Inside the Industry: West Virginia’s Health Care Facilities

February 28, 2017

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Inside the Industry: West Virginia’s Health Care Facilities

West Virginia hospital CEOs offer professional insight into the challenges of the state’s health care industry, including advances in technology and the impact of the ACA and Medicaid expansion.


Compiled by Jennifer Jett Prezkop

 

Health care is an ever-evolving industry, and what is good for one patient, doctor or facility is by no means the answer for all of them. When West Virginia Executive set out to plan the 2017 health care issue, we wanted to find a way to share with our readers the varying perspectives of the state’s hospital CEOs on the industry itself, changes in patient care, advances in technology, the impacts of the Affordable Care Act (ACA) and Medicaid and the challenges they face in running a health care facility in the Mountain State. The range of answers we received provides insight into the obstacles faced based on a facility’s location, size and patient population.

For these interviews, we reached out to the CEOs of the member organizations of the West Virginia Hospital Association who offer traditional health care services. In the instances of hospital systems, in which there are multiple hospitals under one management umbrella, like Charleston Area Medical Center and WVU Medicine, we interviewed the system’s CEO instead of the leaders of each hospital to offer a broader perspective. The results provide a better understanding of the challenges our hospitals are facing as legislation, cost and patient needs continue to change.

Editor’s Note: The participants of this Q&A are the CEOs of the member organizations of the West Virginia Hospital Association that provide traditional health care services. In the instances of health care systems, we interviewed the leader of the system and not the individual hospitals. Those not included were either specialty facilities or opted not to participate.

Doug Bentz – Roane General Hospital
Peggy Coster – Fairmont Regional Medical Center
Darryl Duncan, FACHE – Mon Health System
Karen Fiducia – Summersville Regional Medical Center
Kevin Fowler – Cabell Huntington Hospital
John Frankovitch – Weirton Medical Center
Thomas Kluge – Hampshire Memorial and War Memorial Hospitals
Daniel Lauffer, PA-C, MS, FACHE – Thomas Health
Jeffrey Lilley, CPA, MHA- Princeton Community Hospital
Thomas Neal – Greenbrier Valley Medical Center
Cynthia Persily, Ph.D. – Highland Hospital
David Ramsey – CAMC Health System, Inc.
Michael Sellards – St. Mary’s Medical Center
Virgil Underwood – Boone Memorial Hospital
Stephen Whited – Minnie Hamilton Health System
Albert Wright, Jr. – WVU Medicine
Kevin Zachary – Logan Regional Medical Center


Doug Bentz, CEO
Roane General Hospital

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

We’ve had a serious drug epidemic for several years with the inappropriate use of opioids, methamphetamines and new synthetic drugs. It is very challenging to care for these patients. The addiction may drive patients to lie, steal and cheat, which sometimes leads to adversarial interactions with physicians, nurses and other caregivers, especially in our emergency departments. Couple this with a lack of addiction treatment facilities in West Virginia, and it is clear that the drug epidemic, as well as addiction medicine, has to be a priority for our state’s public health policy moving forward. The epidemic we are experiencing has far-reaching effects that are shaping the health and wellness and types of patients we will treat for years to come. The impact will be seen in our clinical settings and experienced by the staff that provides care for these future patients.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The ACA and other recent health care legislation has been a blessing and a curse for small rural hospitals across the state. First and most importantly, the ACA expanded coverage for low-income individuals and assured access to coverage for individuals with pre-existing conditions. These positive changes have allowed thousands of individuals and families to receive quality health care in the most appropriate settings. The expanded coverage should also improve the overall health status of the state in years to come.

The challenge with the ACA and other health care legislation has been the added mandates and bureaucracy placed on hospitals and physicians. Although these mandates are intended to improve patient care and outcomes, the implementation has been a bigger challenge for small rural hospitals and small physician practices. For example, our hospital’s electronic health record is held to the same standard as the Cleveland Clinic or WVU Medicine. The patient information must be secure, portable and structured to provide optimal care and eliminate harm to the patient. The difference is the larger hospitals have more depth and breadth of resources and expertise to implement and manage the system. When you add other mandates such as ICD-10, meaningful use and the new physician payment guidelines under the Medicaid Access and CHIP Reauthorization Act, the future of independent rural hospitals and small physician practices is in jeopardy.

Moving forward, my hope is that any health care legislation introduced will be a bipartisan effort that is patient-centered and not driven by special interests and political motivations.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

As a critical access hospital, the Medicaid expansion has been a financial breakeven compared to the larger hospitals in the state. Although we have seen a significant decrease in bad debt and uncompensated care, we have also seen a dollar-for-dollar decrease in another funding stream called disproportionate share. The net result is a financial wash or no net gains in revenues.

In relation to our clinical operations, we’ve seen an uptick in utilization of services due to the expanded Medicaid population. Many of these patients went without the needed primary care and basic hospital services prior to expansion, and now these patients have access to these services. The overall impact has been positive for our community and hospital.

 

 

Peggy Coster, CEO & Chief Nursing Officer
Fairmont Regional Medical Center

What are the major challenges facing West Virginia’s health care industry?

Changes to reimbursement will be the biggest challenge the industry faces in the upcoming years. This will not only affect West Virginia’s health care industry but the national health care industry as well. Federal and state government need to work with health care facilities to determine the best course of action. Collaboration is the key to navigating the turbulent reimbursement waters that lie ahead.

 

How has the approach to patient care changed over the last 10 years?

Patient care has become, and will continue to become, more quality focused. This includes how well you care for the patient in your facility as well as how you assist in the caregiving of that patient after he or she is no longer being cared for within your organization. Providing good patient care is no longer the acceptable norm. You must be great.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

West Virginia’s drug epidemic has resulted in the state having the highest death rate from drug overdoses in the nation. This has severely impacted both hospitals and their affiliated physician providers. Earlier this year, the West Virginia Hospital Association recommended pain treatment guidelines for emergency department physicians across the state. Emergency physicians are using other medications for pain and are limiting prescriptions for controlled substances.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

Our facility has seen an increase in the Medicaid population due to the Medicaid expansion reform from the ACA. Along with expanded coverage, those who now qualify for insurance are also seeing significant rate increases that may affect their ability to pay for the insurance.

 

Tell us about the importance of performing clinical trials in West Virginia and which ones, if any, are taking place at your facility.

Fairmont Regional Medical Center’s participation in clinical trials is mainly through our accredited cancer program. Patients are usually placed in these trials at larger treatment centers, and we see these patients when they are admitted to our facility or treated as outpatients.

 

Darryl Duncan, FACHE,n President & CEO
Mon Health System

What are the major challenges facing West Virginia’s health care industry?

We are a state that has a stagnant to shrinking population that is getting older as a result of the younger age groups leaving the state to find employment. Nearly one third of the population is enrolled in the Medicaid program, and the incidence of disease within our population is much higher than the national average. On top of these issues, we are challenged to have enough skilled health care workers to fill the vacant positions in the industry, which is resulting in significant increases in wages. I would like to see us collectively incentivize more students to choose professions in health care and use our resources, such as the Promise scholarship, to not only encourage the students but also the higher education institutions in our state to grow the programs in high demand, such as nursing, and incentivize the graduates to stay in the state for careers in health care.

I would also suggest increasing the soft drink tax and directing those funds to the West Virginia Medicaid program. It would be the best investment the state could make. We receive $2.70 from the federal government for every $1 we invest in the Medicaid program. The goal would be to decrease the purchase and consumption of sugar-sweetened beverages through the increase in the tax and raise additional funds for the Medicaid program, which is where many of the results of sugar-sweetened drinks cost the state through increased risk of obesity, diabetes, heart disease, high blood pressure and poor dental hygiene.

Our state also has the distinction of being one of the worst for drug abuse and mental health issues. Many of these patients are being treated in emergency departments and primary care physician offices because of a lack of appropriate resources.

 

How has the approach to patient care changed over the last 10 years?

At Mon General, we choose to focus on the fact that health care is still a personal relationship between the provider and the patient. There is certainly a lot of talk about population health and how to reduce utilization of health care services in order to make health care more affordable, and those are certainly important discussions to have. However, our main focus is on the patient and on each and every interaction we have with them. We are large enough to have all the technologies and treatments necessary but small enough to really focus on the patient, their family and the experience they have with us. We never want to lose sight of our purpose.

 

Karen Fiducia, CEO
Summersville Regional Medical Center

How has the approach to patient care changed over the last 10 years?

Patients are now included in their health care, health care is provided by more than physicians, and a greater focus is being placed on wellness and chronic disease management.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

The individual hospitals will have a difficult time incentivizing physicians to practice in the state. There needs to be a cooperative effort in recruiting primary care physicians to the rural areas and specialists to the tertiary care facilities.

 

 

Kevin Fowler, President & CEO
Cabell Huntington Hospital

What are the major challenges facing West Virginia’s health care industry?

While every health care entity in West Virginia strives to exceed nationally accepted standards in the delivery of health care, the major challenges are access, particularly in rural areas; an aging population and poor overall health status. West Virginia residents have higher rates of smoking, binge drinking, obesity and physical inactivity as compared to other states. The challenges facing West Virginia health care require that we find ways to encourage healthier behaviors.

 

How has the approach to patient care changed over the last 10 years?

One of the most obvious ways patient care has evolved for the past decade is a shift from inpatient to outpatient and observation settings. Thanks to enhanced training and technology, procedures that once required hospital stays are now performed minimally invasively or robotically. These small, button-size incisions mean less invasive surgery, less pain, faster recovery and faster return to activities. Technology and highly specialized services will continue to evolve and offer patients better outcomes and confidence.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

Cabell Huntington Hospital recognized the importance of attracting highly skilled and trained physicians to the tri-state more than two decades ago. As such, we have worked closely with the Marshall University Joan C. Edwards School of Medicine to build facilities, expand programs and recruit specialized physicians who are eager to work in our region in an academic setting. Through growing our own, we have been able to provide world-class medical training to West Virginia residents who want to remain home to practice medicine. However, as we look forward, it’s imperative that we are able to attract and retain specialty and subspecialty physicians.

 

How are you using technology to improve patients’ lives?

Technology is providing higher quality, better outcomes and overall better experiences. Da Vinci robotic surgery now offers many procedures, including gynecologic, gynecologic oncology, urology, general surgery, surgical oncology and thoracic surgery. Patients not only have less pain and shorter hospital stays, but they have less risk of infection, decreased blood loss and less scarring. The Edwards Comprehensive Cancer Center introduced the TrueBeam™ linear accelerator, a state-of-the-art radiation delivery platform that allows radiation oncologists to treat challenging cancers throughout the body, including those in the brain, spine and liver, while avoiding healthy tissue. Because procedures are performed in a shorter amount of time, the experience is more comfortable and convenient for patients. Orthopedic patients having total knee and hip surgeries are going home the same day or next day. Patients suffering with gastroesophageal reflux disease, or chronic indigestion, can have Stretta therapy, a minimally invasive endoscopic procedure that provides symptom relief for 10 years. Urololift offers men with enlarged prostates a safe, minimally invasive option that restores regular urination function. Last year, we opened a new hybrid operating room that enables advanced vascular procedures, including abdominal aortic aneurysm, carotid artery disease, peripheral vascular disease, deep vein thrombosis and chronic venous insufficiency.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

Initially, Medicaid expansion helped reduce the number of uninsured patients. However, reimbursement for services continues to decrease with some below the cost of delivering care. We hope any repeals by the new administration address the reductions in payments for hospital services, specifically the cuts to Medicare and Medicaid disproportionate share hospitals payments that are responsible for treating all patients, especially our most vulnerable patients.

 

Tell us about the importance of performing clinical trials in West Virginia and which ones, if any, are taking place at your facility.

 

Recently celebrating its 10-year anniversary, the Edwards Comprehensive Cancer Center supports a very active clinical trials program. Recognizing that many of today’s most effective standard treatments are based on cancer research and the results of previous clinical studies, ongoing research is essential in the fight against cancer. The Charles H. McKown, Jr., M.D., Translational Genomic Research Institute (TGRI) allows scientists to work in close proximity to clinicians, fostering collaboration. This facility supports the medical school and clinical researchers by enabling them to rapidly translate genome-based laboratory research into clinical applications that will improve patient care. The TGRI offers the appropriate environment for performing leading-edge cancer research and conducting clinical trials that are helping shape the future of cancer research. Current clinical trials include breast, lung, melanoma, gynecologic, brain, gastrointestinal and genitourinary cancers.

 

 

John Frankovitch, President & CEO
Weirton Medical Center

What are the major challenges facing West Virginia’s health care industry?

West Virginia hospitals face the same issues as facilities in other states, namely the challenge of continuing to deliver high-quality care with declining reimbursement. The challenge in the Northern Panhandle is even greater since the managed care market is more mature than in other areas of West Virginia, and our managed care reimbursements are materially lower than the rest of the state. Our strategy has been to partner with physicians to create a medical network to attract and import patients from surrounding states to offset these challenges and grow as a provider.

 

How has the approach to patient care changed over the last 10 years?

Technology has been and will continue to be a major change agent for the industry. In terms of medical advances, we have seen a major shift in the manner in which care is delivered. For example, advances in pharmacological management and endovascular technology have reduced the need for open heart surgeries. Hospitals will need to continue to make major investments in order to support these advances. The other area is in expansion of the electronic health record (EHR). The development of a fully functional EHR has great value in terms of developing a seamless flow of patient information across many providers, but the cost to hospitals can be staggering in real dollars as well as use of existing resources.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

Being located 30 minutes from the Pittsburgh market, we have been fortunate to be able to recruit high-quality specialists by partnering with other facilities and large practice groups. However, the challenge of developing a strong primary care physician base exists for nearly every hospital. When you look at the overall cost of obtaining a medical degree along with the burdens of complying with federal EHR regulations and then compare that to primary care reimbursements, it’s impossible to make the math work for most new physicians. We believe the model moving forward will be for hospitals to take the responsibility of providing employment opportunities to develop partnerships to attract physicians. The days of hoping a physician will come to your town and set up a new, independent practice are essentially over for most communities. As hospitals, we have to actively develop and support the establishment of comprehensive physician networks to serve our communities.

 

How are you using technology to improve patients’ lives?

Our urologists and gynecologists now use an implantable wireless device to provide urinary control for patients experiencing severe incontinence. To hear them describe the emotional impact this device has for patients who have not been able to live normal lives due to incontinence is pretty remarkable. We continue to see major technological advances in nearly every medical discipline across our facility.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

The main financial challenges we face are the disparity of reimbursement for Northern Panhandle hospitals versus the rest of West Virginia and a cost structure that is much higher than surrounding states. The steel industry introduced managed care to our market decades ahead of the rest of the state, and although that industry has been radically downsized, the effects of this reimbursement disparity continue to exist. Also, we, along with all West Virginia hospitals, have cost burdens such as sales and provider taxes that do not exist for Ohio and Pennsylvania hospitals. After partnering with R&V Associates since 2012 to provide strategic direction, we have experienced incredible growth, essentially doubling in patient revenue in spite of these challenges. R&V has really done incredible work to help us not only survive but actually grow in a difficult market.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The ACA has had a major impact on every hospital in terms of regulations and electronic record requirements. Although many hospitals have reported a decline in charity and uncompensated care, they have also experienced an increase in bad debt. If you have a family of four that makes $50,000 a year, having an ACA market insurance policy with a $10,000 deductible is really just catastrophic coverage. Those families cannot pay their deductible in most cases, which then falls to the hospital or physician. What is encouraging is the post-election discussion of reintroducing more patient choices for coverage such as health savings accounts (HSAs). HSAs supported with tax incentives prove to be very effective in giving patients control of their health care as well as making them more savvy consumers. The ACA initially eliminated these types of consumer-driven plans, but including more of these types of options could help increase coverage as well as bend the health care inflation cost curve.

We have also implemented direct-to-consumer services such as lab panel testing, which has been very successful. For $50, a person can walk in to any of our sites and get a comprehensive lab profile with no insurance billing.

 

 

Thomas Kluge, President
Hampshire Memorial and War Memorial Hospitals

How has the approach to patient care changed over the last 10 years?

Health care delivery has changed dramatically. The payment system for hospitals and health care providers is transitioning from volume based to value based. There is an increased emphasis on reimbursement tied to quality measures for payment. For example, portions of Medicare hospital payments are directly tied to performance on measures of quality—readmission within 30 days of hospitalization, hospital-acquired infection rates and patient satisfaction scores. Hospitals are challenged to bring value to patients by improving quality of care at an acceptable cost. The reimbursement push-away from volume has forced providers to focus on patient outcome rather than the number of patients treated.

The evolving payment system has also forced health care providers to be more involved in a patient’s care after a hospital acute care discharge by linking Medicare reimbursement to bundling payments for select hospital acute care inpatient stays to include payment for any health care services 90 days post-acute discharge. Health care providers have responded by forging partnerships with post-acute care providers like home health agencies and skilled care providers. Hospitals are also addressing the payment for reducing readmissions. Hospitals have created programs to coordinate patient care in the community, following patients that have multiple chronic diseases with patient navigators to make sure patients follow up with their primary care provider, obtain their medicines, et cetera.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

West Virginia’s drug epidemic is placing additional stress on an already resource-challenged part of the health care industry—community-based first responders and hospital emergency departments. An example of the stress is what happened in Huntington last summer. The extraordinary number of people who overdosed in a short period of time affected the response of emergency providers to not only care for those who overdosed but also the care of non-overdosed patients with emergency conditions. Patient care is not the only part of the industry affected by the opioid epidemic. Security staff have been added to both of our hospitals. There are increased emergency department security risks in caring for the drug epidemic population.

 

Daniel Lauffer, PA-C, MS, FACHE, President & CEO
Thomas Health

What are the major challenges facing West Virginia’s health care industry?

Substance use disorders, overall poor health of residents and a poor economy. We must get the West Virginia economy improved to see the overall quality of life and health improve. The state’s health culture must change as well. Many of the health issues in West Virginia are preventable if we change to a culture of prevention rather than seeking care only after we become acutely ill. If our citizens value their health, we must be more active than passive in engaging patients in disease prevention and management.

 

How has the approach to patient care changed over the last 10 years?

Patient care is now under a fee-for-service model focused entirely on acute illness rather than prevention. The financial system has rewarded providers for the acute care model. The model of fee for value is evolving and has brought improvement in patient care approaches, but its implementation under the ACA has been mixed at best. Quality measures and metrics are good, but too many exist, and multiple measurement methodologies abound. There needs to be some rational standardization agreed upon. Much of this implementation has brought on many more regulations and required resources being spent to comply with little improvement or notice by the patients or the staff that need to deliver bed-side care.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

The state now has approximately 600,000 patients on Medicaid. We have the lowest work force participation rate in the country, high unemployment and the poorest health habits. All West Virginians should undergo a health care assessment to be used in a statewide database that will be used to determine the top five health concerns of residents. Each resident, however, must understand their personal health issues and accept personal accountability and responsibility to comply with recommendations by physicians and mid-level providers in addressing their problems. Providers must also be reimbursed appropriately for their time in educating and evaluating residents. If we only reward providers for acute care, that will be the focus even though focusing on engaging patients in their care has greater long-term benefits. There must be some co-pays required under any plans that are meaningful to patients with continuing return visits if they do don’t comply with their health assessment recommendations.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

Substance use disorders exact a huge toll on providers, nurses, ER personnel and first responders physically and emotionally. There are also huge financial resources being spent to care for these patients medically for complications resulting from overdoses and chronic abuse as well as for treatment programs to assist these patients in trying to manage and control their addictions. This care is often at the taxpayers’ expense. This care is stretching the hospital systems’ resources to be able to treat other patients as well.

More integrated treatment programs are needed. Providers need to be compensated appropriately, but patients must also have some personal responsibility in complying with treatment, which is difficult with this patient population. More behavioral health care personnel are needed to address the current shortage of behavioral health personnel. Collaboration of all behavioral health providers and programs must be a priority to track, treat and provide recovery care for these patients. Substance use disorder care is long-term and requires multiple approaches to achieve success.

 

How are you using technology to improve patients’ lives?

The patient IT portal and online express scheduling is something we are working on to make health care more convenient and accessible. Patients who are not computer or tech savvy, however, still cannot access this service, but we are working on models to help patients schedule their visits and understand the costs, and we are helping with engaging them as to how they can improve their health status on a day-to-day basis. Engaging patients with the benefits of a family physician or clinic for care helps lower their cost and the cost to the system in providing care and raising quality outcomes. Hopefully smartphone technology will help us connect with patients in the near future. After all, today you can call up an Uber driver or locate your nearest restaurant for reservations with your smartphone. We are making this kind of technology a goal of ours at Thomas Health.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The ACA brought a shift in providing care from a fee-for-service to a fee-for-value model with emphasis on quality outcomes, lower cost and better health to patients. These are welcome changes to the health industry, but the implementation of these goals occurred too fast. Many providers, hospitals, clinics and insurers are suffering from change fatigue and regulatory burden. Since January 2017, there have been 37 new guidelines issued, constituting 14,000 pages of text from Medicare and other government agencies.

Compliance and cost are mounting, and this change in the industry at this pace is putting the entire infrastructure of health care at risk. We need to hit the reset button and provide for greater flexibility to health care systems and providers to achieve the value we seek in health care. Health care will top 19 percent of GDP in the near future and will make our businesses difficult to compete in a global economy if we do not change. Current statistics show that with the baby boomers turning age 65, a patient becomes Medicare eligible every eight seconds now and for the foreseeable future. I welcome the idea of block grants to states for Medicaid with fewer regulations, implementation of health care savings accounts and tax credits applied to help all Americans achieve health coverage, putting personal responsibility and accountability by patients as a requirement in the form of co-pays or penalties for noncompliance in all payer programs both commercial and governmental. Other ideas will have merit, and the country needs to come together to address Medicare and its future if it is to be there for our children and grandchildren.

 

Tell us about the importance of performing clinical trials in West Virginia and which ones, if any, are taking place at your facility.

Clinical trials are important for bringing new drugs and technology to health care. West Virginia’s academic centers should pursue clinical trials to improve our state and country’s knowledge and therapies for difficult chronic medical conditions. West Virginia with its poor health population could be a center for such clinical trials.

 

 

Jeffrey Lilley, CPA, MHA, CEO
Princeton Community Hospital

How has the approach to patient care changed over the last 10 years?

There continues to be a shift from inpatient to outpatient services. As the reimbursement continues to evolve, facilities must find ways to provide services more efficiently and at a lower cost. Some of these changes are beneficial while others can be problematic. It is important to take every step possible to eliminate as much of the risk as possible. Hospitals spend an enormous amount of resources on technology to alleviate this risk. Moving forward, facilities will continue to invest millions in improving quality, outcomes and efficiency. This compression of the health care system will evolve and strengthen in an effort to provide for the high expectation of the patient. Telehealth services will continue to grow and evolve. Much of the expansion has been stunted by difficulties with reimbursement; however, new policies and legislation will likely eliminate some of that issue. We are evaluating opportunities with teleneurology and telepsychiatry. Additionally, improvements to broadband and other connectivity issues throughout West Virginia will continually need to be addressed.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

The triggers are everywhere, and West Virginia’s economy issues are going to further exacerbate the problem. Many of the issues that stem from the epidemic are waiting time and overcrowding in the emergency departments. It is already difficult to manage patients in an efficient manner; however, this population creates an environment that requires additional resources. People get angry when their needs are not met, leading to the possibility for mental and physical abuse within the staff who are trying to provide the care. Patients with chronic pain generally find it difficult to get an appointment for their issue because of the limited availability of providers. Additionally, the epidemic leads to further behavioral health needs in an already overburdened service line.

 

How are you using technology to improve patients’ lives?

Our hospital began performing diagnostic heart catheterizations in the summer of 2016. This service has been something on our radar for a number of years. We constantly monitor transfers out of our emergency department, and patients presenting with heart problems generally top the list. The implementation of this service will not eliminate the entire problem, but it is helping serve a community need and keep people from traveling either to other parts of the state or out of state to get care. We have also implemented 3-D mammography. This technology is particularly beneficial for women who have a history of cancer in their family. With the recruitment of a new OB/GYN physician, we have been able to expand the types of URO/GYN cases being performed in the OR.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

Reimbursement is always a problem when operating a health care facility in West Virginia. Everyone wants to provide the best care, but finding the dollars to obtain and distribute that care can be problematic. The number of patients that are covered with commercial insurance is dwindling and doesn’t appear to be improving, at least not in the short term. It is important to find ways to have the institution survive on Medicare and Medicaid rates of reimbursement. That means there will be some sacrifices, and employees will be asked to wear many hats and work more efficiently than ever before.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The single biggest benefit of the ACA in West Virginia has been the expansion of Medicaid. Where many patients didn’t have any type of health insurance, they are now covered by Medicaid. Along with that, facilities are required to participate in a number of quality programs, such as antibiotic stewardship programs, sepsis programs and readmission initiatives. These programs are all worthwhile and will lead to higher quality programs moving forward. However, these programs come at a price—higher staffing and increased technology costs.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

The Medicaid expansion has reduced the percentage of patients who were considered to be self-pay. We have seen the Medicaid population increase and the self-pay patients decrease. This has been somewhat tempered in the past year with people moving in and out of the exchanges supported by the ACA. Even though they have insurance, the deductibles and co-insurance are so high, it can be simply unaffordable. Going forward, I would like to see the expansion programs stay in place. However, there will need to be some sort of funding mechanism. Personal accountability within our population must be addressed and improved. Additionally, when concepts and changes in policy are considered, I think the folks in the organizations are sometimes left out of the discussion while decisions are made at the federal level.

 

Thomas Neal, CEO
Greenbrier Valley Medical Center

What are the major challenges facing West Virginia’s health care industry?

An aging population, increased disease disparities and chronic disease continue to plague our state. Behavioral health services continue to be underfunded and inaccessible to many. We must identify strategies to begin addressing these issues through collaboration with primary care providers and other community partners and working together to create long-term strategies and empowering patients to better manage their health.

 

How has the approach to patient care changed over the last 10 years?

Medicine and technology have made significant advances over the last 10 years. This has both improved and changed the delivery of health care. As an example, telemedicine offers patients in rural communities access to specialists that would have otherwise not been available unless the patient traveled to a large urban health care provider. For poorer residents, this is equivalent to denying access.

As a second significant change, much of hospital care has shifted to an outpatient setting. This has the effect of compressing care that once occurred over days into hours and reducing reimbursement for hospitals. This impacts hospital staffing, recruitment and expense control as we plan for lower inpatient volumes and greater needs in outpatient areas.

A final change to note is the increased transparency in health care. While the intent is laudable as it promotes quality improvement and public awareness, the reports are still difficult for the public to understand and have several weaknesses that need improvement.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

Developing regional strategies is key for rural hospitals in order to fulfill specialty needs in our communities. By creating partnerships, the possibility of recruiting a specialty physician to a rural area will increase because a higher population is available to build a new practice with more available resources.

Secondly, the Certificate of Need (CON) laws limiting hospital-employed physicians access to office space need to be addressed. The trend for physicians to seek hospital employment is not likely to change, and the state needs to relax these standards to allow physicians access to clinics without facing a CON fight.

A final area to consider is the utilization of telemedicine. To make this happen, the state needs to promote improvement of the network infrastructure and assure reimbursement for telemedicine covers the cost of care.

 

How are you using technology to improve patients’ lives?

In a rural setting, having access to all specialties at all times can be a challenge. While access to surgical services cannot be covered via telemedicine, we have utilized telemedicine to cover medical services like neurology and psychiatry. By utilizing these services, we are now able to assess on-site rather than immediately transferring the patient and have been able to decrease the number of transfers by utilizing teleneuro services.

A second technical tool that has greatly impacted the way we provide care is the utilization of a video language interpreting service. This program enables us to communicate with patients in their native language via webcam devices.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

Obviously, the expansion of Medicaid and many of the other coverage changes have improved access. While it is unknown how President Trump will repeal the ACA, millions are counting on health insurance to secure the health care services they need. Another area that has had significant impact is value-based purchasing. The alignment of outcomes with reimbursement have had the effect of redirecting attention toward quality.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

Before Medicaid expansion, 17 percent of our patients seen in the emergency department were self-pay. Since the expansion, the percentage has reduced to 6 percent.

 

Cynthia Persily, Ph.D., President & CEO
Highland Hospital

What are the major challenges facing West Virginia’s health care industry?

West Virginia has an aging population that will require more and more care in the future. We also have an aging health care provider population as well as a physician shortage—this is a perfect storm at just the time when more care is needed. As a state, we will need to figure out how to provide the care that is needed at a price we can afford.

In addition, the dependence on state-funded health care insurance is a potentially unsustainable model for the future of the health care industry in West Virginia. Our state leaders need to create good-paying jobs that offer employer-based health insurance and decrease our population’s reliance on Medicaid and other government-supported programs to fund health care.

 

How has the approach to patient care changed over the last 10 years?

The approach to patient care over the last 10 years has not necessarily changed. Hospitals have always been focused on providing safe, high-quality care. However, some of the strategies to meet these goals may have changed. For instance, in our hospital, we rely much more on data that is now more available to us with technology to make decisions about our care approaches. We are also much more focused on population health—thinking about how we can keep people out of the hospital or keep them healthy after they leave our doors. I believe technology will continue to evolve to allow us to know even more about our patients and their behaviors and help us discover ways to facilitate better health in our community in the process.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

As a psychiatric hospital, we see the first-hand impact of West Virginia’s drug epidemic each day. We are actively treating those with substance use disorder, a chronic brain disease. As a treatment facility, we are challenged to be able to find innovative ways to reach the population, facilitate treatment and support recovery. We work daily to change the attitudes of the general population about addiction, decrease the stigma related to seeking help for addiction and provide education regarding help that is available. We are a major supporter of the HELP4WV hotline, a project linking those in need to a care site in real time. Innovations such as these will change the way our patients access care for the future, and we need to continue to provide that support.

 

How are you using technology to improve patients’ lives?

Psychiatry is a relatively low-tech environment. At Highland Hospital, we were relatively late adopters of the electronic medical record (EMR) but are now seeing the value added by the EMR through improved communication between providers, the ability to automate certain processes and ways to use it to assure safety in high-risk areas such as medication administration. There is still a lot of work to be done, but we are beginning to see a difference.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

One of the features of the ACA that has the potential to impact all hospitals is a shift from payment for volume to payment for performance. Over the next several years, we expect to see more and more of our reimbursement tied to quality indicators. As a psychiatric hospital, we would like to see more of a focus on quality indicators that address our patient population and their unique care needs. Right now, most indicators that have been developed by the federal government and will be tied to reimbursement for the future are medical or surgical performance measures and must be forced to be applicable to our population and truly reflect the quality of services we provide.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

Medicaid expansion has been a benefit to our patients, particularly to children whose families may be working but not qualified for insurance in other ways. The ability to serve this client base and be reimbursed for those services is integral to our successfully meeting our mission of providing high-quality behavioral health care. However, Highland Hospital remains prohibited from accepting Medicaid for the treatment of adults, so despite Medicaid expansion, we are unable to serve this population.

 

 

David Ramsey, President & CEO
CAMC Health System, Inc.

How has the approach to patient care changed over the last 10 years?

The basic approach to the delivery of health care has not changed over the last 10 years. It is still people taking care of people. There has clearly been advancement in technology and medication, resulting in more care being delivered in the home, the doctor’s office or outpatient facilities.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

This drug epidemic is a social issue, not a health care issue. Hospitals do their best to care for people who drive without seatbelts, drink and drive, smoke or get shot or stabbed, and we take care of people who abuse drugs. Health care providers are much more aware of individuals seeking drugs. Our emergency rooms are seeing far too many horrible situations, but it has not changed our desire to provide the best care possible to our patients.

 

How are you using technology to improve patients’ lives?

There are so many technological advancements, it’s impossible to mention them all. From diagnosis to recovery, all of the new procedures and equipment are patient-centered to provide enhanced care. More than 10 years ago, we converted a closed nursing unit into a simulation training center. Physicians, nurses and other providers use simulation and virtual patient experiences to gain valuable experience. Using telehealth allows patients and their primary doctors in rural areas of the state to interact with a specialist without having to drive all the way to Charleston. This provides easy access to health care providers and saves patients and the health care system money.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

Everyone involved in health care wants each individual to have access to health care. In our country, having health insurance is vital to access health care services. The ACA’s promise of everyone having health insurance and access to health care has greatly improved. The disappointing aspect of the ACA is the continued increase in the cost of health insurance to the point where families cannot afford health insurance. The main premise of the ACA was that if everyone had health insurance, the cost would go down. The idea was that young and old utilizers of health care and those who rarely use health care services would pay into health insurance plans and costs would come down. Regrettably, this has not worked as hoped. People who use the health care system buy insurance at a higher rate than those who infrequently use health care services. This has resulted in increased health insurance costs, the opposite of the intent of the ACA, for those with private insurance. The ACA has insured millions of people through the Medicaid insurance program. The unfortunate reality for health care providers is Medicaid pays below the cost of care. In addition, approximately half of the trillion-dollar cost of the ACA is paid for by a reduction in Medicare reimbursement to health care providers, primarily hospitals. The reduction to West Virginia hospitals is millions of dollars.

The changes I would like to see made in the ACA would be to require reimbursement to hospitals at cost for Medicaid and a reversal of the millions of dollars of Medicare cuts made to and planned for hospitals. In addition, future Medicaid and Medicare reimbursement would keep pace with increased cost of medicine’s technology and facilities. This should lower the cost of private insurance, making it more affordable for families and individuals.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

Before Medicaid expansion, CAMC provided more uncompensated care than any hospital in the state. The expansion provided insurance to many of the people for whom we provided care, thus receiving reimbursement for patients we previously cared for with no reimbursement was very beneficial to the hospital. The increase in Medicaid reimbursement helps to offset the reduction in reimbursement from Medicare mandated by the ACA and the loss of private insured patients due to the loss of jobs in the region.

 

Michael Sellards, President and CEO
St. Mary’s Medical Center

How has the approach to patient care changed over the last 10 years?

Advances in technology have allowed for quicker recovery times, and patients are going home from the hospital more quickly than in the past. The challenge for hospitals is to make sure patients follow through on discharge instructions and home care so they don’t end up being readmitted to the hospital. All health providers are trying to help patients focus on wellness and overall health with preventative medicine and regular checkups and screenings. Consumers have better access to quality rankings to help them make health care choices.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

The state, hospitals and the three physician training programs must redouble efforts to expand the size and quality of their programs in order to recruit and retain more physicians and develop policies that address medical liability, fair reimbursement and regulation. Also, continued training and recruitment of more mid-level providers will enhance additional access to care.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

The drug epidemic is causing a strain on every level of the health care delivery system. Drug abusers often have multiple visits per year to hospital emergency rooms. The patients are tying up EMS crews and ambulances needed for other emergency runs. When addicts become inpatients, those suffering from addiction often try to have family members bring them illegal drugs to their hospital bed. Illegal drug use in the hospital also makes treatment and diagnosis of other medical problems difficult. Addiction patients also pose additional security risks for the hospital environment, and hospitals have to devote more resources to security. There are very few recovery programs for addicts to go to once they are discharged from the hospital, and more resources are needed for addiction treatment.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

The mission of St. Mary’s states: “We are inspired by the love of Christ to provide quality health care in ways which respect the God-given dignity of each person and the sacredness of human life.” In order to fulfill our mission, we recruit and retain qualified physicians, nurses and hundreds of additional professionals working in a well-equipped atmosphere of compassion and caring. Our emphasis must focus on population health, quality outcomes and effective cost management.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

We believe health care is a right of each person and support the continued expansion of coverage to the uninsured. However, the ACA has forced millions of people into exchanges with high deductibles and increased premiums and caused the loss of their individual physicians. The program must be streamlined and costs brought under control.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

There are now fewer uninsured patients, but some patients who shifted to Medicaid had access to commercial insurance before the expansion, so hospitals get reduced reimbursements when treating those patients. We still have to provide millions of dollars in charity care each year for patients who don’t pay for their share of the bill or who are uninsured or underinsured.

 

 

Virgil Underwood, CEO
Boone Memorial Hospital

What are the major challenges facing West Virginia’s health care industry?

Major challenges facing West Virginia’s health care industry are rising costs, quality payment programs and unanswered questions regarding the ACA.

I think the way to address them is to become involved with associations spearheading strategies to stay ahead of the program and educate administrative staff to remain compliant with the programs to avoid penalties. We must become involved in health care initiatives and take advantage of every opportunity to collect any and all incentives available. We must also educate with the evidenced-based practice internally to strengthen our health care team with knowledge and skills. Efforts must be geared to achieve success with strong positive outcomes.

As for the West Virginia health care industry, the unknown future of the ACA is a great concern. Under the ACA, the number of uninsured West Virginians dropped from 246,000 down to 76,000 by the year 2016. This means there will be an increased cost to insure the additional 170,000 individuals on the Medicaid expansion plan. The plan West Virginia chose at the inception of the ACA was fully funded by the federal government up through fiscal year 2016. West Virginia, however, will have to pay 10 percent of the total cost starting in fiscal year 2017. With a declining economy and the state relying on the state rainy day fund, matching this federal dollar will become an additional challenge to our already economically challenged state.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

We need to create new health care certifications for support staff programs. A larger health care support staff can help physicians and nurses care for the large load of patients in a quick and caring manner. Health care that is more appealing to the patient population up front will lessen the load on the back end. If more unlicensed assistive personnel were permitted to perform more duties, it would prevent our physicians and nurses from becoming so overwhelmed. With time to process patient issues and complaints in a more methodical and controlled manner, health care workers could provide more intense and thorough health care.

In combating the physician shortage in West Virginia, there are several mechanisms that could be put in place to retain physicians. The greatest challenge of physicians coming out of medical school is the amount of debt from attending undergraduate and medical school. Currently, there is a loan payback program through the government; however, many times larger medical facilities will pay back the loan in its entirety to recruit the physician. This leaves many small and rural hospitals unable to compete for these physicians.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

There are many obstacles in running a health care facility in West Virginia. The declining coal industry has led our payer mix to become one that is less commercial insurance and more Medicare and Medicaid. Therefore, we must reduce costs and offer more services that can be reimbursed under these payer programs.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The ACA has actually helped our facility due to the number of citizens eligible for the Medicaid expansion program. We have increased our revenue due to more people being covered under the Medicaid expansion program. However, with a Republican president and Republican Congress that has filed to repeal the ACA, the future is uncertain at this point. Today, Republicans have announced they may repeal the mandatory guidelines, and this was the most unpopular part of the ACA. This means those who could choose not to have health care coverage may elect to do so. This could possibly lead to fewer insured Americans in the future.

 

Stephen Whited, CEO
Minnie Hamilton Health System

What are the major challenges facing West Virginia’s health care industry?

Probably the two most daunting issues we are facing at Minnie Hamilton Health System are the disallowance of rural health clinic costs in the disproportionate share hospital (DSH) payment method and the continuation of uncompensated care even though individuals have health insurance coverage. The DSH issues surround DSH payments, which are made to hospitals that serve high proportions of Medicaid recipients and uninsured individuals. For more than a decade, several of West Virginia’s critical access hospitals received DSH payments for treating Medicaid and uninsured patients at our hospital-based rural health clinics. However, the West Virginia Bureau for Medical Services (BMS) and the West Virginia Department of Health and Human Resources decided, as a result of contractor audits, that not only should future DSH payments to the rural health clinics be disallowed but the hospitals should have to pay back several million dollars of such payments going back to 2011. Years prior to 2011 have already been forgiven, wiped clean by the BMS. We operate on such a thin margin that paying back millions of dollars years after we counted on that money would be very detrimental. We have already provided the care to patients for which we received those DSH payments.

The uncompensated care issues surround the simple fact that individuals do have insurance, but their co-pays and deductibles are not being paid and in many cases are so high they can’t afford to pay. The end result is that we do not receive payment for services, thus increasing uncompensated care. However, the state uncompensated care grant funding has decreased simply due to the fact they believe everyone is covered by insurance—it’s not that simple.

Both of these issues could be addressed by the Legislature listening to those boots on the ground and seeing that the hospitals are struggling. We are still providing the care, but overall reimbursement is not there. I understand the state not having money and dealing with budget issues, but there has to be a better way of dealing with this. The DSH monies are federal funds, which means the state has no skin in the game, and this could be fixed with a simple state health plan amendment. However, they do not see it that way.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

I think programs that no longer exists, such as the Rural Health Education Partnership program that gave two hours for every one-hour rotation in rural areas for med students, was very beneficial. This exposed students to our facilities and was a great recruitment tool. We are all spending hundreds of thousands of dollars each year trying to recruit providers. Pooling this money for scholarships may be a better, more productive avenue. However, who gets the recruit would be difficult to decide.

 

How are you using technology to improve patients’ lives?

We have mixed feelings on technology. Technology is very useful, but it’s very expensive to maintain. Electronic health record software is so different for each facility that still most can’t talk to each other. We are getting ready to implement our third software in four years. We hope the third time is the charm. I believe this new software will assist patients via the patient portal in seeing and reviewing results, asking questions and making appointments.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

The increase in covered individuals was originally a good thing, and we got paid a little quicker. However, as the managed care expands, so do the co-pays and lower reimbursements. The presumptive eligibility process is very beneficial for many patients.

 

 

Albert Wright, Jr., President & CEO
WVU Medicine

How should the state and its hospitals work to address West Virginia’s physician shortage?

WVU Medicine is working hard to expand access to our physicians, specialists and subspecialists. We have recruited nearly 200 new physicians this year alone and expect to recruit even more next year as we continue to expand clinical programs in a variety of areas, including cancer, neurosurgery, pediatrics and heart and vascular. The challenge, though, is not limited to just the recruitment of physicians. Given the national shortage of nurses, we have developed partnerships with schools of nursing across the state to recruit new nurses. We are also working with West Virginia University to create a new program to train physician assistants who can provide certain types of care while supporting the treatment plan created by the physician and patient. We also continue to focus on growing our own by creating enthusiasm with young students to pursue careers in medicine or nursing and stay in West Virginia once they complete their training.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

This is perhaps the greatest health care crisis we face as a state and has had an undeniable and lasting impact on how we care for our patients. Today, we closely follow guidelines, such as those developed by the Centers for Disease Control and Prevention, for prescribing opioids for chronic pain. We also use prescription monitoring systems and tools, such as pain prescribing algorithms, that help guide the physician in selecting the best treatment option, which may include alternative therapies.

Education is also crucial, and at the West Virginia University School of Medicine, first- and second-year medical students are taught how to identify patients who are at risk for addiction and how to care for those individuals. WVU Medicine has also developed the Comprehensive Opioid Addiction Treatment (COAT) clinic that offers comprehensive treatment, including outpatient, group-based and individually tailored programs combining medication and therapy. WVU Medicine is expanding the COAT program across the state and into some of the state’s most rural and isolated parts where the problem is most severe.

 

How are you using technology to improve patients’ lives?

As an academic health system, WVU Medicine is at the forefront of using new technologies, surgical techniques and innovative clinical trials to transform lives. Examples of clinical trials include the Tendyne FDA Early Feasibility Trial and the Relay PRO Thoracic Stent-Grafts Trial. In the case of the Tendyne trial, WVU Medicine was one of just 25 institutions in the world and one of just seven in the United States to be selected to participate in this trial. Other sites include the Cleveland Clinic, Emory University and Baylor University.

WVU Medicine was selected for this trial as it specializes in repairing or replacing diseased or damaged heart valves and is the only provider in West Virginia that uses the minimally invasive procedure known as transcatheter mitral valve replacement (TMVR) for the treatment of severe cases of mitral regurgitation (MR). TMVR is the most recent advance in heart valve care available. WVU Medicine also performs robotic mitral valve repair and the Mitraclip procedure for patients with MR.

Our vascular surgeons are offering a new approach to treating patients with thoracic aortic aneurysms as well as penetrating atherosclerotic ulcers in the thoracic aorta through the relay trial, and our interventional neuroradiologists are using the latest in technology to treat ischemic stroke through a procedure known as intra-arterial thrombolysis. Finally, our orthopedic surgeons are on the forefront of delivering the most advanced care, so much so that they are now doing hip replacements on patients and sending them home that same day.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

The rural nature of our state can present some challenges, but none of them are insurmountable, especially given new technologies that can help extend our reach more easily into some of the state’s most isolated areas. Through virtual medicine, our specialists and subspecialists in Morgantown, Bridgeport or Martinsburg can consult with a patient or physician in any part of the state. We continue to expand that technology and capability so patients can more easily access the care they need.

We also believe the best care is the care delivered close to home, so we strive to provide care in the local community. Currently, WVU Medicine has outreach clinics in 32 West Virginia counties, and we expect this number to grow.

 

How has the ACA affected your hospital’s operations, and what changes would you like to see made?

The move to value-based care is positive and will fundamentally change how providers deliver care. My hope is that we continue that transition to a value-based model where providers assume some level of risk in managing the health and wellness of their patients. The current fee-for-service model simply isn’t sustainable—we have to operate more efficiently, deliver better outcomes for our patients and assume some level of risk to ensure we are actively partnering with our patients to keep them healthy.

 

What impact, if any, has Medicaid expansion had on your facility’s operations?

Due to Medicaid expansion, more of our patients now have health care coverage, which means we are able to reduce the amount of charity, or free, care we provide each year. This allows us to invest more resources into our infrastructure, expand our services and programs and recruit more physicians, which will provide our patients with greater access to a variety of services, from primary care to advanced specialty care.

 

 

Kevin Zachary, CEO
Logan Regional Medical Center

What are the major challenges facing West Virginia’s health care industry?

One challenge we face is our ability to continuously provide the same level of care our communities deserve and have grown to expect. Factors such as reduced reimbursement at the federal and state levels, difficulties around the recruitment of physicians and declining inpatient volumes all have challenged our hospital to find innovative ways to deliver high-quality care and ensure we are operating in the most effective and efficient manner possible.

To overcome these challenges, we regularly evaluate the needs of our community to ensure we are meeting the dynamic needs of those we serve and offering our community members access to high-quality, affordable care across the continuum. We leverage the resources and operational expertise of our national health care system, and we are diligent in our efforts to create places where people choose to come for health care, physicians want to practice and employees want to work.

 

How has the approach to patient care changed over the last 10 years?

As patient care has moved in recent years to a greater focus on value and outcomes, Logan Regional Medical Center has implemented a number of intentional and detailed quality improvement initiatives. For instance, we have launched a training program called Professional Practice at the Bedside. All of our nurses have participated in this program, which focuses on four basic building blocks: bedside shift reporting, communicating with white boards, managing patient safety utilizing pledge boards and executive rounding. Each of these tactics is designed to improve communication between clinical teams and the patient and family, as well as ensure every member of the care team, including the patient, has a voice in the care process.

We have also engaged the support of a community coalition, a group of local businesses and thought leaders who are helping us transform the delivery of high-quality care across the continuum. This group has helped us identify ways to improve post-acute care and prevent readmissions to the hospital.

This is only the beginning. Our commitment to quality is a journey we will continue to refine in the years to come. We will never stop looking for ways to further improve patient care and ensure every person who enters our facility receives high-quality, safe and compassionate care.

 

How should the state and its hospitals work to address West Virginia’s physician shortage?

A constant challenge for hospitals and physicians across the country is directing patients to the right physician at the right time. This can be particularly challenging for rural providers. We are always actively working to recruit top-notch physicians who can meet the ever-changing needs of our communities. We do this by continuously working to build strong and collaborative relationships with our physicians by ensuring our physicians have access to the latest tools and technologies that will facilitate clinical collaboration and provide greater access to patient data and creating inviting and engaging environments for all of our physicians.

 

What impact has West Virginia’s drug epidemic had on how health care is delivered in the state?

The drug epidemic our region is facing is something we must address as a community—and quickly. We are eager to work with the new governor and the Legislature to find innovative and effective ways to help individuals get the resources and support they need to overcome addiction and live healthy, productive lives.

 

Tell us about the obstacles of running a health care facility in the Mountain State.

The economic depression our region has faced has taken a tremendous toll on the overall health and wellbeing of our communities—economically, physically, socially and emotionally. Many patients who previously went out of the region for advanced care are no longer able to afford traveling to other facilities, both in terms of time and resources. We are continuously looking for innovative ways to bring these needed health care services close to home.

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