Concerning critical access hospital designations in Skagit county.

SB 5923 creates a new pilot program for critical access hospitals in Skagit County located on islands, allowing them to opt out of standard federal critical access hospital payments. Hospitals participating in this "Washington rural health access preservation pilot" would receive value-based payments focused on quality and essential services (like emergency care) instead of traditional fee-for-service rates. The pilot requires the Department of Health and Health Care Authority to establish alternative payment methods that sustain rural hospital services, with optional participation and reporting requirements to the legislature. It directly affects Skagit County island hospitals certified as critical access hospitals, replacing their standard Medicaid payment structure with the pilot’s methodology.