Healthcare is going through a once-in-a-lifetime transformation

| September 29, 2014

Robertson, VidantBy Roger A. Robertson, president of Vidant Community Hospitals, published in The Daily Reflector, September 27, 2014.

The American health care system is going through a once-in-a-lifetime transformation. Many of these changes are for the better. In the state of North Carolina, these changes are playing out in ways that are quite evident but not always predictable. As part of this transformation, revenues provided to deliver health care continue to decrease, but the demand for these services does not. While hospitals and health care providers across the country are adjusting to the newly imposed regulations, we are all searching for the best long-term solutions. Today’s health care delivery will look quite different from the way it will in the future. Rural health care is particularly challenging because the solutions must be sustainable, or they are not solutions.

The Affordable Care Act (ACA) made deep cuts to Medicare and Medicaid payment rates for hospitals and other providers of care, making it more difficult to operate small, rural facilities. While half of the states in the U.S. have adopted the more flexible Medicaid eligibility rules allowed under the ACA, many states, including North Carolina, have not. Hospitals that rely on Medicare and Medicaid to pay most of the bills are left to find ways to provide the same level of care with reduced payments. This is neither possible nor sustainable using the current models of care that have been in place for more than 50 years that do not deliver needed levels of health, regardless of their cost.

Vidant Health is working to change the health care model in our region to better provide health and sustainable health care. Today, we serve a geography of more than 1.4 million people in eastern North Carolina and are the largest private employer in the region. Hospitals serving rural communities have faced multiple pressures that have led a number of facilities in the Southeast to close. Alan Morgan, CEO of the National Rural Health Association, blamed the closures on a number of factors, including reimbursement cuts, state decisions not to expand Medicaid under the ACA, and broader changes in the market.

Vidant Health is committed to delivering the needed health care services to our entire geography and all its communities.

Take, for example, the town of Belhaven, with a population of just over 1,600 people. In 2011, Vidant took over Pungo Hospital, a small community hospital serving residents in Hyde and Beaufort counties. We worked with the community to provide a sustainable health care model, a path we continue today. On July 1, 2014, we closed the aging hospital facility and simultaneously opened a 24/7 clinic. Now we provide around-the-clock primary, preventative and urgent care to patients including lab work, X-rays and helicopter access for emergencies. Vidant Health’s commitment to serve the health care needs of Belhaven has never wavered. As part of our long-term commitment to provide health care services to Belhaven and surrounding communities, we have applied to begin construction of a new 12,000-square-foot, $4.2 million multi-specialty facility in Belhaven — a new model of ambulatory care. The facility also will be open 24/7 and will serve as a model for improving care in communities like Belhaven. Under this new model, people’s health will be improved with greater access to primary care, specialized services and specialty care, and sustainable under the new market conditions.

Vidant Health serves the health care needs of all of eastern North Carolina through our hospitals, clinics and medical practices. Our mission at Vidant Health is to improve the quality of life of the people and communities we touch, serve and support. We take that mission very seriously and have made long-term investments in this region and its communities. More than 70 percent of patients treated at Vidant Health hospitals and clinics are paid for by government programs with reimbursement rates set below the cost it takes to provide the care. In 2013, Vidant invested more than $135 million in unreimbursed charity care and community programs and services in eastern North Carolina. Our commitment is to provide these communities with access to sustainable and affordable care.

Vidant Health is adapting to these changes, developing new models and delivering new approaches to the region and communities we serve. Vidant’s health care model will continue to evolve to deliver health care services in a sustainable manner.

Category: Healthcare, SPIN Blog

Comments (1)

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  1. Norm Kelly says:

    ‘Many of these changes are for the better.’ Most are definitely NOT for the better! Socialized medicine is definitely detrimental to the majority of those forced to live under it. Care will be reduced. Care will eventually be rationed here as it is in every other country/nation/state that has implemented Socialized Medicine. There is no alternative. Want proof that a central planner take-over of the health care industry is bad? Do some research on the VA Health care system. You will find that the scandal, the poor service to our veterans is not new. The central planners have known for years that there was trouble in the VA Health system, but they have continued to kick the can down the road, just like most every other problem the central planners know about. Their solution has been to spend more money on it and call the problem solved. What did they do most recently to appease people? They decided to spend more money on it. Problem solved. Ta-da! Like magic. Cuz there’s no other way to describe what they expect to happen. If it happens everywhere else in the world, it happens in the VA Health system even though our kindly, loving, non-racist central planners are in control. What makes you think it won’t happen when millions and millions more are covered by government employees?
    ‘The Affordable Care Act (ACA) made deep cuts to Medicare and Medicaid payment rates’. You mean the budget for socialized medicine was CUT in order to implement Obamascare? When the demon party was in charge of the central planners? Really? You are admitting that the central planners under control of the demon party actually CUT the budget for medicare & medicaid? This can’t be possible. First that you admit the demons did this. Then, this close to an election, you point out that K’s recent ad is a lie (another lie!). You know, the one where she claims Tom Tillis WANTS to cut medicare and kick seniors to the curb. Are you telling us in this editorial that the slur against Tillis is actually TRUTH ABOUT K but only an accusation about Tom? Yes, whether that’s what you wanted us to walk away with or not, that actually IS THE TRUTH. The Demon Party, with the help of K HAGAN, cut major dollars from medicaid/medicare in order to make the budget projections for Obamacancer appear to be ‘real’. Instead, we ended up with cuts to medicare/medicaid and some smoke & mirrors from the demons. Along with REAL cuts to medistuff.
    ‘While half of the states in the U.S. have adopted the more flexible Medicaid eligibility rules allowed under the ACA’. So, this is actually a statement of ANOTHER bribe that the central planners put in place to coerce states to participate in socialized medicine. Kinda like the non-bribe that the central planners used to bribe states to participate in Communist Core? When will a majority realize that central planners FAIL by default. One size does NOT fit all! In ANY situation that the central planners have any control of.
    ‘This is neither possible nor sustainable using the current models of care that have been in place for more than 50 years that do not deliver needed levels of health, regardless of their cost’. So, this scheme has been in place for more than 50 years. Who was in control the majority of that 50 year period? Yes, the demon party. The current models do NOT deliver needed levels… Are you admitting that medicare/caid is and has been a failure? That the central planners have been pinching the providers in order to keep their own costs down? Isn’t this kinda like telling lies? Isn’t this kinda like the central planners putting private business out of business by NOT paying them for services delivered? Which is the net result of socialized medicine anyway, you just don’t want to admit that part of the equation. Truth sometimes hurts. You know, kinda like you can keep your insurance if you like it. Etc. Etc. Etc.
    ‘including reimbursement cuts’ which is actually budget cuts to the program, reducing payments to service providers yet expecting those providers to continue to do the providing. Eventually what happens is rationing so the providers can stay in business. How else are costs kept in line while also allowing private businesses to stay in business? The alternative is for the providers to be government employees. Kinda like those people at the airport who are so efficient at screening the flying public. The central planners told us that if we allowed them to convert all those employees to demoncrat voters, I mean government employees, the process would become much more efficient and we all would be much more safe. How’s that working out for us? How many times can you shower with only 2 ounces of body wash (or whatever the limit is)?
    ‘Vidant invested more than $135 million in unreimbursed charity care and community programs and services in eastern North Carolina’ combined with ‘will continue to evolve to deliver health care services in a sustainable manner’ makes for a very confusing read. How is it possible to continue to provide services when you spend 135 million dollars more than you bring in? You spent that 135million dollars because the central planners didn’t pay you enough to cover the cost of delivering your services. Money comes in. Much much much more money goes out. How is this SUSTAINABLE? You use the word sustainable several times in your editorial, yet you continue to show us that the central planners are making it IMPOSSIBLE for you to sustain this. They have already started rationing health care by making sure you can’t afford to sustain this level of expenditure. Yet you see this as an effort to provide services in a sustainable manner. Your own words prove that your defeat is built into the system designed and forced on you by the central planners.
    Is the take-away from your editorial supposed to be that we are to encourage our state legislators to capitulate to the bribe offered by the central planners? Is the solution to give in to socialized medicine completely? Because partial socialization of health care has worked so well? You may have WANTED me to walk away from your editorial with the belief that more involvement by the central planners in the health care industry is the solution. But what you PROVED to me is that there already is too much involvement by the central planners in the health care industry. You helped convince me, though this wasn’t that hard, that central planners are completely, totally, unquestionably incapable of running anything, let alone the health care industry. They are the worst group to make any decisions about my health, and they scare the hell out of me. Not just for me. But for my entire family, as well as people I know and love. I am scared for our futures because some of the most critical decisions of our lives will be in the hands of government types. Who could NOT care any less about anyone I know or love, including myself. Even when VA health system employees faked records, no punishment. Even when VA health system employees lied about our vets deaths while waiting for service, no punishment. What part of this should make me feel comfortable about having government employees who don’t care about anything except themselves and their ability to do very little work and make more than the people they serve? And for most of them, those employees can’t get a job in the real world, so they get a job with the central planners where they know their future is secure and their benefits are secure. And in many cases, they are exempt from the same laws/rules that I am subjected to. No thanks. I will NOT feel comfortable about central planner health care; ever.
    (i know. there are some government employee types that do care about their jobs and do a good job. they are just too few and too far between. and i doubt any of them work in any of the dmvs around the country. and there obviously aren’t too many that work for the VA. and damn few of them work for the irs!)