The national economic downturn is affecting local health care, but Wyoming Medical Center officials would not discuss some of their hospital's specific issues in public at a Natrona County Commission work session on Tuesday.

The commissioners voted to go into executive session to hear hospital officials, but changed their minds after reporters objected.

WMC chief executive officer Vickie Diamond and board chairman Steve Chadderdon requested the executive session because the hospital's finances were proprietary, especially because of competition from the new Mountain View Regional Hospital, they said.

Commissioner Barb Peryam asked if the public receives any formal accounting from the Wyoming Medical Center.

Diamond responded the hospital is obligated to make public only what is in its lease agreement, she said.

The nonprofit Wyoming Medical Center Inc. leases Natrona County's hospital assets in exchange for providing indigent and prisoner care. The lease is overseen by the five-member Memorial Hospital of Natrona County board of trustees.

Reporters objected because Wyoming law limits executive sessions to discussions of personnel matters, real estate transactions, and legal disputes.

Chadderdon relented, saying he would modify the presentation by presenting only two items in executive session that dealt with proprietary financial matters.

The commissioners then voted to come out of executive session.

Diamond told the commissioners that Moody's Bond Rating service has downgraded the outlook for hospitals to "negative from stable," she said.

Economic pundits have assumed demand for health care would remain constant or increase because of the aging baby boom generation, but the national economic climate has changed that, Diamond said. "Health care is not recession-proof."

Reimbursements for health care from the federal Medicare and Medicaid programs continue to fall short of costs, she said.

Uncompensated care - bad debt and charity care - continues to exceed planned budget increases, Diamond added.

Americans are using health care resources less, to the point of foregoing checkups, she said.

The WMC's chief financial officer, Nancy Brandt, told commissioners that the hospital has been able to keep its increasing costs lower than the national average.

Natrona County budgets $120,000 for prisoner care, but that falls far short of the hospital's actual costs - at estimated $800,000 this year - including billing Wyoming Behavioral Institute for sending it patients with psychiatric needs, Brandt said.

To deal with some of the rising costs, Diamond said the Wyoming Medical Center is making some changes, such as using insulin in "insulin pens" instead of bottles and reducing staff through attrition.

Everyone feels the stress, and the WMC has an obligation to communicate with the public, Diamond said. "We want to convey confidence to the employees and the community."

Reach Tom Morton at (307) 266-0592, or at Tom.Morton@trib.com.