Coordination seen as rural health remedy

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health care in rural ATLANTA —– Lack of access to hospitals and doctors may not be rural Georgia’s biggest health-care problem after all. What’s missing is collaboration, Jimmy Lewis, CEO of HomeTown Health, told lawmakers Monday.

In some cases, representatives of different groups involved in local care don’t know each other despite their proximity and shared problems, he said.

“These silos have just been so non-communicative over time that it’s just frightening,” he said.

That is among the early discoveries of a pilot program focused on improving rural healthcare. Launched last year, the project involves seven health-care systems in the state including Crisp Regional Hospital and Miller County Hospital.

Legislators have put about $6 million toward the program, which features a “hub and spoke” approach. Local hospitals are the hubs. Public health agencies, school boards, nursing homes and other organizations are the spokes.

The program gives local health-care leaders a chance to try new approaches, such as equipping ambulances so that paramedics communicate directly with doctors and nurses while out in the field.

Monday, Lewis joined Charles Owens, who served on the state’s Rural Hospital Stabilization Committee, as part of a check-up with lawmakers starting to prepare for what is expected to be a busy legislative session.

Sen. Renee Unterman, R-Buford, told reporters she believes health care will be the top issue for the Legislature in January, even as Gov. Nathan Deal pushes education reforms.

“With the crisis that we’re in, I don’t see that health care cannot share that same limelight,” said Unterman, who chairs the Senate Health and Human Services Committee.

Nearly 40 percent of the state’s hospitals operated in the negative as of two years ago, and that percentage has likely since grown. Some rural hospitals face closure.

Unterman said she’s concerned the pilot program may be too late.

Other solutions – including some type of Medicaid expansion – should be considered, she said.

“I believe it is a tool in the toolbox,” she said. “I think it’s our fiduciary responsibility to leave that toolbox open.”

Other Republicans, however, have been steadfast in their opposition to broadening the state’s insurance program for the poor. Among them is Deal, who has said the state cannot afford it.

Still, the issue was raised repeatedly Monday.

Sen. Larry Walker, R-Perry, asked the head of Navicent Health in Macon whether a waiver program would save rural hospitals.

“Or is it just going to fill your beds with more Medicaid patients that you’re losing money on?” he said.

Dr. Ninfa M. Saunders, CEO of Navicent Health, said more Medicaid patients could help stabilize rural hospitals, but more must be done to ensure those new recipients are also healthier.

“There’s got to be a repurposing that happens in terms of the fundamental mission of hospitals beyond its walls,” she said.

The pilot program, she said, is a part of that.

Owens said the project gives local hospitals and others a chance to try things they otherwise wouldn’t.

“When you’re so busy back at the hospital making sure that you’re meeting your obligations financially, you’re a little less willing to stick your neck out for something that may or may not work,” he said.

Lewis said some of the program’s early success comes just from connections forged between people working in health care and human services.

Increased communication is sorely needed, he said, as is more focus on telemedicine and coordination of care.

“It sounds so elementary. However, it ain’t elementary,” he said. “This is the key to the palace.”

Jill Nolin covers the Georgia Statehouse for CNHI’s newspapers and websites.

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