CEOs: Health-care industry still needs correcting

BOULDER — Health-care professionals are concerned that the current wave of new health-care facilities including hospitals and stand-alone emergency rooms going up in Boulder County and Northern Colorado will harm rather than help the region’s health-care system.

“Too much capacity is being built,” Peter Powers, vice president of operations for Longmont United Hospital, said Tuesday at BizWest’s CEO Roundtable on health care. “We already have too many beds that are underutilized.” Power said statewide hospitals are using 61 percent of the beds already in service. “The state is the fifth lowest nationwide for utilization based on population,” he said.

UCHealth is building a hospital in Longmont that will compete directly with Longmont United.

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Powers explained that the region is attractive to out-of-state health providers because the population is growing and “reimbursement is still high here.” Powers said the unused space in hospitals could be dedicated to behavioral health or rehabilitation services but “they don’t have the highest reimbursements (from the government or insurance companies).”

Clint Flanagan, founder and chief executive of Nextera Healthcare, a group of physicians that work directly with patients, said the whole community will be affected by adding more services when they appear not to be needed.

“The community will bear the cost. It will drive up health-care costs,” Flanagan said of the new facilities as they try to maintain a bottom line with less market share. “Money should be put into preventive care, not hospitals and free-standing ERs. … Longmont didn’t need a second hospital. What else could we do with that $175 million?” referring to the cost of UC Health’s hospital being built in Longmont.

“The health-care system has a whole has lost sight of its purpose. We need to focus on the patient.”

Patrick Menzies, CEO of Boulder Medical Center PC, said Colorado does not require health-care systems to meet standards for a Certificate of Need allowing health-care systems to build where they feel they can succeed.

“Communities should decide through a vote if they need added services,” he said.

Menzies said a by-product of the added facilities is that the competition will drive up the salaries of physicians that will be passed on to patients.

Menzies also said the next trend should be the virtual hospital, using home-health services and telemedicine to work with patients.

A dying breed

The group on Tuesday discussed the causes and repercussions of large health-care systems acquiring independent physician groups.

“Family medicine doctors are a dying breed,” said Molly Ferris, a registered nurse with Strada Healthcare in Omaha, Neb., and an associate of Flanagan. “A lot of what they have done is being covered by physician’s assistants and nurse practitioners.” She said med students are opting to become specialists rather than primary-care doctors.

Menzies said doctors are selling practices to get out from under the weight of time-consuming administrative reporting required by the Affordable Care Act, better known as Obamacare.

“Hospitals say, ‘come with us — just be a physician,’ ” Menzies said.

Judy Ladd, executive director of the Boulder County Medical Society, said when they go to work for a larger health-care system, “physicians are treated like little cogs.”

Susan Buchanan, executive director of the nonprofit Women’s Health, said while there are flaws in Obamacare, that it came about by “recognizing there were significant problems with the health-care system.”

Health insurance

To comply with Obamacare, which requires that everyone be offered health insurance, insurance companies have raised premiums or they offer lower premiums with high deductibles.

Andy Neary, an insurance-benefit consultant with VolkBell, said the system has created the “functionally uninsured,” those people who have insurance but don’t use it because they don’t want to or can’t pay the deductibles.

“They won’t go to see a doctor until it’s too late, and then they require expensive surgery,” Neary said.

Powers said LUH doesn’t necessarily look to take insurance companies out of the middle but are working with self-funded employers on direct-to-employer initiatives. “We have many programs with the payers but also have direct arrangements as well. ”

Neary said some employers are turning to direct-pay systems, but in general, most employers haven’t made the switch.

“It’s too easy to accept the status quo, but employers need to change,” Neary said.

Finding workers

Most everyone at the roundtable said it is increasingly difficult to find good help.

Brian Wilson, owner of FirstLight HomeCare, said he’s seeing a cultural shift in work ethics and commitment to a job.

“We’ve interviewed people, trained them, and then they don’t show up for work,” he said.”

Catherine Higgins, CEO of the BoulderCentre for Orthopedics, said “it’s hard to find the right people at the right price point. … We’re having to compete with hospitals and match benefit packages.”

But Buchanan had a different perspective because she runs a nonprofit.

“We pay self-sustaining wages, and nonprofits get passionate people who go over and above and are very loyal,” she said.

ColoradoCare

Most people at the roundtable believe Colorado Care, or Amendment 69, will fail in the November election.

The proposed constitutional amendment would create ColoradoCare, a single-payer health-care system that would cover 83 percent of Coloradans, with the balance receiving health-care benefits from Medicare and other systems.

ColoradoCare would be funded by a 3.33 percent payroll tax to be paid by all employees, taking the state’s income-tax rate from 4.63 percent to 7.96 percent, among the highest in the nation. Employers would pay 6.67 percent — getting the total payroll tax to 10 percent — to help fund ColoradoCare, on top of the taxes they’re already paying. Sole proprietors would have to pay the full 10 percent ColoradoCare tax.

Craig Beyer, CEO of BoulderEyes/Beyer LASIK, said it won’t happen because there is no provision for cost-containment.

Flanagan questioned how it would be administered. “I’d be surprised if it gets more than 25 percent of the vote.

Neary chimed in, “Free care? Guess who comes here?”

Participants

Craig Beyer, CEO, BoulderEyes/Beyer LASIK; Susan Buchanan, executive director, Women’s Health; Clint Flanagan, founder/CEO, Nextera Healthcare; Catherine Higgins, CEO, BoulderCentre for Orthopedics; Ann Kessel, business manager, BoulderEyes/Beyer LASIK; Judy Ladd, executive director, Boulder County Medical Society; Patrick Menzies, CEO, Boulder Medical Center PC; Andy Neary, benefit consultant, VolkBell; Peter Powers, vice president, operations, Longmont United Hospital; Brian Wilson, owner, FirstLight HomeCare. Moderator: Christopher Wood, co-publisher/editor. BizWest Media LLC. Sponsors: EKS&H and Berg, Hill, Greenleaf and Ruscitti.