Rural health workgroup discusses care options
CHESTERTOWN — Ensuring patients receive the best care tailored to their specific needs while keeping overall costs at a minimum was the theme of the Maryland Health Care Commission’s Rural Health Care Delivery Plan Workgroup meeting Monday, Jan. 9.
Held in Washington College’s Hynson Lounge, this was the workgroup’s third meeting. The group is responsible for developing a plan to meet the health care needs of the five Mid-Shore counties.
The panel included health care representatives, elected officials and business owners from different counties. The session was led by workgroup co-chairs Deborah Mizeur, owner of Apotheosis Herbs in Chestertown, and Dr. Joseph Ciotola of the Queen Anne’s County health and emergency services departments.
Health Services Cost Review Commission Principal Deputy Director Katie Wunderlich provided an update on the ongoing Maryland All-Payer Model project. It was formed through a partnership between the State of Maryland and the Centers for Medicare & Medicaid.
The rate setting system model is designed to be statewide, encompassing the total cost of care for a hospital and not just inpatient and outpatient services.
“We want to make sure that our health care delivery is not just in one setting, but captures a continuum of places where patients experience care,” Wunderlich said.
She said this model would be effective for rural hospitals, which can experience “declining margins” and lesser demands for inpatient services.
Howard Haft, deputy secretary for public health at the Department of Health and Mental Hygiene, talked about a primary care model centered around “patient centers.”
He said these centers, overseen by a care transformation organization, would be located in a community rather than a hospital. They would have both physicians and specialists, from nutritionalists to care managers, working as a team to help patients.
Haft said primary care physicians, especially those in a rural setting, would benefit from the concept. He said they would be able to treat each patient thoroughly and “get off their treadmills” of rushing to see as many people as they can.
“It’s hard to recruit primary care doctors to a rural area. The pay is not great, the work is hard and you’re isolated,” he said. “This is one of the antidotes for that.”
Haft said the primary care model would align all interests, from large to small hospitals, and promote cooperation within health systems. He said the model is expected to launch next year and ties in with the AllPayer Model.
A discussion, led by Health Management Associates Principal Jack Meyer, revolved around the primary care model. Garrett County Memorial Hospital was a focus, due to its implementation of the Well Patient program inside the hospital.
President and CEO Mark Boucot said though it is “not cheap,” the program has helped improve overall statistics across the board.
He said it allows a cadre of hospital employees and community health workers to not only tend to a patient with health management problems, but also provide a support structure that allows the patient to become self-sufficient.
“We’re shifting resources from being completely hospital-based to a more community focus,” Boucot said. “It’s a little bit different and I feel pretty proud.”
Most of those at the workshop spoke in favor of the primary care model. Margaret Malaro of Centreville Family Medicine said this model would help her to not feel “like she is on a gerbil wheel every day.”
“I feel that the essence of this model is ‘What you would do if it was your family member who came in?’” she said.
However, there were concerns. Maryland State Medical Society President and CEO Gene Ransom, former Queen Anne’s County commissioner, said he was worried that the creation of new programs would only put more pressure on hospitals.
He also raised points about about the associated costs that come with a primary care model, especially for rural patients.
Other participants called the model’s leadership
Maryland Rural Health Care Delivery Plan Workgroup co-chairman Deborah Mizeur and Joseph Ciotola lead a discussion on how to best serve patients in the five Mid-Shore counties Monday, during a meeting at Washington College in Chestertown.