Delta County Memorial Hospital dodged a bullet when the hospital provider fee was moved into a state enterprise fund, ensuring continued financial support for rural hospitals in Colorado. But with the Republican proposal to repeal and replace the Affordable Care Act, DCMH continues to operate in a world of uncertainty, CEO Jason Cleckler reported at an Indivisible gathering in Cedaredge.
Indivisible groups nationwide have mounted an effort to fight what they're calling "TrumpCare." The Cedaredge gathering was low-key, with Cleckler talking about why it's better to try and tweak the existing health care legislation.
He said the Affordable Care Act was the result of escalating health care costs -- costs that were pricing many consumers out of the marketplace. With the U.S. spending 25 percent of its gross national product on health care, the current system was not sustainable.
Sweeping reform was enacted, with the intent of improving the quality of care, controlling or decreasing the cost of health care, and improving access so folks weren't showing up at the emergency room with chronic illnesses that could have been managed or prevented through primary care.
The ACA has forced Delta County Memorial Hospital to focus on those three pillars of health care, Cleckler said. Reimbursement is tied to quality of care. Efforts are being made to help patients manage chronic health conditions such as diabetes. And it's no accident the hospital is opening a clinic in Hotchkiss, an urgent care facility in Paonia and rehab services/lab draw station in Cedaredge.
Electronic medical records are another facet of the Affordable Care Act. Electronic records make it fast and easy to share information with other providers. They also ensure consistent treatment, but Cleckler said implementation has been expensive and it sometimes seems medical providers spend more time interacting with their computer than with their patients. Physicians have also expressed frustration, he said.
But most frustrating for most consumers is the lack of affordability in the Affordable Care Act. In Delta County, only Anthem Blue Cross Blue Shield offers coverage in the marketplace. The company has exited the marketplace in Indiana and Wisconsin, and Cleckler fears a domino effect. If no plans are offered through the marketplace, the only option for individuals not covered through the workplace will be to seek individual plans. Those plans may not have ACA protections, including coverage for pre-existing conditions.
But the scenario could be worse under the GOP's American Health Care Act, with an estimated 20 million individuals losing coverage across the nation, Cleckler said.
Prior to implementation of the ACA, Cleckler said 12 to 13 percent of the care provided by Delta County Memorial Hospital was uncompensated. That percentage dropped to 2.25 percent, which is "absolutely remarkable." Some people purchased individual policies, as mandated by the ACA, but here in Delta County it's really reflective of how many people signed up for Medicaid, Cleckler said. While Medicare/Medicaid reimbursement rates for the hospital are low, at least residents have some type of coverage.
He reiterated the hospital's desire to improve quality of care, remove barriers to access, and be transparent about costs. But true savings will not be realized until pharmaceuticals, insurance companies and medical manufacturing companies step up to the plate and help control costs.
"If that happens I think we would see a drastically different health care system," he said.
Cleckler encouraged members of the group to reach out to Senator Cory Gardner, who he believes is truly listening to input. Senator Michael Bennet, he said, is in favor of keeping the Affordable Care Act, but is open to ideas about how the law can be tweaked. Rep. Scott Tipton, while very supportive of Delta County and Delta County Memorial Hospital, has already voted in favor of the House version of the American Health Care Act.
Cleckler is the featured speaker at a health care town hall meeting in Paonia Monday, July 10. He will provide an update on the hospital and talk about the most recent changes in the Affordable Care Act. His presentation runs from 5:30 to 7:30 p.m. at the Paradise Theater. There is no charge for admission and everyone is welcome.