Hospital CEOs address local impact of proposed clinic

? Newton Medical chief says clinic will provide additional services.

Steve KellySteveKelly522cmyk The chief executive officer of Newton Medical Center believes the new clinic it plans to open in Hillsboro will benefit the community in the short-term as well as the long run.

And it may be opening sooner than later.

?We?re going up there to accomplish several things,? Steve Kelly said last week during an interview in his Newton office. ?No. 1 is to provide additional medical services in that community, but also there?s strength in numbers by going up there and being a complement to whatever is there that is important.?

A lot for the proposed facility has been cleared in the 800 block of East D Street, but the clinic may open before the building is erected. Kelly said NMC may temporarily lease the vacant building at 121 N. Main formerly occupied by Good Health Chiro?practic & Diagnos?tic Center.

?We?re looking at that,? Kelly said. ?I don?t know that it will happen, but the best policy I?ve had is to be transparent because people are (speculating).?

Kelly said opening the clinic sooner may help NMC recruit a physician to serve it.

?We?ve come across a really good physician who actually has some ties in the community,? Kelly said. ?For us to keep him and lock him in here, we may need to do something quicker before we build a new clinic.

?But eventually the goal is to get that new clinic.?I think the community deserves really nice, new facilities, and there?s efficiencies to be gained in building some new things.?

Small-town concern

Having grown up in a Texas town only slightly larger than Hillsboro, Kelly said he understands why the announcement of NMC?s clinic has generated local concern, particularly the potential negative impact on Hillsboro Community Hospital and St. Luke Hospital in Marion.

?I know there?s a lot of people saying you?re coming in, you?re going to destroy this,? Kelly said. ?That?s not it at all. We expect (our physician) to be on the medical staff of the hospitals in both (Newton and Hillsboro), but he?ll be what is called courtesy staff.?

In other words, the NMC physician will not follow inpatients to HCH, but will refer patients to HCH for basic diagnostic tests.

?In our clinic, what we will have is just a basic x-ray, like if you smash your finger or you come in with a cough, we might see if you have pneumonia in the lungs,? Kelly said. ?And clinics are allowed to have, really, a minor kind of lab?we can do 11 tests.

?Those things that exceed those minor tests, or that minor radiology, will be referred to the hospital there because they have a CT and a more complex lab. We expect people to use that.

?I?ll be shocked if (HCH) non-inpatient services don?t increase.?

Kelly said he has heard the concern that the NMC clinic is coming to Hillsboro to steer patients to the Newton hospital. He said people who use the NMC clinic can be admitted as inpatients at HCH if they choose to.

?What we are hoping is that we?re creating a network of primary care?that?s where the future?s going, a network of primary care clinics,? he said.

Kelly cited a market study that indicated six out of 10 people who live in Hillsboro but seek health care outside of Hills?boro don?t come to Newton Medical Center.

?Hillsboro would be losing that (group) anyway,? he said. ?What we hope to do is that people who are choosing to leave (Hillsboro), or maybe the services are just not there, will have a connection to Newton because of our clinic.?

Significant investment

Kelly did not indicate a specific timeline for the building project, but said by the time the lot on D Street is developed and the clinic is completed, NMC will have invested close to $1 million in the project.

?Our hope is that in two or three years, we?ll help balance our expenses through people choosing to come here,? he said.

Noting what he characterized as unprecedented volatility in health care these days, Kelly said huge profits are not NMC?s motivation for coming to Hillsboro.

?I know small communities don?t believe this, but if that was a gold mine there you?d have people beating down the door to put in clinics?but it?s not,? he said. ?That?s why Via Christi pulled out (after taking over the former Hillsboro Family Practice Clinic for a time).

?It?s very expensive to run a clinic,? Kelly added. ?Not counting physicians? salaries, it can cost anywhere from $15,000 to $20,000 a month. You have to see a lot of people (to cover that expense).

?If it was just a business venture, most business advisers would say, ?Don?t?what are you doing?? But in this case we?re in it for the long run, regardless of what happens in our area.?

Local advantages

Kelly said he believes the Hillsboro and Marion County will appreciate NMC?s presence over time.

?One thing I think the community will find interesting is that we have a very generous charity policy,? he said. ?For instance, if you come and you?re treated here at the hospital, and you?re at or below the 200 percent of poverty, we?ll write your bill off.?

He said as a not-for-profit entity, NMC reinvests its ?profits? in facilities, equipment and charitable care.

?We do a lot of things we don?t get paid for, but that?s part of what we are,? Kelly said. ?This fall we?ll be covering ball games at Tabor College to make sure they have a trained physician at the field. I don?t know that we?re getting paid a penny for that.?

Kelly also mentioned connections that already exist between Hillsboro and the medical center in Newton.

?We have people on our board who have come from Hillsboro?we?re integrated in that,? he said. ?We have maybe 30 people from Marion County that work here at the hospital and earn their living here.?

He said some jobs at the new clinic could be filled by local residents.

?We?ll run it pretty lean because of the cost of it, but we?ll probably have a physician, a nurse, maybe a nurse practitioner and probably an office manager?according to what the patient demand is. And they could be local.?

Kelly said when people feel threatened they naturally envision the worst outcome.

?But I think they?ll be surprised,? Kelly said. ?I think the community will be pleased because we?ll be able to partner because of the services we offer that can?t be offered there now.

?Our goal is to make the medical community stronger (locally),? he added. ?As they get to know us, I think that fear of the foreigner will go away.?

? Strong local hospital is key for city?s future, says HCH chief.

Marion RegierAs chief executive officer at Hills?boro Com?munity Hospital, Marion Regier knows the operation of a Newton Medical Center clinic in Hills?boro will mark a new chapter in medical care for the community and county.

How that story will develop over ensuing years is less clear in her mind.

?My understanding is that part of NMC?s strategic plan is to open clinics in outlying areas primarily to increase referrals to their specialists and increase inpatient admissions to their hospital,? Regier said.

?In this instance, they are choosing to come to a community where there are two hospitals along with clinics in the county already providing primary care to their respective communities.?

Despite the assurances of NMC leaders, including CEO Steve Kelly, that the new clinic could actually enhance Hillsboro Community?s outpatient revenue, Regier is not so sure.

?The loss of outpatient services, including lab and x-ray is a concern,? she said. ?The largest portion of our revenue comes from outpatient services. We look forward to providing any and all of those outpatient services ordered by the providers in this clinic.?

Regier said patients will be able to choose where they go for testing and treatment.

?We have many patients who doctor out of town, but choose to have their lab and radiology done here at HCH and we send the results to their physician,? she said. ?Each patient has the right to choose where those services will be performed.

?As a rural critical access hospital, we know we can?t provide for every level of everyone?s care and we greatly appreciate the patients who choose to support us by having their diagnostic tests done here.?

Speciality physicians

Regier said she believes the presence of the NMC clinic should not affect HCH?s relationship with specialty doctors who presently are associated with the Hillsboro hospital.

?We do have several specialty physicians who come from Newton and have been very supportive of HCH for many years,? she said. ?We value these as well as our other specialty physicians and know they provide a great service to our community.

?To my knowledge, that relationship will continue and we will still have those visiting specialists come to the hospital and provide the services they do, including surgical services.?

Medicare changes

Regier said she doesn?t believe the long delay in building a new hospital?as promised by HMC/CAH Consolidated, owners of HCH?was a significant factor in NMC deciding to establish a clinic in Hillsboro.

?Medicare reimbursement has changed and all hospitals are faced with reduced funding,? Regier said. ?This reduction is greater for the larger hospitals than it is for critical access hospitals.

?In this case, the way to offset that reduced reimbursement is by increasing their patient base, which could be to the detriment of the two hospitals in Marion County.?

Bigger picture

Regier, a longtime Hillsboro resident, said the importance of Hillsboro Community Hospital?s continued operation goes beyond the survival of the institution itself.

?There are two things experts say are key to a community?s economy and the ability to attract and grow businesses,? she said. ?They are the school system and the hospital.

?The responsibility I have to make sure the hospital is meeting the needs of our community is something I take very seriously.?

Regier cited several changes made at HCH over the past year and a half that have enhanced the hospital?s services, including the addition of Amber Monson as a doctor of physical therapy ?to ensure our P.T. department is providing the therapy needed for patients of all ages and diagnosis, including those with sports related injuries.?

Regier said HCH is ?fully engaged? in quality programs with a continual focus on providing excellent patient care, including the local clinic it has established.

?Hillsboro Clinic has grown and is busy providing primary care to our community, and is looking ahead at additions to our medical staff,? Regier said.

She said Alisa (Jost) Schmidt, a Hills?boro High School and Tabor College product, is expected to join the staff as a physician in two years.

?We are here for you, our entire community, because caring for our friends and neighbors is what matters most,? Regier said.

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