Despite numerous challenges, there are opportunities to improve rural health care, Lindsborg Community Hospital Administrator Larry Van Der Wege said Tuesday.
At a Lunch and Learn program at Salina Public Library, sponsored by the League of Women Voters, Van Der Wege said rural health care providers are challenged by a lack of providers, limited increases in reimbursements from insurance and government programs, loss of population and aging facilities, but there are solutions to those challenges.
Across the nation, he said, about half of physicians are becoming burned out.
Nurses, staff needed
“This can be due to changes in health care and always being on call, especially in rural areas where those physicians are needed more, as opposed to larger areas,” he said. “Today, physicians have to conduct and manage more tests and more medications. Just 10 to 15 years ago those tests and medications didn’t exist.”
Additionally, most rural health centers are in need of nurses, therapists, nurse assistants and other staffers, “which sometimes leads us to use other agencies for staffing,” Van Der Wege said.
“Those outside agencies can come at premium cost.”
He said there are fewer patients in hospitals because the population is getting older and younger people are moving away.
“This causes us to lose revenue,” Van Der Wege said.
Also, facilities are getting older, so they’re dealing with wear and tear. The Lindsborg facility was built in 1991, which is considered relatively new, but it still has needed new carpet and paint.
“As rural health care providers, we still want to be able to provide the same care you would receive at a metro hospital. Not having the proper equipment can make that a more difficult task,” he said.
“There are always competitors. For instance, MedExpress is now in Salina,” Van Der Wege said.
There also are “Dial-a-Doc” apps that allow patients to speak to physicians across the country.
Van Der Wege said advanced practice providers are one solution to lack of staffing in rural areas.
“These individuals, such as physician assistants and nurse practitioners, are supervised by a physician and have the ability and knowledge to provide a great deal of health care to rural areas,” he said.
Van Der Wege said different retention methods also are helpful.
“These additional methods may add cost, but it will enable us to retain physicians and improve the quality of care we provide,” he said.
Offering scholarships “to get students involved in the health care field,” is a possibility, Van Der Wege said.
Partnerships between larger and smaller health care institutions and associations is another solution.
“Whether that’s contracting for services, management or ownership, this will help provide capital support, better technology and assist larger, regional facilities with referrals,” he said. “This provides better care coordination between the two and less duplication of tests. It will also provide both with more purchasing power for supplies and pharmaceuticals.”
Van Der Wege called Salina Regional Health Center’s management of Lindsborg Community Hospital, which began four years ago, “very good, very responsive and cost-efficient.”
He is a member of the Kansas Hospital Association’s rural health visioning technical advisory group, which discusses better ways of providing health care in rural areas.
He is also a member of the patient and family advisory council, which seeks outside advice and suggestions from Lindsborg residents.
“We’re seeing more telehealth. There are so many services where a physician doesn’t need to lay hands on you and that can be done over a Web cam,” he said. “We think we know what patients want, but we don’t. We have to give them an avenue to come to us and let us know what they’re seeking.”
Kansas is one of 19 states that hasn’t expanded Medicaid under the Affordable Care Act. As a member of the rural health vision group, Van Der Wege hopes legislators approve Medicaid expansion during the current legislative session.
“The bill is currently in the House Health and Human Services committee, but we’re waiting to see if it reaches the floor,” he said. “It is establishing the KanCare ‘Bridge to a Healthy Kansas’ program. The issue here is the fact that the state and federal government may be moving in different directions. The federal government may be repealing the Affordable Care Act and we’re trying to expand it on what’s currently in place. We’ll see what happens.”
Lindsborg hospital administrator speaks on rural health care | Local News