The Ottumwa Courier

Wapello County

January 25, 2013

Rural health care discussed

Lieutenant governor tours ORHC

OTTUMWA — To survive, small towns and rural communities need their hospitals. During her visit to Ottumwa Regional Health Center on Thursday, Lt. Gov. Kim Reynolds said she and the governor understand.

Rural hospitals are “extremely important” she said. “We want to make sure there is access to health care in rural communities.”

During a recent Courier interview with hospital CEO Phil Dionne, he agreed that without certain establishments in place — schools or hospitals, for example — it’s very hard for a community to grow. Thursday, he said he felt like Reynolds understood that.

Reynolds said health care is important to keep “rural communities vibrant.”

That’s why there’s extra emphasis on rural communities in the governor’s physician “residency reimbursement program.” Getting doctors to an area, Reynolds said, is a big part of supporting health care.

About a week ago, during Gov. Terry Branstad’s Condition of the State address, he mentioned some problems and a plan to resolve them, Reynolds said.

Over the past 10 years, Iowa has fallen behind other states in the rate of doctors per 100,000 residents. Iowa is last in the country in numbers of both emergency medicine and obstetrics/gynecology doctors. Other specialties don’t look much better: Iowa is 46th in the nation in internal medicine, 47th in the nation in pediatrics and 48th in psychiatry.

Reynolds said she was impressed with the recruitment successes of ORHC. In an area that was so short on doctors that many were refusing to accept new patients, ORHC brought in 11 new physicians in about a year.

The state hopes to help increase the number of physicians, too.

The governor’s budget calls for $2 million to support medical residency programs in Iowa and an additional $2 million to launch the Rural Physician Loan Repayment Program.

In that plan, young doctors will receive assistance with their tuition from medical school if they practice in high-need areas. On Thursday, Reynolds said the program was initially just for primary care physicians, but it has now been expanded to include OB/GYN and emergency medicine doctors.

The other productive part of the meeting came from discussing a federal issue. While Medicaid may be a state program, Dionne explained, the state needs to know what the feds will be offering,  since that’s where the funding from Medicaid comes from.

The board of the hospital and administrators escorted Reynolds through the hospital, showing her the new emergency department and the rescue units. She said she enjoyed seeing the hospital, but the visit was also productive for Ottumwa Regional, Dionne said.

Last week, he told the Courier about the IowaCares program, which requires the poorest and most vulnerable patients to drive from Ottumwa to Des Moines.

Dionne said that program will soon sunset, and he believes Reynolds will bring his concerns about it to the governor. Reynolds said there are only two hospitals in the state where those patients can go, which is not ideal.

In fact, under the current program, if an IowaCares patient goes to ORHC instead of the designated hospital, ORHC will not be reimbursed at all by the program.

That defies common sense, Reynolds said. It’s reasonable to want to be paid for services rendered, she said.

She added that during Branstad’s speech, he made a bold claim that they fully intend to pursue: One of the administration’s priorities, she said, is to ensure that Iowa is the healthiest state in the nation.

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