By PHIL DRAKE
A group is putting together a plan in which Montana’s 48 rural hospitals will join together, using a $16 million grant to form an Accountable Care Organization (ACO) that supporters say will lower costs, improve quality of care, make customers happy and encourage people to come to their local hospitals in times of need.
The plan received the blessing of Gov. Brian Schweitzer on Feb. 8, when he met with two officials from Mineral Community Hospital in Superior who were on their way to meet later in the day with colleagues in Livingston.
The Frontier Medicine Better Health Partnership has applied for the three-year Innovative Challenge Grant with the Centers for Medicare and Medicaid Services to be used to develop better patient data for Montana’s rural hospitals. The consortium, according to organizers, could also purchase drugs as a group, drive down costs and pass savings on to patients. ACOs are defined as health care providers that providing medical care for a defined population.
“Smallness does work,” said George Bailey, director of business development for Mineral Community Hospital. He said the challenge was in showing people they are not losing any quality over choosing a rural hospital over a hospital in a big city.
He said there were 300 ACOs in the United States.
The plans include hiring a chief executive officer, chief financial officer, education director and human resource staff. It also calls for regular meetings among members, looking for high cost areas, prioritizing 10 areas that lower costs and improve care, and establishing connections with the Mayo Clinic.
Schweitzer said often the big city hospitals want the smaller facilities to get the patient stabilized and moved to them.
He said he has compared cost in Montana to Saskatchewan, Canada, which is also rural, has a population about the same age and government subsidized health care.
“They do for $4 million what Montana does for $8 million,” Schweitzer said.
But he added that 87 percent of their health care was delivered in smaller, local clinics.
Bailey said Montana could save money in medical costs if people received their care at rural facilities. Some estimates put the savings at $25 million from Medicaid and Medicare.
“We’re wasting money and it’s plumb silly,” he said.
“If someone has some savings and we’re improving patient outcomes, why aren’t we doing it that way?” he asked. “Here’s a perfect time to make it happen.”
Schweitzer noted that in Montana, about 10 percent of patient care is in hospitals considered rural. It’s almost the polar opposite in Saskatchewan.
In a Jan. 20 letter to the Centers for Medicare and Medicaid Services, Schweitzer said the project had his full support.
“The challenges faced by Critical Access Hospitals and Rural Health Centers in rural Montana are daunting and I believe FMBHP will help address several primary issues with rural/frontier medicine in the state,” he wrote.
Bailey, who said he supported Schweitzer’s proposal to start a health clinic for state employees, said, so far, 15 hospitals have signed letters of intent to be part of the challenge grant. A decision on the grant is expected April 1.