News

RiverView Healthcare Association members heard both the highs and lows of 2025 during the Association’s 128^th Annual Meeting, held virtually Monday, Jan. 26.

Chief Financial Officer Betty Arvidson presented preliminary financial results for Fiscal Year 2025, covering the period from Oct. 1, 2024, through Sept. 30, 2025. The report marked Arvidson’s final annual presentation, as she is set to retire in February after nearly 14 years of service to the organization.

In her annual operations report, President and CEO Carrie Michalski described 2025 as a “substantially improved, yet fourth consecutive challenging financial year.”

“Year over year, we reduced the total margin from -8.4% in Fiscal Year 2024 to -4% in Fiscal Year 2025; a $2.4 million improvement to the bottom line,” Michalski said.

Despite the improvement, the financial gains were not enough to prevent workforce and program reductions announced the week of Jan. 19.

Impacts of the One Big Beautiful Bill

RiverView Health was among 140 Minnesota hospitals that joined a bipartisan effort to allow Minnesota to join 42 other states with a federally approved Directed Provider Payment (DPP) program. DPP allows state Medicaid programs to direct managed care plans to make supplemental payments to hospitals for specific services at designated rates. It would have allowed Minnesota to capture a greater federal match to support Medicaid programs in the state.

The initiative received overwhelming bipartisan support from the Minnesota Legislature and Gov. Tim Walz. The passage of DPP would result in about $2 million annually for RiverView. However, the program was eliminated following the federal passage and enactment of the One Big Beautiful Bill (OBBB).

Because of the OBBB, funding for rural hospitals has been reduced, leading to fewer resources and services for local communities.

With the DPP revenue safety net removed, RiverView officials announced last week the upcoming closure of RiverView Home Care, affecting 55 clients currently receiving services. Additionally, hours were reduced or positions eliminated for 28 employees, equating to approximately 15 full-time positions.

Charting a Path Forward

With a goal of improving RiverView’s bottom line by approximately $6 million over the next 24 months, Michalski outlined three targeted areas for improvement—each projected to contribute roughly $2 million:

• Improving productivity and expense controls
• Enhancing revenue cycle efficiencies to lower the cost to collect and improve net cash yields
• Targeting areas of organizational growth

“Our Fiscal Year 2026 budget is break-even to slightly positive, with a return to a positive margin no later than September 2027,” she reported.

Following Arvidson’s retirement, a transitional CFO will oversee restructuring and performance improvement efforts within the Finance and revenue cycle departments.

Strength through Collaboration

RiverView is one of 20 independent rural hospitals that form the Headwaters Network, started in April 2024. The network collaborates on clinical and operational initiatives aimed at enhancing quality of care, access, and affordability in rural communities. Michalski serves on the network’s board, working to achieve economies of scale and negotiate contracts that are more equitable with larger insurers.

Over the past year, the Headwaters Network successfully negotiated:

• A $750,000 strategic investment from Blue Cross Blue Shield of Minnesota
• Value-based quality payments from Blue Cross Blue Shield and UnitedHealthcare
• Expanded participation options in Medicare Accountable Care Organizations

In the coming months, the network will launch population health tracking and monitoring software, referral tracking tools, market analysis software, and will onboard a third-party partner to support patient communications focused on care management for at-risk patients—helping ensure timely delivery of preventive and therapeutic care.

Funding could also come from the $193 million the OBBB awarded Minnesota for the Rural Health Transformation Program aimed at strengthening rural healthcare infrastructure, expanding the workforce, and improving technology like telehealth.

While details on how the funds will be distributed have yet to be determined, the dollars will be restricted to reimbursement for new investments and may not be used for day-to-day operational expenses, according to Michalski.

“As we continue to transform care delivery in rural Minnesota as a network, we intend to apply for and succeed with the competitive grants that will be offered by the State of Minnesota using rural health transformation dollars,” Michalski said.

Celebrating New Team Members, Successful Programs

Numerous achievements were highlighted during the annual meeting, including the successful recruitment of several new providers. Michalski reported that the 2025 recruitment class was among the strongest in RiverView’s recent history, with the addition of the following physicians and a clinical dietitian:

• Ian Glidden, MD – Family Medicine and Palliative Care
• Israel Mostafa, MD – Internal Medicine
• Comfort Olayioye (Ola), MD – Internal Medicine
• Rachel Rudolph, MS, RDN, LD – Clinical Dietitian

“Bright, talented, kind, driven, compassionate, dedicated, and humble are adjectives I would use to describe these new additions to the RiverView team,” Michalski said. “Feedback from our patients is strong and full of compliments and gratitude. Each has made an immediate positive impact on our organization and the patients we serve.”

Michalski also announced that Dr. Cassandra Okorie, a Family Medicine with Obstetrics provider, will join RiverView in the summer of 2027 following completion of an obstetrics fellowship.

As a reminder, Michalski shared that RiverView continues with its Community Recruiter Program, which offers financial incentives to community members who assist in recruiting talented providers. To date, four physicians have joined RiverView through the program. The organization is currently recruiting for orthopedics, physician assistants or nurse practitioners for spine and orthopedic services, and part-time providers for urology and gastrointestinal services.

On another positive note, several programs saw growth in 2025, according to Michalski. Senior Life Solutions—an outpatient program serving individuals typically age 65 and older who are experiencing depression and/or anxiety related to life changes—doubled the number of patients served compared to 2024.

The RiverView Recovery Center also expanded its reach with the addition of an outreach site at the Care and Share of Crookston, made possible through opioid settlement funds awarded to Polk County.