Ca­gle: Pre­ven­ta­tive care is key

Geor­gia’s Health­care Re­form Task Force hears from state and na­tional ex­perts on ways to ad­dress ob­sta­cles to ac­cess.

Rome News-Tribune - - FRONT PAGE - By Diane Wag­ner Staff Writer DWag­ner@RN-T.com

En­sur­ing ac­cess to pri­mary care across the state was the pre­vail­ing theme dur­ing the Geor­gia’s Health­care Re­form Task Force’s fi­nal meet­ing Mon­day at Berry Col­lege.

“The path to a more af­ford­able sys­tem starts with pre­ven­ta­tive care,” said Lt. Gov. Casey Ca­gle, who chairs the com­mit­tee of seven state se­na­tors that in­cludes Chuck Huf­stetler of Rome.

The nine speak­ers, rep­re­sent­ing a va­ri­ety of state and na­tional med­i­cal-in­dus­try or­ga­ni­za­tions, ac­cepted the premise but dif­fered some­what on the main ob­sta­cles and how to over­come them.

“What we’re hear­ing to­day is a litany of chal­lenges,” said Dr. Ger­ald Har­mon, who chairs the Amer­i­can Med­i­cal As­so­ci­a­tion.

Har­mon said the big­gest is­sue is the Trump Ad­min­is­tra­tion’s de­ci­sion to not fund the CSRs, cost-share re­duc­tions, that help 7 mil­lion peo­ple who get in­sur­ance through the Af­ford­able Care Act af­ford their de­ductibles.

“We need to sta­bi­lize the cur­rent sys­tem,” he said, be­fore go­ing on to de­tail the reg­u­la­tory is­sues physi­cians face that de­tract from their time with pa­tients.

High de­ductibles in pri­vately funded plans also keep peo­ple from fol­low­ing through on treat­ment that can keep chronic con­di­tions from es­ca­lat­ing, said Dr. Scott Bohlke, pres­i­dent of the Med­i­cal As­so­ci­a­tion of Geor­gia.

“Just be­cause you have in­sur­ance doesn’t mean you have health­care,” he said.

Bohlke echoed Har­mon’s call for pay­ment re­forms. He said the tran­si­tion from fee-for-ser­vices to out­come-based pay­ments in the Medi­care and Med­i­caid sys­tems makes it es­pe­cially risky for physi­cians in ru­ral ar­eas that lack good fa­cil­i­ties and equip­ment.

Monty Veazey, pres­i­dent of the Geor­gia Al­liance of Com­mu­nity Hos­pi­tals, spoke of the many dif­fi­cul­ties fac­ing ru­ral coun­ties. He said 63 have no pe­di­a­tri­cian and 78 have no OB-GYN — and telemedicine is not an im­me­di­ate fix be­cause broad­band speeds aren’t up to par. That makes the state’s cer­tifi­cate of need law “ab­so­lutely vi­tal” to pre­serve res­i­dents’ cur­rent level of health­care ac­cess, he said. CON reg­u­la­tions re­quire state ap­proval be­fore most ex­pan­sions or the ad­di­tion of new ser­vices in an area.

“It’s the only tool the state has to en­sure geographic dis­tri­bu­tion of health­care re­sources … of fi­nan­cially sta­ble fa­cil­i­ties with an ap­pro­pri­ate payer mix,” he said.

Dev Wat­son of the Geor­gia As­so­ci­a­tion for Pri­mary Care and Tom An­drews, pres­i­dent of Mercy Care, ex­plained their pre­ven­ta­tive care op­er­a­tions.

GAPC rep­re­sents clin­ics in ar­eas with­out hos­pi­tals. Mercy Care reaches the home­less and pro­vides ser­vices to se­niors who oth­er­wise couldn’t stay in their homes.

“Safety net providers are cru­cial to keep­ing costs down,” An­drews noted.

Data-driven so­lu­tions were the fo­cus for Jeff Sel­berg of the Peter­son Cen­ter on Health­care and Dr. Lara Jacobson of the Geor­gia De­part­ment of Pub­lic Health. LaSharn Hughes, ex­ec­u­tive di­rec­tor of the Geor­gia Board for Physi­cian Work­force, pre­sented sev­eral ini­tia­tives aimed at in­creas­ing the num­ber of doc­tors work­ing in ru­ral ar­eas. And Lucy Mar­ion, dean of the Au­gusta Univer­sity Col­lege of Nurs­ing, talked of how APRNs — ad­vanced prac­tice reg­is­tered nurses such as nurse prac­ti­tion­ers and nurse mid­wives — could help fill the gaps if re­stric­tions are lifted by the state.

“They’re will­ing to go into un­der-served ar­eas. That’s what we do,” Mar­ion said.

Ca­gle said he an­tic­i­pates a re­port from the task force by early Jan­uary with rec­om­mended ac­tion-items for the up­com­ing leg­isla­tive ses­sion along with “larger items that point to a di­rec­tion for the fu­ture.”

‘It’s the only tool the state has to en­sure geographic dis­tri­bu­tion of health­care re­sources …of fi­nan­cially sta­ble fa­cil­i­ties with an ap­pro­pri­ate payer mix.’ Monty Veazey Pres­i­dent of the Geor­gia Al­liance of Com­mu­nity Hos­pi­tals on cer­tifi­cate of need law

See Wed­nes­day’s Rome News-Tri­bune for Part 2 of this re­port.

Lt. Gov. Casey Ca­gle

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