News
Cochise County citizens consider health care priorities
Dana Cole/Wick Communications
Tough budget cuts and physician recruitment challenges loom as key concerns when it comes to Arizona's health care delivery.
Health care experts and local elected officials gathered this week for the Cochise County Rural Health Policy Assembly at the county board of supervisors' building in Bisbee to discuss issues that impact health care across the county. About 75 people attended the forum Monday where some of the area's more pressing health care challenges were addressed and recommendations for shaping future policies were discussed.
Brian Bickel, chief executive officer of Southeast Arizona Medical Center in Douglas, spoke about physician recruitment challenges that rural hospitals throughout the country face. "Rural America is a wonderful place to live and a wonderful place to raise kids and a wonderful way of life," Bickel said.
But unfortunately, not everyone feels that way, he added. "Not only are we recruiting physicians, but we're recruiting the physicians' spouses and children, and that's where the larger challenges come in. Because families enjoy the conveniences of urban life, we have to work a lot harder in our recruitment efforts to show them what rural communities offer."
Julia King, human resources director for Chiricahua Community Health Centers Inc., also addressed recruiting challenges. "We can't produce enough doctors to keep pace with health care needs, and then there aren't enough for rural communities," she said. "We're not only having a difficult time competing with metropolitan communities because of the cultural opportunities, but doctors and nurses make more money in larger metropolitan areas."
Young families also look at available housing and the quality of education, said King, who spoke about some of the recruiting challenges she has faced in the Douglas area.
"Employment opportunities for the spouses of physicians is another issue," she added.
King talked about CCHCI's Pediatric Center of Excellence and its pediatric mobile unit as some of the reasons for wanting to work in south Cochise County.
Copper Queen Community Hospital Chief Executive Officer Jim Dickson has experienced struggles with physician shortages, with access to specialty physicians as a particular problem. In order to compensate for those shortages, CQCH has implemented a successful telemedicine program that offers specialty care in dermatology, cardiology, neurology, radiology and home health monitoring.
But these services are in serious jeopardy because of reimbursement inequities from federal and state health care programs, as well as private insurance plans, Dickson warned. "A telemedicine consult needs to be paid at the same rate as any physician's bedside or office consultation, and that's not happening. With the exception of teledermatology, our doctors are not being reimbursed for their consults."
Most private insurance plans are following federal guidelines for their own reimbursement structures.
In addition, Medicare and Medicaid reimbursement policies were established more than a decade ago, during a time when telemedicine was fairly new and untested, Dickson said.
"We need legislative support to change these reimbursement policies, or this technology is going to be in serious jeopardy," he said. "Our telemedicine program actually saves a tremendous amount of money through fewer transports and fewer emergency room visits."
Telemedicine has played a vital role in bridging a health care delivery gap for rural Arizona, and continues to make great strides as other specialty areas are added, he said.
Donna Zazworsky, vice president of Carondelet Community Health and Continuum Care, attended the conference to learn more about rural health concerns. "We've been providing different telemedicine services in this area, using the University of Arizona's network," she said. "Having dedicated people in these different communities to manage the technology on their end has helped make this program a success."
Recognizing the advantages of telemedicine, several rural hospitals are now using the technology and have formed the Southeastern Arizona Telemedicine Alliance. The group includes CQCH, Northern Cochise Community Hospital in Willcox, Benson Community Hospital, Mount Graham Regional Medical Center in Safford, and Southeast Arizona Medical Center in Douglas.
"Bisbee's Copper Queen is at the heart of this alliance," Zazworsky said. "Carondelet facilitated bringing the cardiology and dermatology groups together, with 24/7 telecardiology service available. Prior to that, people who came to the hospital with any type of cardio problem, had to be transported to a hospital in Tucson or Phoenix," Zazworsky said.
Robert Sorce, assistant director of the Arizona Department of Health Services' Division of Behavioral Health out of Phoenix, talked about the status of behavioral health services in Cochise County in the wake of serious state cuts.
He talked about the importance of coordinating primary care and behavioral health to streamline care for patients with better coordination and less duplication. Reducing the stigma attached to behavioral health is another challenge for patients.
"We're expecting some profound ramifications to behavioral health because of recent, drastic budget cuts," said Sally Holcomb, director of communications and community affairs for Southeastern Arizona Behavioral Health Services, or SEABHS. "Cuts to behavioral health will have a profound impact on emergency rooms, not to mention emergency responders. We're expecting to see increases in incarcerated individuals who are no longer receiving the medications and counseling services they need because of these cuts."
Behavioral health was hit with one layer of cuts that started in January, with a second layer that went into effect on July 1, Holcomb said.
"Even more troubling, these cuts are disproportionate. For example, rural Arizona experienced a 60 percent cut in prevention services, versus urban cuts, which were between 26 and 35 percent," she said.
The rural health assembly, sponsored by the Rural Health Office and Arizona Rural Health Association, Cochise County Health Department, Copper Queen Community Hospital and Southeast Arizona Area Health Education Center, was facilitated by Joyce Hospodar, Rural Health Office flex program coordinator. The forum provided an informational venue for policy makers and health care professionals.
Alison Hughes, Rural Health Specialist for the Rural Health Office at the Mel and Enid Zuckerman College of Public Health at the UA, said this assembly marked her office's second effort. The first rural health meeting was held last December at Lake Havasu for Mohave and Yuma counties.
Tough budget cuts and physician recruitment challenges loom as key concerns when it comes to Arizona's health care delivery.
Health care experts and local elected officials gathered this week for the Cochise County Rural Health Policy Assembly at the county board of supervisors' building in Bisbee to discuss issues that impact health care across the county. About 75 people attended the forum Monday where some of the area's more pressing health care challenges were addressed and recommendations for shaping future policies were discussed.
Brian Bickel, chief executive officer of Southeast Arizona Medical Center in Douglas, spoke about physician recruitment challenges that rural hospitals throughout the country face. "Rural America is a wonderful place to live and a wonderful place to raise kids and a wonderful way of life," Bickel said.
But unfortunately, not everyone feels that way, he added. "Not only are we recruiting physicians, but we're recruiting the physicians' spouses and children, and that's where the larger challenges come in. Because families enjoy the conveniences of urban life, we have to work a lot harder in our recruitment efforts to show them what rural communities offer."
Julia King, human resources director for Chiricahua Community Health Centers Inc., also addressed recruiting challenges. "We can't produce enough doctors to keep pace with health care needs, and then there aren't enough for rural communities," she said. "We're not only having a difficult time competing with metropolitan communities because of the cultural opportunities, but doctors and nurses make more money in larger metropolitan areas."
Young families also look at available housing and the quality of education, said King, who spoke about some of the recruiting challenges she has faced in the Douglas area.
"Employment opportunities for the spouses of physicians is another issue," she added.
King talked about CCHCI's Pediatric Center of Excellence and its pediatric mobile unit as some of the reasons for wanting to work in south Cochise County.
Copper Queen Community Hospital Chief Executive Officer Jim Dickson has experienced struggles with physician shortages, with access to specialty physicians as a particular problem. In order to compensate for those shortages, CQCH has implemented a successful telemedicine program that offers specialty care in dermatology, cardiology, neurology, radiology and home health monitoring.
But these services are in serious jeopardy because of reimbursement inequities from federal and state health care programs, as well as private insurance plans, Dickson warned. "A telemedicine consult needs to be paid at the same rate as any physician's bedside or office consultation, and that's not happening. With the exception of teledermatology, our doctors are not being reimbursed for their consults."
Most private insurance plans are following federal guidelines for their own reimbursement structures.
In addition, Medicare and Medicaid reimbursement policies were established more than a decade ago, during a time when telemedicine was fairly new and untested, Dickson said.
"We need legislative support to change these reimbursement policies, or this technology is going to be in serious jeopardy," he said. "Our telemedicine program actually saves a tremendous amount of money through fewer transports and fewer emergency room visits."
Telemedicine has played a vital role in bridging a health care delivery gap for rural Arizona, and continues to make great strides as other specialty areas are added, he said.
Donna Zazworsky, vice president of Carondelet Community Health and Continuum Care, attended the conference to learn more about rural health concerns. "We've been providing different telemedicine services in this area, using the University of Arizona's network," she said. "Having dedicated people in these different communities to manage the technology on their end has helped make this program a success."
Recognizing the advantages of telemedicine, several rural hospitals are now using the technology and have formed the Southeastern Arizona Telemedicine Alliance. The group includes CQCH, Northern Cochise Community Hospital in Willcox, Benson Community Hospital, Mount Graham Regional Medical Center in Safford, and Southeast Arizona Medical Center in Douglas.
"Bisbee's Copper Queen is at the heart of this alliance," Zazworsky said. "Carondelet facilitated bringing the cardiology and dermatology groups together, with 24/7 telecardiology service available. Prior to that, people who came to the hospital with any type of cardio problem, had to be transported to a hospital in Tucson or Phoenix," Zazworsky said.
Robert Sorce, assistant director of the Arizona Department of Health Services' Division of Behavioral Health out of Phoenix, talked about the status of behavioral health services in Cochise County in the wake of serious state cuts.
He talked about the importance of coordinating primary care and behavioral health to streamline care for patients with better coordination and less duplication. Reducing the stigma attached to behavioral health is another challenge for patients.
"We're expecting some profound ramifications to behavioral health because of recent, drastic budget cuts," said Sally Holcomb, director of communications and community affairs for Southeastern Arizona Behavioral Health Services, or SEABHS. "Cuts to behavioral health will have a profound impact on emergency rooms, not to mention emergency responders. We're expecting to see increases in incarcerated individuals who are no longer receiving the medications and counseling services they need because of these cuts."
Behavioral health was hit with one layer of cuts that started in January, with a second layer that went into effect on July 1, Holcomb said.
"Even more troubling, these cuts are disproportionate. For example, rural Arizona experienced a 60 percent cut in prevention services, versus urban cuts, which were between 26 and 35 percent," she said.
The rural health assembly, sponsored by the Rural Health Office and Arizona Rural Health Association, Cochise County Health Department, Copper Queen Community Hospital and Southeast Arizona Area Health Education Center, was facilitated by Joyce Hospodar, Rural Health Office flex program coordinator. The forum provided an informational venue for policy makers and health care professionals.
Alison Hughes, Rural Health Specialist for the Rural Health Office at the Mel and Enid Zuckerman College of Public Health at the UA, said this assembly marked her office's second effort. The first rural health meeting was held last December at Lake Havasu for Mohave and Yuma counties.
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