After months of uncertainty over the future of one of Wyoming’s most ambitious health-care experiments, the Hoskinson family is announcing that their clinic, which they’d hoped to turn into the “Mayo Clinic of the West,” is changing hands.
Monument Health will take over the former Hoskinson Health & Wellness Clinic, operating it as a multi-specialty clinic and employing providers and staff under a lease agreement for the building and equipment.
“From the beginning, our goal was to bring Mayo Clinic-level care to the people of Gillette,” the Hoskinson family said in a media statement to Cowboy State Daily. “This transition to a Mayo Clinic Care Network member means that vision is now a reality. We are grateful to Monument Health for stepping in and making sure this community continues to have access to the care it deserves.”
Monument health, which operates five hospitals and more than 40 clinics and specialty centers in 14 communities across western South Dakota and eastern Wyoming, has direct access to Mayo Clinic expertise and resources, a connection that has now been extended to Gillette.
A finalized list of providers is being developed, the Hoskinson family added. They also encouraged patients to continue scheduling appointments as normal.
The clinic is staffed by 15 physicians and a full support team in a state-of-the-art facility. In joining Monument Health, it becomes part of a system that spans 31 specialties, five hospitals and more than 40 clinics and specialty centers across western South Dakota and eastern Wyoming.
“The people of Gillette deserve access to high-quality care close to home, and that is exactly what this clinic has provided,” Monument President and CEO Paulette Davidson said in a statement to Cowboy State Daily. “We are proud to expand our presence into eastern Wyoming and committed to making sure these patients continue to have a place to go for the care they need.”
'One Of The Hardest Decisions'
The Hoskinson family posted on Facebook as well not long after announcement, emphasizing that Monument is “working to retain the care team, so the people who know you and our health history can still be here.”
Charles released a video hailing the agreement, and saying it’s something that “we worked on for a little while.”
“One of the things you learn in business and in life is that sometimes you’re not the best person for the job,” he said in the video. “You may have the vision, and you may have the ability to get it started, but sometimes other people need to finish it to get it done.”
Making that decision was “one of the hardest decisions we had to make.”
“It’s a tough business, medicine,” Hoskinson said. “And so we said, ‘Let’s find a path where somebody with the same level of passion, enthusiasm, and wonderful track record can come on in and give the people at Gillette Wyoming the best health care in the entire state of Wyoming.'”
The negotiations were tough, he said, because Monument has some of the best people in the United States.
“(They’re) part of that broader Mayo network, and really there is nothing better on the planet,” he said. “So the clinic is not going to go dark. There will be a bit of a transition, but when those lights come back on, (it's) the same mission to make sure that everybody in Gillette Wyoming gets wonderful health care and take care of as many people as we can the best way we can.”
With a Mayo-networked affiliate arriving, that fulfills his original promise, Hoskinson added, to bring a Mayo clinic to the West.
“We never imagined that a Mayo affiliate would actually be the one doing it, but I can live with that,” he said. “And I think a lot of you can, too.”
Much of the artwork on the walls and the special equipment are staying put, Hoskinson said, meaning the “three-Tesla MRI is not going anywhere.”
The 3T MRI is one of the most advanced, widely used diagnostic imaging tools in medicine today.
“(Monument's) a great organization,” Hoskinson concluded. “And to the Monument family, let me be the first in Gillette to welcome you to Gillette... We’ll have more to say after this, and hopefully an open house for people to talk about transition.”
Built By A Crypto Tycoon
The move follows a rocky two-year arc for Hoskinson, a $200 million, 70,000-plus-square-foot facility bankrolled by cryptocurrency tycoon Charles Hoskinson. The family has said the facility is the largest family-run clinic in the United States.
It offered dozens of specialties in addition to primary care, as well as research and regenerative medicine under one roof — all more commonly found in large, urban academic centers than in a small town of 30,000 on the High Plains.
In a video released after the Hoskinson family announced it would close the clinic, Charles said the economics of American health care and the realities of operating in a small, remote market had killed the operation.
He said the clinic was losing millions every month, even after aggressive attempts to pare back and optimize operations.
Primary care, he argued, is fundamentally under-reimbursed, forcing providers to see 24 to 28 patients daily just to break even. That volume was incompatible with the slower, more thorough care model he wanted the clinic to provide.
“The Hoskinsons have been in medicine for over 70 years since the 1950s,” he said in the video. “They’ve watched the entire health-care industry transform and change from mostly rural and mostly solo practitioners or small groups — excluding cities — working basically with a direct relationship with the patient, direct financial relationship with the patient, to a system that’s become kind of a bureaucratic hellscape.”
Gillette’s clinic easily attracted 20,000 patients, yet still wasn’t close to breaking even, Hoskinson added.
“I had aspirations to do something in regenerative medicine,” Hoskinson said. “I’m a big believer in network medicine.”
Some day, current medical knowledge and AI enhancements are going to combine and create a high degree of personalized medical care, he said.
That’s “really going to change things so we can cure stuff,” Hoskinson said.
Patients, Workers Caught In The Middle
As the financial picture for the clinic worsened, patients and would-be employees felt caught in the middle.
In one case, a billing specialist who had accepted a role at the clinic, including a $20,000 relocation reimbursement, learned her offer had been abruptly withdrawn for “business” reasons. That left her without a job after she’d given notice and made plans to move.
Patients with complex conditions also began to worry about what it would mean for their care.
Shawna Langdon, for example, diagnosed with aggressive rheumatoid arthritis after COVID, had come to depend on weekly visits to the clinic for injections, diagnostics and specialist care. Having multiple specialists under one roof so close to home had made it possible for her to manage a disease that otherwise meant frequent exhausting travel — so exhausting she sometimes was unable to make the trip.
Sarah Pierce, whose child has Beckwith-Wiedeman Syndrome, had needed frequent care in Philadelphia. While the clinic didn’t eliminate such travel, it did help to cut down on it by having a knowledgeable ENT in Gillette, making the family’s life significantly easier.
Langdon told Cowboy State Daily she was openly rooting for Monument to take over, knowing it would make her life easier.
"It is very very welcoming news for me and gives me a lot more comfort knowing they're gonna still be right around the corner," she said Wednesday. " Not just for me either, but for the entire community. We need this."
Renée Jean can be reached at renee@cowboystatedaily.com.
