Despite recent staffing and service reductions across Spokane's healthcare sector, some providers here expect to maintain their workforces and offerings, even as they face rising expenses, growing patient demand, and difficulties with Medicaid compensation.

In 2025, Providence closed several orthopedic therapy programs in Spokane and Stevens counties due to state and federal funding cuts, impacting about 60 employees, the Journal previously reported.

More recently, in September, MultiCare Health System announced several Rockwood clinics would close by the end of 2026 in the Spokane area, including several eye and optical centers, its Rockwood Primary Care Access Clinic, and the Rockwood Dermatology Center, the Journal previously reported. The closures are due to financial challenges in the healthcare industry and are expected to impact 83 employees.

Currently, rising employee wages, insurance costs, and supply expenses are challenging Spokane-area providers along with inflation, says John Browne, chief operating and strategy officer at Community Health Association of Spokane, which does business as CHAS Health.

“Inflation's affecting everybody, and we in the healthcare system are certainly not insulated to that,” he says. “Whether it's wages or costs of goods and supplies, or purchasing or leasing property, everything has gone up significantly, and the revenues associated with healthcare payment have not followed in the same way.”

Revenue isn't keeping the same pace as increased expenses, Browne explains. CHAS works to remain competitive in the market and pay employees fair wages, but employee insurance has increased in cost, as have medical supply costs. Additionally, the number of uninsured patients CHAS provides care for has ticked up slightly, he adds.

CHAS has 53 physicians; 129 advanced practice providers, including physician assistants and advanced practice nurse practitioners; and 1,855 total employees, says Kelley Charvet, chief administrative officer at CHAS, in an email to the Journal. Between Oct. 1, 2025, and Sept. 30, 2026, CHAS served an estimated 99,000 patients at its clinics in Spokane County, she says.

“We’re trying to be efficient and effective with our staff and their time,” Browne adds. “We haven’t laid staff off or closed clinics down, or have any plans on doing that, but we’ve just been a lot more intentional and a lot slower to hire and to add new sites.”

Another challenge healthcare providers here face involves changes to Medicaid coverage and eligibility. Uncertainty is due to House Resolution 1, known as the One Big Beautiful Bill Act, says Dr. Rebecca Mallo, chief medical officer at Providence Medical Group's Inland Northwest region. 

“Medicaid reimbursement has only gone up very little amounts over the last several years, but costs of labor have gone up significantly,” says Mallo. “Between that headwind and those coming at us from legislative changes to Medicaid, which is increasing the likelihood of losing a lot of the Medicaid-covered lives, is going to impact us.” 

House Resolution 1 reverses some previous expansions to Medicaid’s coverage, including some that were put into place by the Affordable Care Act, providing coverage to uninsured individuals, she says.

Because Providence doesn’t turn away patients in need of care, a growing number of uninsured patients is leading to both higher charitable care costs for the provider, and an uptick in the number of expensive procedures required for treatment, as uninsured patients often are unable to cover the costs of preventative care, Mallo explains.

“If you can prevent a disease rather than letting it come to full fruition, that's better,” Mallo says. "(Because of these changes), you’ll end up with a lot more cost of care in ERs and urgent cares. Because at Providence, we don’t turn patients away, we will see more patients that can't afford to pay the bills, understandably, and therefore our cost of charitable care will increase.”

Medicaid coverage changes are expected to begin in 2027, she adds.

Despite ongoing pressures, Providence is working to grow other service areas. The healthcare provider recently took over space previously occupied by North Spokane Women’s Health Clinic, an OB/GYN practice located on Providence’s Holy Family Hospital campus in North Spokane, Mallo says. Providence retained three of the clinic’s physicians and three advanced practice providers and is looking to hire additional providers.

Future expansions are expected to be small and limited to areas where patients have the most need, she says, adding that she doesn’t expect staff or service cuts in the future.

Separately, Excelsior Wellness is also planning to expand into areas where patient needs are growing the most, says Ryan Kiely, executive vice president of the Spokane-based organization.

Kiely is projecting moderate growth in patient volume in 2027, largely due to an increasing need for primary care and behavioral health services. Excelsior is also working on rural community expansion to help fill healthcare gaps in areas across Spokane and surrounding counties.

Additionally, having the staff and resources to provide enough care to an aging population in the Spokane area will add more pressure on providers, Kiely says.

“Healthcare is a labor-intensive environment and it's human-delivered often, and so inflationary pressures are real, and they impact the ability to deliver services,” he says.

Excelsior is seeing a higher demand for physician services as a result. However, rather than consolidating services or eliminating employees, Kiely suggests organizations consider partnerships with other providers to integrate services instead of closing or eliminating positions or programs.

“Everyone in the healthcare space right now is looking at their core services and evaluating what they’re really good at delivering, and it's a time of reflection and trying to get the highest and best use out of a finite number of resources,” he says.