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Memorial Hospital CEO sees challenges ahead

Union Leader Correspondent

December 17. 2012 9:58PM

CONWAY - Memorial Hospital president and CEO Scott McKinnon said Dec. 11 that over time the Affordable Care Act will "radically change" health care. He said he's not an expert, and that so far he's only read 843 pages of the legislation.

McKinnon was speaking before the Mount Washington Valley Economic Council's monthly Eggs & Issues forum at the Technology Village in Conway.

"The future is going to get very challenging," he said.

He said the hospital, along with its partners, is preparing for the future through increased collaborations on small and large scales. The Affordable Care Act, otherwise known as ObamaCare, puts a greater emphasis on wellness, with value-based purchasing as part of the reform. That value is assigned for good outcomes, he said, with providers compensated "on how well they take care of their community."

He said if patients have to be readmitted, then it better be for something unpreventable, or else the hospital might not get paid for it. He said instead of providers billing for individual procedures, payments will be bundled collectively, the new law emphasizing "value, not volume" in the care of patients.

He said the hospital is focusing on three things: cost, access, and quality. McKinnon said the hospital's trustees recently revisited its strategic plan, adopting a revised one in November, with a new mission statement: "Your partner for a lifetime of good health."

He said several years ago local provider agencies such as the White Mountain Community Health Center and Visiting Nurse & Hospice Care Services of Northern Carroll County came together to better collaborate. He said Memorial Hospital is also partnering with other North Country hospitals, including Androscoggin Valley Hospital in Berlin, and sharing specialists in some areas, instead of each hospital hiring its own.

On the financial side, McKinnon said that under the new legislation the critical access designation to help sustain rural hospitals is expected to go away, which will have a "tremendous" impact on the hospital's balance sheet. That designation has enabled the hospital, as well as 12 others so designated in the state, to be at the top of the list for disproportionate share payments. Those payments provide additional help to hospitals with higher percentages of low-income patients not covered by other programs.

The justification for phasing out those payments is that under the health care act, everyone is supposed to carry health insurance, so there should be no uncompensated care. Cuts in Medicaid reimbursements have also presented a fiscal challenge for the institution.

He said as the act's provisions are rolled out, there will likely be a surge in primary care demand as the newly insured access the system.

The hospital and its partners, he said, are preparing for that, partly with the "one patient, one record" effort, which he said will "rapidly" accelerate over the next few years.

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