In the interest of full disclosure, there are two things you should know about me in reading this column.
One is that I was employed in administration of Olympic Medical Center (OMC) for nearly seven years. I was the Assistant Administrator of Planning and Development for most of those years.
In the late 20th century, my boss, then-CEO Mike Glenn, sent me out to talk with the community about what the community most wanted from OMC.
The top answers were: 1) local services for people that required daily or frequent treatments such as radiation therapy and chemotherapy, and 2) access to primary care physicians and specialists like cardiologists, neurologists and endocrinologists.
Today, well into the 21st century, OMC provides all of those services and more developed under the direction of Mike Glenn and Eric Lewis, who became CEO in 2006.
Many of you will recall the general panic around losing physicians when Virginia Mason pulled out of Sequim first and later Port Angeles.
The community came to OMC and OMC stepped up by contracting with some physicians and collaborating in the recruitment and retention of physicians with Jamestown Family Health Clinic in Sequim and Family Medicine in Port Angeles.
These activities are continuing today as OMC and other clinic providers attempt to relieve the physician shortage.
‘Call for Action’
This brief trip down memory lane brings me to my second disclosure. I chair the Access to Healthcare Committee of the Clallam County League of Women Voters. Our committee has issued a “Call for Action” to the community to tell Sens. Murray and Cantwell to keep our health services intact by amending a proposed federal legislation that will result in an annual loss of $3 million to OMC.
The proposed legislation, if passed, will result in the elimination of what’s called “Hospital-based” Medicare reimbursement on physician services better known to OMC physician patients as the “facility fee.” OMC is sending representatives back to Washington, D.C., to persuade our senators to make OMC and hospitals like OMC an exemption to proposed legislation called “Medicare Site Neutral Payment or Reimbursement.”
Not just any hospital
My sincere hope is that none of you will have to learn and cope with the concept of “Medicare Site Neutrality payment” ever again. Here’s the hard part but I will attempt to make clear the jargon-laden, bureaucratic, convoluted, and, some would say, irrationality of this particular aspect of our very broken health care system.
You probably won’t need to remember much because the Senate will vote to eliminate this particular Medicare reimbursement provision for all hospitals. Truth is most hospitals won’t be harmed, or for that matter, impacted to the extent OMC will be. They no doubt would like the extra money but they can do fine without it.
The problem is that OMC is not like other hospitals. OMC can’t do fine without it. OMC is a rural hospital too big to be what’s called a “critical access” hospital like Jefferson and Forks hospitals which receive a better Medicare reimbursement rate and too small to support with any efficacy the provision of involved medical and surgical procedures the result in millions of dollars for large urban hospitals. OMC is what’s called a “Sole Provider” hospital because it is the only hospital that serves a fairly large rural population.
More importantly, OMC is designated a “Safety Net Hospital” with more than 80 percent of its revenue coming from Medicare (58 percent), Medicaid (16 percent) and Tricare (7 percent), all of which pay below cost.
In keeping with its broken system character, our health care system puts hospitals in the position of relying on commercial insurances to make up the difference in covering the cost of low payers like Medicare, which doesn’t work for OMC with less than 20 percent of its revenue coming from commercial insurances.
Any Medicare reimbursement reductions means loss of services
OMC has a history of managing revenue and expenses within this so called system. Lewis says that OMC is currently able to fund recruitment of physicians, build facilities to house physician offices, manage its service debt and replace expensive equipment with up to date models.
The “facility fee” OMC currently collects from Medicare helped OMC maintain physician services in our community when the Virginia Mason crisis occurred and continues to help bring physicians to our community today.
$3 million less a year means something will be lost and my guess is that the loss will be greater than the loss of a therapy pool and too substantial to be made up by community donations.
The OMC board and administration are developing contingency plans that will involve reductions in service and increased costs to patients. It will happen if “Medicare Site Neutral Payment” legislation passes and OMC is not given an exemption.
Senators need to hear the voice of the community before March 20.
Community voices are needed to tell Sens. Murray and Cantwell to amend the proposed legislation to exempt OMC. Just tell them “Help us maintain our hospital and physician services by exempting OMC from “Medicare Site Neutral Payment” – copy and paste or write that sentence in the following:
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Bertha D. Cooper is retired from a 40-plus year career as a health care administrator focusing on the delivery system as a whole. She still does occasional consulting. She is a featured columnist at the Sequim Gazette. Reach her at email@example.com.