The Wyoming Medical Center writes off two times as much uncompensated care -- bad debt and charity care -- of its gross revenues on average than hospitals nationwide.

"It truly is a puzzle, why Wyoming, Casper, Wyoming, seems to be twice the national average," said Serena Cobb, chairwoman of the board of trustees that oversees the WMC's lease of Natrona County's hospital assets.

The nonprofit Wyoming Medical Center Inc. budgeted for $57 million in uncompensated care for the 2013-2014 fiscal year, which ended June 30, said Yvonne Wigington, the hospital's chief financial officer

As of May 30, the hospital had written off $28.5 million in bad debt, which results from patients who can afford to pay but don't, and $27.3 million in charity care, which results from patients who cannot afford to pay, Wigington said.

That amounted to 12.2 percent of the hospital's gross revenues, she said.

Wigington said the bad debt is partially a result of people who refuse pay for their care, even modest co-payments according to their insurance policies.

Patients' deductibles on their insurance policies also have soared, she said. "The normal patient can't come up with $5,000 or $10,000."

Boom times can cause problems, too, because the energy industry draws a lot of transient workers who receive care and leave without paying, Wigington said.

Wyoming Medical Center CEO Vickie Diamond added the Wyoming' Legislature's refusal to expand Medicaid -- a proposal to allow the use of Mediacid funds to pay private health insurance premiums -- has had an effect as well.

But all these factors, Cobb said, still don't explain why uncompensated care costs are so high here.

Cobb heads the five-member Board of Trustees of the Memorial Hospital of Natrona County, which oversees the nonprofit Wyoming Medical Center Inc.'s lease of the county's hospital assets, most of which are located in the 1200 blocks of East Second and East Third streets. The WMC's rent for the use of the property, in effect, is to provide care for the indigent and the prisoners at the county jail.

The board, which is appointed by the Natrona County Commission, has two new members: former Casper City Councilwoman Kim Holloway and retired dentist Dr. Forest Irons. The terms of former trustees Roxy Skogen and Crystal Mueller recently expired.

During the meeting, Diamond said the hospital will open its new tower in September, pending approval by building inspectors. It will sponsor an open house later in September and begin moving in patients in October, she said.

The Wyoming Medical Center's board of directors recently chose Pope Construction to build its Mesa Primary Care Clinic on the west side of Casper, she said. The new clinic is scheduled to open in April 2015.