A Look at the Local Medical Industry

Over the past two years, the Statesman-Examiner has followed local industries as they face the challenges of their trades. This week’s edition checks in with the local medical industry, reporting on medical care, support services, and recent changes in state and national mandates that may impact patients in northeast Washington. 

In Colville, with an approximate population of 5,000 that has remained steady since 2022, the reported rate of citizens without medical insurance also remains as a steady 5% (datausa.io). By contrast, citizens saw an insurance rate increase across the country last year, with some out-of-pocket rates for individuals going up 50%, according to Johns Hopkins University. 

The problems of medical insurance and the ability to provide services are detailed in a study

titled “Barriers to Care and Healthcare Utilization Among the Publicly Insured” published by the National Institutes of Health. The study stated that even patients who can afford to keep their medical insurance may face high deductibles and have to choose whether or not to seek medical care, even in an emergency. The National Rural Health Association stated that alternative models to the traditional healthcare industry are becoming an increasingly appealing solution in rural locations such as Stevens County where doctors may be scarce.

One such alternative is Direct Primary Care model Heartland Medicine, located on Main Street in Colville. 

“I started Heartland Clinic in 2019, because there was a need for expanded access for people without insurance and a need for urgent care as an alternative to the emergency room,” said Dr. Barry Bacon, who has been a family doctor in northeast Washington since 1990. “We practice cradle-to-grave-medicine, which includes delivering babies to performing surgeries to geriatric care.”

According to Bacon, the Direct Primary Care model is based on funding that comes entirely from members of the clinic who pay a monthly fee. This fee gives members access to on-site services such as x-rays. “We also negotiate for the lowest possible costs for various services, including lab fees, medications, and off-site imaging,” he said.

“We have done well in 2025,” stated Bacon. “We have more than 800 members who provide a solid income for the clinic. We’ve been in operation for seven years and have only had to increase our membership fees once.

“Our mission is to provide care to people who can’t afford care. We are not insurance. Because of that, we can’t afford to cover the big ticket items. But we are prevention and primary care. We hope to prevent some of the catastrophic events.”

A significant contributing factor to the rising costs of medical insurance is administrative cost. According to the American Hospital Association, the cost of non-medical care services such as staffing, coding, billing, and claims cost Americans hundreds of billions of dollars each year.

“Compared with other countries, the United States’ administrative costs for health care is out of line,” said Bacon. “The cost per person in the U.S. averages out to $1,000 per person per year. That amounts to 17% of our gross national product going into health care costs.

“Because of the increased costs, we are not visiting the doctor’s office as often as we should. The cost per visit is too high.”

Heartland Clinic, backed by the Direct Primary Care model, is much more affordable, Bacon said. The clinic negotiates for reduced costs for medications, tests, and lab work and does not charge insurance companies, and that helps to keep costs low.

“If I charged insurance companies, then I’d have to hire a coder and a biller, and then the administrative costs would increase,” Bacon said.

“People are going to have to make really difficult decisions. We try to fill a gap, we have compassion for people who are suffering in the community, and we have the ability to help. People don’t have a whole lot of options.”

Bacon recommended that people hang onto their high deductible plans, if they have them. While Heartland Clinic treats many levels of urgent medical situations, it is not a hospital and cannot replace an emergency room, he said.

“I have a lot of concern moving into 2026,” Bacon said. “Not only are administrative costs increasing, so are drug costs and epidemics that include obesity, addiction, and mental illness. If we address these epidemics, it would save us a lot in health care. We need to address the things we have control over and make a commitment to what we can do.

“It would do well to become less self-focused and look at what happens in the community. We can do something about this. We can invest in our community and work to restore lives, reunify families, work on our education and employment, and work on recovery.”

Bacon said he foresees a surge in the Direct Primary Care model due to the increase in people without insurance in 2026. “We may see other businesses like Heartland running in our community.”

Like Heartland Clinic, Providence Hospitals incorporates a model intended to care for those in need; its mission statement includes the steadfast service to all, “especially those who are poor and vulnerable” (providence.org). 

Providence Hospitals is a nonprofit, Catholic-based healthcare system based in Renton, Wash., and includes 51 hospitals, over 800 medical facilities, and several assisted living facilities in the western United States. Providence Mount Carmel Hospital in Colville and Providence St. Joseph Hospital in Chewelah fall under the jurisdiction of Chief Administrative Officer (CAO) Ron Rehn.

As CAO, Rehn said he is responsible for ensuring quality access to medical care, financial responsibility and accounts.

“The main focus of Providence is rural care and creating access for our rural neighbors,” said Rehn. “Access to high quality care in Stevens County is paramount. This means ensuring access to delivery for childbirth, emergencies, and 24/7 access to care.

“Providence takes care of residents regardless of ability to pay.”

Providence provided $25.6 million in free or reduced care for underinsured or uninsured patients in 2024, according to Rehn. Providence has charity care programs and also provides patients with the opportunity to set up payment programs. 

“We accommodate those who fall in the middle,” said Rehn. “They’re making just enough money to not be eligible for public programs, but don’t make enough money to have medical insurance. There is an income component to the charity programs. But we will see all patients in our emergency department. We take good care of people.”

In rural communities, there is a larger percentage of Medicare and Medicaid patients, and according to Rehm, this affects medical care in Washington state. “The decisions, policies, and new laws have a large impact in rural areas and communities,” Rehm said. “We haven’t yet seen the changes that have been enacted in 2025.

“We anticipate seeing big changes in 2027, and our responsibility is to fill in the gaps and make sure that we match needs with programs. We do a needs assessment every three years, and some of our current goals are to consolidate rehab services, expand on home health care in Chewelah, and sifting out. In other words, can needs be met by others in the community?” He said. 

Rehn continued, “We will be expanding some of our services, the details of which will be disclosed later.

“We do not anticipate closing any of our services. The federal government has classified ours to be Critical Access Hospitals, which means that these are rural hospitals that have been designated by Medicare to make sure that essential health services are available. There are only 39 Critical Access Hospitals in Washington, and I am responsible for two of them.”

Rehn said one of the primary goals for himself and his service area in Colville and Chewelah is to maintain excellence in the hospitals and primary care. Colville’s family practice residency is the first in the nation to graduate two family practice physicians in one year, Rehn said..

“The goal is to make sure that we have the physicians, the ER (Emergency Room), the hospitals… and also the deliveries and the workforce development. We need people in all of these categories for our small hospitals.

“We have a rural workforce, so we want to reach out to local people to enroll in our trained programs. We train nursing assistants and collaborate with Colville High School to get students into this program. This year, we are expanding this program to meet students where they are. We also train people for our facilities, labor, and food programs. We help with financial assistance and provide scholarships for training.”

Rehn added, “In the news, we hear talk about the negatives in medical care in rural areas, like hospitals closing and services being cut. But Providence works hard to preserve the commitment to serve the rural community. We are outstanding in continuing to provide that care.”