Scott Swanson
10/09/12
East Linn County is on the cutting edge of new advances in the way medicine is done, Samaritan Health Services CEO Dr. Larry Mullins told a Sweet Home Chamber of Commerce dinner forum Wednesday, Sept. 26.
Speaking to a crowd of about 30 chamber members and visitors at the Police Services Building, Mullins outlined some of the changes and challenges facing the medical industry, particularly those brought about in the state of Oregon by the statewide effort to reform health care that went into effect Aug. 1.
Mullins called the changes in health care at the federal and state level “confusing.”
He said they will result in changes in how health care is provided.
“We’re changing the delivery model to make sure you have access to care,” he said. “This is not the old Good Sam Hospital.”
He said those changes are driven by both economics and government mandates.
Before the recession set in, Samaritan Health – with hospitals in Corvallis, Albany, Lebanon, Newport and Lincoln City, together with dozens of affiliated physician clinics, several health plans and a senior care facility – employed some 5,000 people and had an annual budget of about $1 billion, of which approximately $650 million were operating expenses. Mullins said those expenses have dropped to about $550 million in the last several years.
“We have to reduce costs to match up to the dollars coming in,” he said.
Those efforts have included centralization of some services, which might be offered at one or two locations in Samaritan’s system, instead of all five hospitals.
Also, he said, Samaritan is changing some of the ways it offers its services, including increased emphasis on in-home care for some patients.
One new trend, he said, is a return to “the old days” when doctors drove to their patients’ homes and treated them there.
“We want to reduce unnecessary admissions,” Mullins said, adding that approximately 20 percent of patients could be “handled differently” – particularly in regard to hospital admissions. That, he said, could lower costs to patients, insurers and businesses that pay for insurance.
He showed a short video of such a program run by Presbyterian Health Services of New Mexico, which depicted a doctor and nurse visiting an elderly woman who was being treated in her home for lung problems.
Mullins said new technology allows medical personnel to “virtually connect” into patients’ homes, even testing blood chemistry in absentia.
He said Samaritan is on the forefront of the home care approach to medicine, particularly in the area of mental health, in which early intervention often can stave off bigger problems.
He said, for instance, that a psychiatrist can sit at a console with multiple screens and watch and listen as resident doctors in training talk with patients at other locations.
“We’re going through a huge information technology transformation,” Mullins said. “We have to get our innovative activities up to the level that we can do this kind of stuff, but at the same time our revenue is shrinking.”
The other major change that Samaritan is responding to is the Oregon Health Plan’s Coordinated Care Organization, created by landmark legislation over the past two years and implemented on Aug. 1.
CCOs are health plans that include of all types of health care providers who have agreed to work together in their local communities for people covered by the Oregon Health Plan — Oregon’s version of Medicaid, the government insurance that is mainly for low-income residents. Mullins said about 10 to 15 percent of the state’s population are covered by the Oregon Health Plan and will be served by the CCO approach.
He said the CCO is a more aggressive approach to health care than even the accountable care organizations (ACO) that is a centerpiece of the Patient Protection and Affordable Care Act – Obamacare.
“Our model is a little like an ACO on steroids,” Mullins said.
He said that although alternatives to hospital care will be used in the system, “we still have to be able to take care of people who need to come into the hospital.”
Mullins noted that, whereas heart patients used to be sent to Portland for major procedures such as open heart surgery, an open heart program began in 1996 at Good Samaritan hospital in Corvallis.
“Survival rates increased dramatically,” he said, adding that Samaritan is using that approach for other specialized procedures, working to make sure they are within patients’ reach.
Muilins showed a schematic of plans for the medical campus across from Samaritan Lebanon Community Hospital, which already includes the COMP-NW medical school, Sam Fit and the future veterans home, already under construction after ground was broken two weeks ago. Other elements of the plans include a chronic disease management center, an 80-room hotel complex (with a pool), and a meeting area that will accomodate up to 400 people for conferences and events.
“The Health Services Campus will exceed anything we’ve ever done,” he said. But it hasn’t been easy.
“Samaritan employees are doing the heavy lifting right now,” he said in regard to the planning process. “They have to do more with less.”
He said what Samaritan is trying to do is “transform, not reduce” its workforce, and cited the veterans home as an example of where that may happen, should Samaritan be chosen to provide medical staffing for the home, which is run by the Oregon Department of Veteran Affairs.
Mullins also discussed Sweet Home’s medical needs and stated that Samaritan has plans for the community, but he and Becky Pape, CEO of SLCH both said that they aren’t far enough along yet to divulge and didn’t want to fan speculation.
“It’s kind of hard,” Mullins said. “The economic uncertainty makes us pause before we take on another project.” He said Samaritan was under pressure “a few years ago” to build a new facility for SLCH and noted how disastrous that would have been in the current economic climate.
“I’d rather keep people working, quite candidly, than build structures,” he said. “We’re trying to have a sustainable system that works. I don’t think you’d tolerate it very well if it didn’t.”