Bartlett Hospital board outlines budget pressures, clinic growth and Medicaid uncertainty

Bartlett Hospital leaders told a joint session with the Special Assembly Finance Committee that FY26 spending is higher than planned because of clinic startups and one-time reimbursement timing, but they expect FY27 to finish positive if projected improvements in outpatient revenue are realized.

Hospital CEO Joe Wanner said the hospital added two primary-care clinics (family practice and Glacier Pediatrics) and expanded specialty services, which increased personnel and startup costs. He said a reimbursement timing issue tied to Wildflower Court cost the hospital roughly $1.2 million early in the year but that internal fixes (including identifying about $3.2 million in previously unbilled pharmaceutical revenue) are expected to recover funds later in the fiscal year.

Wanner told the meeting Bartlett is not receiving a previously available rural demonstration payment (worth about $4.2 million in earlier years), which contributes uncertainty to future revenue. He said the hospital is pursuing alternative reimbursement models and is engaging with congressional staff to explore extensions or other mechanisms, but outcomes are not yet known.

On services, board members discussed hospice and home care, which the hospital reports are operating at a monthly loss (approximately $30,000/month for hospice and $50,000/month for home care) under current reimbursement rules. Wanner said hospice is primarily home-delivered and that longer average lengths of stay are a clinical and financial priority.

Bartlettalso described capital and operational priorities: an emergency department renovation expected to start construction in April and take about 18 months, a placeholder $3.5 million capital figure for expanding Bartlett House (patient lodging and employee apartments) to address staff housing shortages, and facility master planning for long-term needs. The board noted hospice/home-care challenges and the impact of the broader rural health transformation program, which injects federal funds to the state but changes local reimbursement dynamics.

The Bartlett board reported an independent audit identified prior-period adjustments and timing issues (noted as significant deficiencies in interfund reconciliations) that management is addressing; auditors will finalize the report and the hospital expected to have the audit document available by the following Friday.

Board leaders emphasized the hospitalis focusing on financial controls, employee engagement improvements, and strategic community outreach to sustain a community-owned hospital over the long term. No binding appropriations or changes to the assembly budget calendar were taken during the joint session.