MARSHALL -The face of the health care industry is changing, and hospitals will need to change with it in order to survive, while still giving patients the best service possible. Avera Marshall Regional Medical Center is no exception, said Avera Marshall CEO Mary Maertens.
In the months since becoming a privately owned hospital, Avera Marshall has had to continue to grow and adapt with the health care environment, Maertens said, as well as prepare for coming health care reforms and coping with a difficult economy.
Maertens said the goal for Avera Marshall's change from a municipal to a privately-owned hospital was to have a transition that was seamless for staff and patients. So far, Maertens said, that goal has been met.
"Our care to patients was excellent before, and care will continue to be delivered as we would want our family cared for," Maertens said. The transition for staff has also been helped by factors like a $5 million trust contributed by the city of Marshall during the hospital sale.
That trust will be used to replace staff members' public PERA retirement benefits, she said, so pensions are not taking a hit.
And although the hospital is no longer public, Maertens said, Avera Marshall does plan to be transparent about its governance and finance. Maertens has already given one presentation to the Marshall City Council this summer, updating the city on the hospital's status.
One of the major changes in moving from a municipal to a privately-owned hospital, Maertens said, is that Avera Marshall employees now have the option of going on strike. However, contract negotiations with Avera Marshall staff have only just begun this month, Maertens and Avera Marshall community relations director Deann Holland said, and so far there is no indication that a strike will take place here.
Although nurses' strikes in the Twin Cities area have drawn media attention this year, Maertens said it's hard to tell exactly how specific issues like patient-to-nurse ratios would translate between urban and rural hospitals.
Hospital patient volumes and other factors are often different in less populated areas.
In many ways, joining the Avera health network was an important move for the Marshall hospital's future, Maertens said. It's becoming more difficult for independent hospitals to operate - the health care industry was already feeling a financial squeeze before health care reform measures were passed, she said, and reform will bring changes that may add to the difficulties.
In health care reform, Maertens said, "There will be more emphasis on outcome, not on quantity" of health care. Eventually, this would mean a shift away from patients being charged per medical procedure and more toward a single, bundled bill. Health care insurance mandates would also mean more people would be covered for their medical costs. But at the same time, Maertens said, the level of payment the hospital gets won't increase. A smaller hospital organization may not be able to survive that.
"For an organization to be aligned within a system in today's health care environment is extremely important," Maertens said.
By joining Avera, Marshall has access to a wider range of health care, and resources that will help improve patient care and make the Marshall hospital be as connected and efficient as it needs to be. For example, being part of Avera Health helped make it possible to have tools like an electronic medical records system, or for physicians to collaborate more easily to give patients better care, Maertens said. "All of these things are more easily accessed when we are part of the system."
"It's probably a little too early to tell" exactly how health care reform will affect individual consumers, Maertens said. However, in addition to insurance and billing reforms, it's likely doctors will rely more on "evidence-based medicine" to treat patients. Evidence-based medicine is a practice that uses the most proven treatments for a particular medical problem first. Maertens said the goal is to make medical care more efficient by avoiding unnecessary or more costly treatments.
Overall, Maertens said, reforms will be good for consumers, if a challenge for hospitals.
"More people will have access to insurance, which does create more access to health care," she said. There may also be more emphasis on preventive care, which is a good thing, she said.
One thing is certain - it's not likely that health care reform will go away, Maertens said.
"I think it's going to stick, and it's going to change the face of health care immensely," she said.
Avera Marshall will still need to keep a close watch on its costs and financial management, Maertens said, including constantly evaluating care programs. In some cases, as with Avera Marshall's former in-home health care service, service programs may need to close. But at the same time, there are opportunities for growth.
For example, Avera Marshall is recruiting physicians and taking on new roles, like providing behavioral health services for Worthington patients or Level 3 trauma services, Maertens said. New growth like physician outreach expanded eye care in the region is also here.
Hospitals take hits in an economic recession, too, Maertens said, so that will remain an ongoing challenge.
During a recession, Maertens said, hospitals tend to see "a very large number of people who are uninsured or underinsured, and out of work." That, in turn, affects how much patients are able to afford for care, and what kind of charity care expenses the hospital will incur. At nonprofit hospitals like Avera Marshall, the impact can be bigger.
Medical Assistance funding from the state is also a challenge, Maertens said. Currently, funding levels are below the actual cost of providing care to public health care patients. Data compiled by the Minnesota Hospital Association shows the state currently pays hospitals for Medical Assistance at a rate 14 percent below their 2002 costs.