Hoskinson’s $250 Million Wyoming Clinic Closes, 20,000 Patients Without a Provider

Charles Hoskinson, co-founder of Ethereum and CEO of Input Output Global, the development firm behind the Cardano blockchain, invested nearly $250 million into a medical facility in Gillette, Wyoming, that he called the “Mayo Clinic of the West.” On May 22, leaders of the Hoskinson Health and Wellness Clinic confirmed it will close permanently on July 31, 2026, ending the most ambitiously funded private rural healthcare project in recent Wyoming memory and leaving between 18,000 and 20,000 patients to find new providers before August.

The bill was already visible four months before it arrived. When the clinic cut 40 positions in January and acknowledged it had grown at an “unsustainable rate,” the trajectory was written. Declining Medicaid and Medicare reimbursements, high specialist salaries, and an unfavorable payer mix (the proportion of patients covered by government programs or carrying no insurance at all) were cited as the core causes. The family simply could not fix any of them fast enough.

A Billionaire’s Medical Blueprint

The clinic opened in 2022 at a rented location on Lakeway Road in Gillette, Campbell County’s coal-and-mining hub in northeast Wyoming. William Hoskinson, a physician and co-founder of the facility alongside his parents Patty and Mark Hoskinson, had told his brother Charles what it would take to bring him back to medicine: a clinic where doctors could “be physicians again,” where quality of care came before billing quotas. Charles funded the vision without apparent ceiling.

The family relocated to a purpose-built campus on Highway 50 and began recruiting specialists that Gillette had never had access to locally. Cardiologist Dr. Dan Davidovich, who had been preparing to retire from medicine entirely out of frustration with private equity’s reach into hospitals, joined after learning about the project. Other recruits came from across the country and abroad. The technology budget matched the ambition: the clinic secured the second Vector unit in the United States, a 95-camera system that scans a patient’s entire skin surface in 30 seconds and uses software analysis to flag potential cancers. The first Vector went to the actual Mayo Clinic in Rochester, Minnesota.

Plans went further still. A surgery center connected to the main building by an underground tunnel, a detail the real Mayo Clinic has, was drawn up and publicly discussed. The family’s stated goal was a 100,000-square-foot campus that would eventually operate without any infusion of personal capital. From the start, the clinic accepted patients on Medicaid, Medicare, and no insurance at all. It never applied for government grants. According to William Hoskinson’s January public statement, the local Gillette hospital received roughly $18 million per year in taxpayer funding, while the clinic operated on reimbursements alone. That funding asymmetry would prove decisive.

By 2025, the clinic had introduced specialties that had not previously been available locally in Gillette:

• Rheumatology services
• Board-certified allergy and immunology care
• Ophthalmology
• Cardiology, including the recruited specialist from Washington state
• Full-body dermatological screening via the 95-camera Vector device
• Infusion services for chemotherapy drugs and related treatments

From Layoffs to Closure: The Collapse in Three Acts

The failure was not sudden. It unfolded in stages across four months, each episode announced as a correction before the next revealed a deeper problem underneath it.

December 2025: Construction Companies Fold

Hoskinson Contracting and Hoskinson Concrete, two firms the family had built specifically to control construction costs on the clinic campus, laid off a combined 136 workers in December 2025. Hoskinson Concrete was permanently closed. Wyoming Governor Mark Gordon called the event “one of the most significant layoffs Wyoming has ever seen.” Company executives framed it as the end of a building phase, but the scale of the cuts, and the speed, signaled something broader about the entire enterprise’s financial health. The 260-worker Hoskinson Contracting shrank to a maintenance-only operation, bidding out future construction to local Wyoming contractors.

January 2026: The Clinic Cuts Forty Jobs

Six weeks later, the clinic itself announced 40 additional layoffs and formally admitted it could not continue at its current pace. William Hoskinson posted publicly on the clinic’s Facebook page, accepting responsibility directly:

The blame for growing too fast falls on the Hoskinson family. We moved too quickly because we wanted to say yes to every request for help.

He noted that Charles had spent nearly $250 million in Campbell County on infrastructure, salaries, and investment without recovering a single penny of reimbursement for it. The surgery center connected by underground tunnel was quietly shelved. Unprofitable services were eliminated. The family insisted the clinic would survive in leaner form.

May 2026: Closure Confirmed

The January restructuring did not stabilize operations. On May 22, clinic leadership announced the closure, calling it “the most difficult decision in the history of this organization.” The final date is July 31. Patients who need copies of their medical records are advised to request them before July 17; the records will be preserved for at least 10 years as Wyoming law requires.

Why Medicaid Reimbursements Broke the Model

The clinic’s public explanation for its closure cited three interlocking causes: declining insurance reimbursement rates, high provider salaries, and an unfavorable payer mix. A clinic that accepts Medicaid, Medicare, and uninsured patients collects less revenue per service than one that limits itself to commercially insured patients. In Wyoming, a state that has not expanded Medicaid eligibility under the Affordable Care Act, those reimbursement rates sit near the bottom of any national comparison. The gap between what specialists cost and what government programs pay is simply too wide to bridge through volume when the patient base skews heavily toward lower-reimbursement coverage.

William Hoskinson made the economics explicit in January, noting the clinic accepted Medicaid and Medicare patients because “reimbursement rates are abysmal” and that many private practices in Wyoming cannot afford to do the same. The family also created compound problems beyond that structural gap. Hoskinson Contracting, built to cut construction costs, never generated a profit and became, in William’s words, “a massive cost center that diverted our attention away from managing the clinic.” Real estate purchases intended to house staff, including two motels that turned out to be structurally unsound, absorbed resources that reimbursement revenue could never replenish.

The backdrop is not specific to Gillette or to this clinic. According to Wyoming Public Media’s reporting from the state’s 2026 legislative session, a recent assessment found six of Wyoming’s 30 hospitals in immediate jeopardy of closing, with three more on the verge. Bills to raise Medicaid reimbursement rates for maternal services and skilled nursing failed during that same session. Sixteen emergency medical services organizations across Wyoming have shut down over the past decade. The Hoskinson clinic was not an outlier; it was the loudest example of a statewide arithmetic problem.

Wyoming’s state government and federal programs are attempting partial remedies. The state’s Medicaid program and related rural health infrastructure received $205 million from the federal Rural Health Transformation Program for its first year of allocation. Whether that funding reaches surviving rural providers in time to stabilize them, given the pace of recent closures, is an open question that the state legislature did not fully resolve before adjourning this spring.

18,000 Patients, One Departing Provider

The immediate human consequence of the closure is a gap that Campbell County cannot quickly fill. Between 18,000 and 20,000 patients need to establish care elsewhere by August, in a region where specialty care already requires a long drive under ordinary circumstances.

Amanda Teppo, executive director of the Wyoming Health Resources Network, said in January that the clinic had been “a key source of care for Gillette and surrounding communities.” She warned that reductions, even at that earlier stage, “could mean longer wait times, fewer care options, and increased strain on patients, providers, and emergency services,” adding that the situation reflected “the broader struggle to sustain reliable, accessible health care in rural and frontier communities throughout Wyoming.”

The specialties the clinic introduced to Gillette, rheumatology, allergy and immunology, ophthalmology, cardiology, do not transfer automatically when a practice closes. Specialists in rural markets take years to recruit and rarely stay once their employer shuts down. The Vector skin-scanning device is clinic property, not community property. Patients who relied on any of those services now face the same distance problem the clinic was built to solve.

• $250 million invested across the clinic and related Gillette construction ventures, with zero government grants accepted
• 176+ combined layoffs across the clinic (40) and Hoskinson construction businesses (136) in a four-month window
• 18,000-20,000 patients without their Hoskinson clinic provider ahead of the July 31 close
• 6 of 30 Wyoming hospitals currently at immediate risk of closure, per the state’s 2026 legislative assessment

Hoskinson Refocuses on Cardano, Fights on Two Fronts

The Cardano founder described the clinic closure as one of the worst weeks of his life and posted on his verified X account that he is now “100% focused on Cardano and Midnight” with no plans to pursue further outside ventures. The pivot back to blockchain work comes while both projects are under sustained pressure.

ADA (Cardano’s native cryptocurrency) was trading near $0.25 as of late May 2026, down sharply from year-ago levels. NIGHT, the native token of Midnight (a privacy-focused blockchain built as a partner chain within the Cardano ecosystem), was trading around $0.033, also well below prior highs. In February, speaking from a live broadcast in Tokyo, Hoskinson disclosed that his personal unrealized losses on crypto holdings exceed $3 billion, a figure he attributed to ADA’s sustained decline from its peak. He stated he had not liquidated his position and had no plans to do so.

Governance pressure adds another front. Input Output Global (IOG), the development company he leads, submitted a research funding proposal to Cardano’s decentralized governance system requesting approximately 33 million ADA for the network’s 2026 roadmap, covering the Leios consensus upgrade and post-quantum security research. DReps (delegated representatives, community figures who vote on how Cardano’s treasury is allocated) have shown significant resistance, with voting open until June 8. Hoskinson warned publicly that a failed vote would mean “Cardano will lose its scientists, and our lab will be forced to close.” Midnight, for its part, has named MoneyGram, Vodafone, and eToro as network operators since launching on mainnet, though those partnerships have not reversed NIGHT’s price slide.

Two institutions now face structurally similar questions about the same month. In Gillette, former clinic patients find out by August whether another provider steps into the void. In the Cardano governance system, the June 8 DRep vote tells Hoskinson whether the community he built will fund the research that defines what Cardano claims to be. Both answers hinge on whether ambition, at scale and without adequate financial backing, can survive the economics it was built to transcend.