Administrators discuss health care, health insurance

MOSES LAKE - Administrators at three Moses Lake health care facilities answered questions about health care, health insurance and the cost of it all during a Wednesday meeting of the Moses Lake Noontime Rotary.

The panelists were Tom Thompson, Samaritan Healthcare chief executive officer, Sheila Chilson, Moses Lake Community Health Center CEO and Dr. David Curnel, medical director for Confluence Health in Moses Lake. It was the third year that Rotary has sponsored the panel, club member Dave Campbell said.

Asked about the effect of changes in health care on hospital finances, Thompson said Samaritan Hospital has seen an increase in emergency room visits. He was asked about wait times for ER patients and whether they have increased. He said he didn't know the average wait time, but that the average time from arrival to discharge is about 110 minutes.

Emergency room staff need to explain to people why they are waiting, he said.

Curnel said the medical community in general needs to explain what kind of medical conditions are better treated in the emergency room, and which can be treated at a walk-in clinic. Samaritan Clinic has a walk-in service; so does Confluence Health, and Moses Lake Community Health has an after-hours clinic.

The Affordable Care Act and its impact on local health care was the focus of a few questions, including one about how it's affecting costs. Thompson said about 5,700 people in Grant County signed up through the health insurance exchange, about 80 percent qualifying for Medicaid.

That's had an effect because reimbursement rates for Medicaid are below the cost of service, Thompson said. "We lose 25 cents on the dollar for every Medicaid patient that we have," he said. Curnel said Confluence Health (the Moses Lake Clinic) loses about 50 cents on the dollar for Medicaid care.

Chilson said about 38 percent of their patients were uninsured prior to the opening of the exchanges, and that has dropped to about 30 percent. But the concept of co-payments and deductibles has been a challenge to explain, she said.

In answer to a question, Thompson said it's better to get reimbursed something for services, rather than assuming the entire cost. But more people are using the system, he said. As a result it's important to find ways to reduce costs, Thompson said.

Chilson said her organization is working on ways to use their staff more efficiently, with nurses and medical assistants spending more time with patients. There's also an increased emphasis on preventative care, she said. Early identification and treatment will drive down costs, she said.

The biggest issue facing local health care, Chilson said, is a shortage of physicians, especially in primary care. Curnel said analysis of people entering and leaving the medical profession indicates there will be a nationwide physician shortage by 2020.

Doctors more than 50 years of age comprise the largest group at Confluence, he said. Doctors entering the profession are opting out of primary care, Curnel said, and people who choose primary care are not coming to rural areas.

Chilson said there is research that shows physicians are likely to start practice where they work as residents, and that Moses Lake medical providers are looking at ways to bring some residents to Grant County. Thompson said medical providers are working together to attract more students with rural backgrounds.

In answer to a question about mental health care, Chilson said all providers are feeling the need to expand mental health services, because many patients are requiring simultaneous treatment for physical and mental health issues. There are efforts to recruit more mental health specialists, but they're hard to find, she said.