Medicare, Medicaid discussed at forum

March 15-- Mar. 15--MAHASKA COUNTY -- Medicare for All and Medicaid privatization were topics on the minds of Eggs and Issues attendees.

Mahaska Health Partnership CEO Kevin DeRonde discussed how a Medicare for All proposal might affect the hospital.

The first question that needed to be asked, DeRonde said, is how will it be paid for.

"For example, there's a lot of abuse in our system," he said. "Whether it's abuse in post-acute care, or for example, there was a warehouse down in Florida that was supposedly selling $60 million in durable medical equipment. They never dispensed one medical piece of equipment. So there's a lot of that going on."

Another issue, DeRonde said, is in regard to the proposed implementation timescale of two years.

"It's not feasible to implement Medicare for All in two years," he said.

The third issue, DeRonde said, is the proposal looks at doing away with value-based care.

"But actually, our government has created value-based care programs that work really well," he said. "It's higher patient satisfaction, it's reduced cost and our hospitals and providers receive beter reimbursement. So we want to keep value-based care initiatives going and we're going to bring those to Mahaska health."

Because of those three points, DeRonde said, Mahaska Health is not in favor of Medicare for All.

Medicaid privatization

DeRonde said Mahaska Health Partnership is still working through what Medicaid looks like and the impact it may have on the Mahaska County healthcare community.

A lot of hospitals and private practices have had a hard time getting paid for the services they offer, DeRonde said.

Medicaid privatization is still a process that is in the works, DeRonde said

"But there's been a lot going on since the Affordable Care Act of 2010," he said. "Really, it's been a nin-year process, still hasn't been fully completed."

The Affordable Care Act, also known as Obamacare, was implemented in 2010. In 2013, DeRonde said, there was a 2 percent sequestration cutback.

"That 2 percent sequestration cut might not seem like a big deal for critical access hospitals, but a lot of hospitals operated at either a .5 or a .2 percent positive margin or a negative margin," he said. "So when you cut 2 percent, a lot of hospitals went under."

DeRonde said Mahaska Health Partnership is working diligently to make sure the needle is moved back toward a positive operating budget despite the sequestration.

New to Mahaska Health Partnership

DeRonde shared some additions to the MHP lineup. Additionally, there are 163 volunteers who have given over 11,100 hours of volunteer work.

n MHP has joined an Accountable Care Organization, Heartland Physicians ACO, which was created by physicians and administrators. According to a handout from MHP, ACOs are groups of hospitals and healthcare providers who collaborate to create "a culture of health" and reduce healthcare costs.

ACOs may help patients avoid unnecessary trips to the emergency room, manage drug therapies, shorten hospital stays, and avoid duplicate tests and treatments.

n MHP now offers epidurals and now has a pain management clinic and procedures

n Orthopedic services have been expanded

n Same day appointments are offered and new providers have been employed.

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