‘Round the table Rep. Keller discusses rural Pa. hospitals
LEWISTOWN- Tuesday the Lewistown-Geisinger Hospital hosted a round table discussion with Rep. Fred Keller of the PA 12th District to speak about hospitals in rural Pennsylvania. “One of the things, of course, we’ve been focused on is the hospitals in rural PA-12 and of course they face the same issues all across our nation.” Keller said, “We introduced the Rural Health Act and that is basically dealing with the Medicare payments for in-facility services.” Keller said they want to take a look at the disparity between urban and rural hospitals and come up with an equitable reimbursement for the services provided. “We recognize that delivering healthcare in a rural setting where you don’t have maybe as many patients and so on is different than what you’re looking at in an urban area.” Keller said, “So to help our hospitals we thought that might be an avenue to have some flexibility.”
Keller also said congress is discussing about what happens with Future Cares and how they handle the advance payments for Medicaid and how that is handled going forward. “They were looking in maybe taking some of that back out of Future Service and so on. There has been some discussion or some people advocating for maybe just making that forgivable and just move on from a certain point. “Keller said, “So we are certainly are sensitive to that and think that might make sense.”
Keller also said congress needs to take a look at what has happened with healthcare because Geisinger has taken a lot of steps to make sure they were prepare for the pandemic that maybe some other services that weren’t urgent were not available. “We heard from a lot of providers that they were not and they lost revenue therefore do we maybe look at some of the payments you already received forgivable and maybe so on.” Keller said.
As far as locally Kirk Thomas, chief administrative officer for Geisinger-Lewistown Hospital, said that when the pandemic hit the hospital “Prepared for the worst and prayed for the best.” What Thomas meant by that was the hospital consolidated clinic hours and decreased the volume of patients that came into the clinics. “We took a lot of those staff and providers, brought them to the hospital, cross-trained them from the preparedness side to be ready if we did get a surge.” Thomas said, “It was a way to have the hospital prepared and keep people working.” Michelle Holt, director of outpatient services, added that the hospital used some of the trained clinic staff to run testing sites and perform screening functions as they entered the hospital campuses and clinics.
Mark Reisinger, chief government relations officer, said even with the Cares Act funding the hospital has received (around $175 million) the hospital is still several hundred million dollars that it had lost from the pandemic. “We were losing a hundred million a month. Even now with doing more, the procedures coming back we’re still lagging and we are hundreds of millions of dollars down.” Reisinger said, “So, the APP making that grant would really help close that gap in terms of money.” Reisinger even though procedures are being performed again the process to do such procedures have been slowed. “It takes longer for each surgery now. The preparation you have to do. You can’t have as many people in the room. Reisinger said, “Everything is slowed down and it just takes a lot more time. So it’s these types of things that continue this trajectory of kind of loses that we’re still experiencing.”
Keller said going forward that they are looking at is Telemedicine and Telehealth would still be reimbursable under the Medicare/ Medicaid. “That has some other issues as far as broadband, but as much as we can do I think we should be continuing to let that be part of the coverage.” Keller said.
Geisinger-Lewistown Hospital’s chief medical officer, Dr. Michael Hegstrom who was part of the round table via a live video feed weighed in on the discussion of Telemedicine. “I think that’s a huge point going forward. As a physician it’s so nice to be able to use those Telemedicines to get care to rural system. We have trouble recruiting doctors. And just for me as a surgeon there are things I can do with efficiently with patients without making them have to travel.” Hegstrom said, “I think it’s something that is really an asset to rural communities pacifically and generally for physicians and for healthcare in the future.”
Thomas added that the access of the patients has been tremendous. Thomas also said no-show rates have actually went down in patients with behavioral health issues. “You would think ‘Would that population be comfortable or accept Telemedicine?”‘” Thomas said, “No-show rates went down so that means we approved access and compliance with care.” Thomas said even on the in-patient side the hospital wasn’t allowed to utilize Telepsychiatry for the in-patient unit but with the Covid-19 pandemic guidelines they were allowed. Thomas added the quality of care did not suffer and it was very well received by the clientele.
One of the problems that face patients of rural hospitals is the WiFi connectivity and access to internet. Holt said one thing Geisinger did to address the issue was to bring equipment in to their sites so that patients can connect remotely clinic to clinic. This benefits patients by reducing travel to Lewistown rather than driving to Danville.
Thomas also commented that Telemedicine does so many things for the rural hospital. “It not only improves access for patients to different specialties that they might otherwise not get, but it also helps with recruitment too. There are so many layers that Telemed does. First and foremost is patient access but for rural communities it’s about keeping services local.”
Holt said from primary care perspective flu vaccination this year is going to be a tremendous push. Last year Holt said there was an increase in flu vaccinations. Holt also said to avoid queues of people waiting for shots there is some drive-thru vaccination planning taking place to make getting a shot safer.
“The other thing that is really important the sooner we can get rapid testing and we find out the people who have COVID as soon as we can. And then from there trace and track who they’ve been exposed to and isolate and continue reinforce social distancing and masking. That just helps our job.” Hedstrom said, “If we can keep the numbers low then we can open schools and we can continue elective surgeries, we can see people in clinical. We got to keep out numbers low.”