WSHA Board Chair Testifies at U.S. Senate Rural Health Hearing

May 11, 2015

PMH Medical Center CEO Julie Petersen speaks to Washington state’s challenges and progress in meeting needs of rural communities

May 11, 2015, SEATTLE, Wash. — Washington State Hospital Association (WSHA) Board Julie PetersonChair and PMH Medical Center CEO Julie Petersen last week told a U.S. Senate committee that the state’s small rural hospitals continue to face significant challenges in fulfilling their mission of ensuring access to high-quality and affordable health care in their communities.

In testimony before the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, Petersen said, “Rural communities are older, sicker, have poorer health status and face significant economic challenges.”

“It’s never been easy to provide access to high-quality health care in these communities,” she said. “But, it’s even more difficult today.”

Washington state Senator Patty Murray, who invited Petersen to testify, serves as the panel’s senior Democrat. The subcommittee sets federal funding levels for a variety of health and human services programs that benefit rural and urban providers in the state.

Petersen also described the impact of the shortage of physicians and other health care professionals on rural health care systems and the need for a fairer Medicare reimbursement system for rural providers.

She noted that the state’s Medicaid expansion and its health insurance exchange have enabled more than 700,000 residents to obtain insurance coverage, which means many more residents have access to primary care.

PMH is a critical access hospital located in Prosser; it serves a population of 68,000 people.

“Julie did a great job of representing Washington state hospitals, especially those in rural areas, like Central Washington,” said Cassie Sauer, Senior VP of Advocacy and Government Affairs for WSHA. “Washington state’s rural hospitals are essential to providing high quality health care to enormous geographical areas. They provide not just acute hospital services but a wide range of health care that people who live in rural Washington need.”

Here is an excerpt from Petersen’s testimony to the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies:

The mission of rural health care providers like PMH is to ensure access to high-quality, affordable care for populations that are challenged disproportionately by distance, poverty, age, chronic conditions and cultural barriers.

Many of our patients do not have reliable transportation, paid sick leave and the other resources that allow them to travel to receive care outside their community. In short, rural communities are older, sicker, have poorer health status and face significant economic challenges.

It’s never been easy to provide access to high-quality health care in these communities. But it’s even more difficult today. As in most rural communities, PMH is more than a just a hospital. We are the backbone of a community health system. What you may think of as traditional hospital activity makes up only slightly more than a quarter of our business. 

We are a fully integrated delivery system dedicated to meeting the health needs of our community in a coordinated way. I need to move ahead creating medical homes for my patients and integrating behavioral and medical health in my rural health clinics. 

But there are so many reimbursement variables that I cannot assure my board that we can sustain these programs. The current fragmented financial system destabilizes rural health.

Another challenge we face is that many people in our area remain uninsured. That’s in spite of our state’s successful Medicaid expansion program, which has provided coverage to 535,000 Washingtonians, and the health insurance exchange, which has enrolled another 170,000 residents. 

Rural communities also face greater shortages of health care professionals than urban areas. As a CEO, physician recruitment is constant because we have an aging workforce, and our doctors work longer hours and see more complex cases than their urban colleagues.

Rural providers are dedicated to ensuring that the people who live in rural communities have access to the highest quality, affordable medical care. I am optimistic that we can achieve this goal.

“While many rural hospitals are thriving, others are struggling to continue providing needed health care to their communities,” Sauer said. “We greatly appreciate Senator Murray’s dedication to ensuring people living in rural parts of Washington state have access to quality health care. We particularly applaud her commitment to expanding telemedicine services, creating incentives for doctors and other providers to practice in rural areas, and funding programs to improve patient safety.”

Sen. Murray has a long history of championing rural health programs and recently helped pass legislation that ensures that Washington’s six teaching health centers will continue to train primary care providers in rural areas around Spokane, Yakima, Toppenish and the Puyallup Tribe. She has introduced and supported legislation throughout her career to help rural communities access a broad range of high-quality health care services, including the Community Coalitions for Access and Quality Improvement Act, the National Trauma Center Stabilization Act, and the Health Care Safety Net Act.

To read Senator Murray’s press release about Petersen’s testimony, visit her web page here.

Julie Petersen’s testimony can be viewed here.


The Washington State Hospital Association represents all of Washington’s 99 community hospitals. The association takes a major leadership role in issues that affect delivery, quality, accessibility, affordability and continuity of health care. It works to improve the health status of the residents of Washington state. WSHA is online at


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