staff like doctors to move to the county and serve the needs of locals.
Key to having a vibrant community is valuing the contributions of what rural people do for the country, Theine said as the meeting drew to a close.
Whether the energy from oil and gas wells in Montezuma County or pinto beans grown in nearby Dove Creek, rural communities provide indispensable sources of goods to the country, he said.
“If we don’t have good health care here, who’s gonna move here?”
