KPAX speaks to GCMC chief about ACA repealFebruary 15, 2017
GCMC Maria Stoppler speaks with KPAX regarding the recent ACA repeal and replace executive order.
Faced with already tight budgets in communities where the economy is fare from booming, Montana's small hospitals worry repeal of the Affordable Care Act could make their mission even more difficult. Yet at the same time, there's a spirit of trying new solutions to overcome the challenges....
While the economy is improved from the height of the 2009 recession, many Western Montana's small counties still show jobless rates of between 6% and 10%. The numbers aren't entirely reflective of people living on fixed incomes, or that have simply given up trying to find jobs as resource-based industries dried up.
The ACA didn't solve all the problems In places like Superior, but it's helped some people access health care regularly -- and officials ar the small hospitals worry a repeal could be a big blow.
"We need to keep from shifting the cost of caring for those people to the insurance companies and having our prices go up so that we can cover the cost of those people who don't have any insurance," aid Mineral Community Hospital CEO Ron Gleason.
Taxpayers have been supportive with levies and bonds, but the small hospitals still have reduced programs and minimum staff. "When we have those payments cut there is no place for me to cut costs," Gleason said.
The rural facilities provide what services they can, but the "critical access hospitals" can only do so much. For example, regulations are forcing the closure of Mineral County's assisted living venture.
"We can do some of those kinds of things but we still have to be able to take care of those emergency room victims," Gleason said. "You know, this is a dangerous stretch of freeway through here. And if we aren't here it's a long ways to the next place."
Meanwhile, in Granite County, about 100 people have been able to sign up under the ACA and hospital administrators worry its repeal could remove a valuable tool for controlling health care costs.
"That's a lot in a small community. And then also 70% of our patients that were on the rural health discount were able to get coverage through Medicaid expansion," Granite County Medical Center CEO Mria Stoppler. "So that was a huge benefit for our community. So we need people to be covered because they'll ultimately be healthier."
Without that coverage, Stoppler says people tend to put off preventative medicine and that costs everyone more.
"They'll come into the ER at the highest cost center to the patient and the facility. And even the most well-meaning families can't afford constant emergency visits," Stoppler said. "So that becomes bad debt to the hospital and will ultimately be the demise of the rural facility."
But these small towns continue to innovate. In Philipsburg, there was a trend to provide telemedicine with Idaho Falls until a grant expired. Staffers have now pitched in to train volunteers to solve an ambulance shortage, and a Helmsley Charitable Trust grant could provide a CAT scanner.
"Which will eliminate the majority of our transfers -- so that's another way. How do we fix that ambulance situation? How do we keep more patients here and not have them incur the additional cost of having to be transported to another facility to get a CAT scan," Stoppler said.
Both Stoppler and Gleason say that regardless of what happens with the ACA, Congress could help by taking any steps to trim burdensome regulations, especially for the "critical access" mission.
"What it was originally intended for is those small hospitals that are really isolated that we really need to focus on maintaining because it is so far to the next level of health care," Gleason said.
"So we have to think outside the box and find new and inventive ways to meet the needs of the community," Stoppler stated.
Officials at both hospitals say they wouldn't be able to make it with support from local levies. For example, in Granite County, the hospital routinely has 12-to-20 days cash on hand, which is a big problem when patient numbers fluctuate.
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