Health-care leaders commiserate on industry challenges
FORT COLLINS – Put 15 health-care professionals from docs to administrators in the same room, and they will commiserate on a few things like the cost of health-care skyrocketing out of sight, that the government and insurance companies are mainly to blame, and that it may be the time to ask the question: Is access to health care a right or a privilege?
Participants of BizWest’s CEO Roundtable on Health Care held Tuesday in Fort Collins expressed frustration in being unable to provide affordable health care to a growing and aging population as politicians in Washington battle over repealing and replacing the Affordable Care Act, more commonly called Obamacare, creating an environment of misunderstanding, uncertainty and ill will.
Mac McMullen, chief executive of Rocky Mountain Family Practice, gets worked up when he talks about the quagmire of paperwork Obamacare requires before insurance companies make payouts or the government makes reimbursements through Medicaid or Medicare.
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He said trying to keep up with the required documentation is taking doctors away from their patients.
“Look, we can’t have doctors being data-entry clerks to meet these requirements instead of tending to patients. Enough is enough. … Some payouts depend on what patients do or don’t do after they leave a doctor’s office. How can you control their behavior? … The government needs to get out of our way.”
Jim Laborde, an administrator at the Centers for Gastroenterology concluded that Obamacare hasn’t worked. He said premiums are too high and that timely communication between providers and insurance companies is lacking. He gave the example of a patient paying a premium for one month, seeing a doctor and receiving ensuing treatment over the following months. But the patient failed to make subsequent premium payments. So when the provider first checks to see if the patient is covered, the insurance company says ”yes,” but when it comes time to make payouts, 90-days later, the insurance company doesn’t pay because the patient had stopped making monthly premium payments.
Bob Wilson, owner and CEO of Columbine Health systems, said Obamacare is too complicated.
“I’ve been in this industry for a long time, and I don’t understand most of Obamacare regulations,” he said. … Government workers don’t understand it, either.”
Gavin Kaszynski, chief financial officer for Associates in Family Medicine, said he has tuned out the government. He said less than 5 percent of health-care spending is spent on primary care that includes routine checkups, when conditions can be caught early and remedied for less money. Kaszynski said by comparison, about 15 percent is spent on primary care in other countries.
Kevin Unger, president and CEO of UCHealth’s Poudre Valley Hospital and Medical Center of the Rockies, said, “by definition, Obamacare has failed to be affordable. The ACA has expanded the number of people covered, but deductibles – $5,000, $6,000, $7,000 – are too high.” He said it causes people to not go see doctors until something goes really bad and then run up a big bill trying to fix it.
Laborde said with high deductibles patients pay more out of pocket, and as they pay more they have higher expectations. Using joint replacement as an example, he said patients expect it to be restored to its original condition or make it better. “That can’t always be done,” he said.
Margo Karsten, CEO of Banner Health in Northern Colorado, said she’s not sure that the ACA has made people healthier, and that drives cost.
“We need more time to change behavior of people to be more healthy,” she said.
Unger said health-care providers need to team up with schools to do a better job of educating youth on healthy lifestyles.
“We are trying to work with schools to create health clubs focusing on diet, activity and zero-sugar drinks. … Kids could have positive impacts on each other, and even on their parents,” Unger said.
Lisa Melby, executive director at the Good Samaritan Society’s Loveland Village, said using life coaches in programs to affect social behaviors can be used to help people make healthier choices. She predicts that with a growing and aging population, there aren’t going to be enough facilities to handle the demand and expects there will be a move to more home health-care services.
Dr. John Bender, CEO of Miramont Family Medicine, pointed out there are barriers to health care, such as food deserts – places that don’t have stores nearby residential areas that sell healthy food.
“In some instances, food stamps are being used at convenience stores,” Bender said.
Evan Hyatt, executive director for operations at Kaiser Permanente in Northern Colorado, said Kaiser physicians keep food boxes in their offices to give to patients who are in need of balanced diets, hopefully sparking the idea that eating healthy food can result in less sickness.
Karsten said providers need to focus more on developing programs that impact health, not sickness.
“We need to listen better, then make a strategy that makes it easier to deliver education,” she said.
Unger said health-care providers need to figure out new access points for care. He said he can see using genetics to determine and treat conditions before they become too serious.
Lana Currance, CEO of Clear View Behavioral Health, said there is a lack of government funding for organizations that treat people with mental illness and addictions, a growing population that usually have no or low incomes.
“It’s a thankless job that doesn’t pay that well,” Currance said. “Caregivers can be cursed at, hit and spit upon by their patients,” she said.
Mike Allen CEO of SummitStone Health Partners, said it’s hard to hire doctors because of this environment. But using technology, psychiatrists visit with patients via computer screens. “Docs can live wherever they want and call in,” Allen said. “Not all patients love it, though.”
Allen said we’re not there yet as a society in considering mental health part of health care.
Participants
Michael Allen, CEO, SummitStone Health Partners; John Bender, CEO, Miramont Family Medicine; Mike Bergerson, CEO, Orthopaedic & Spine Center of the Rockies; Lana Currance, CEO Clear View Behavioral Health; Evan Hyatt, executive director for operations, Kaiser Permanente Northern Colorado; Margo Karsten, CEO, Northern Colorado, Banner Health; Gavin Kaszynski, CFO, Associates in Family Medicine; Scott Kenyon, executive administrator, The Women’s Clinic of Northern Colorado; Jim Laborde, administrator, Centers for Gastroenterology; Mac McMullen, CEO, Rocky Mountain Family Practice; Lisa Melby, executive director Loveland Village, Good Samaritan Society; Scott Novogoratz, interim CEO, Encompass Medical; Kevin Unger, president/CEO for UCHealth’s Poudre Valley Hospital and Medical Center of the Rockies; Bob Wilson, owner/CEO, Columbine Health Systems; Shawn Wotowey, CEO, Northern Colorado Anesthesiology Professionals. Moderator: Christopher Wood, editor/co-publisher, BizWest. Sponsors: Russ Henninger and Jennifer Oldenburg, Hub International; Bryan Watkins and Brenda Mares, Elevations Credit Union; Chris Otto and Mike Grell, EKS&H.
