Northcentral Healthcare officials brief committee on fee setting, Medicaid reliance and financial impact of Pine Crest sale

Northcentral Healthcare representatives explained to the Marathon County Executive Committee how their fee schedule is set, why many listed fees do not reflect actual reimbursement, and how the 2025 sale of Pine Crest will affect the organization's 2026 finances.

Jason (Northcentral Healthcare) told the committee that many charges in the health system's posted fee schedule are gross charges: "A lot of our fees are set by Medicaid or commercial payers... we could set it for what we want, but we might get paid a much lower rate," he said. He added that Northcentral contracts with multiple counties and often bills Medicaid rates to those counties.

Committee members asked about whether higher listed fees translate to increased revenue and whether Northcentral maintains waiting lists. Jason said many fees are seldom billed or are captured within lump-sum daily Medicaid payments, so some line-item fees remain at 0% increases because they rarely generate separate reimbursements. On capacity, he said Mount View Care Center can staff up to 160 beds and is currently at about 117'118; waiting lists vary by unit and are driven more by staffing challenges than by payer mix.

Northcentral's finance representative Gary said the Pine Crest sale reduces the organization's ability to absorb indirect expenses: "We have about $1,200,000 of indirect expenses that we need to find in our budget in 2026," he said, and noted Pine Crest contributed about $500,000 net income last year, totaling roughly $1.7 million in impact to cover in 2026. The organization expects a short-term cash dip in 2026 while reconciliations and rate-setting adjustments lag.

Northcentral officials also told the committee that Medicaid is the largest payer and, for many lines, the most advantageous. They flagged two budget risks for 2026: (1) individuals losing insurance coverage and increases in charity-care, and (2) uncertainty over federal/state changes to Medicaid that could affect reimbursements. The county's proposed tax levy contribution for Northcentral in 2026 was given as $5,861,018.18; staff said $1.5 million of that supports Mount View and the remainder supports other operations.

The committee heard that Northcentral is adjusting its internal tax-levy allocation method to show clearer operating performance by program lines, and that longer-term rate-setting changes will be reflected in future reconciliations (hospital rate setting may not pick up full effects until 2027). Committee members asked for follow-up numbers on per-resident subsidy estimates and the near-term cash-flow effects resulting from Pine Crest's sale.

No formal committee action was required on the presentation; Northcentral staff provided the briefing as part of the county's 2026 budget-development discussions.