The health care challenges that we as Americans face are significant. An aging population, high prevalence of chronic diseases, stretched public and private budgets, and a lack of health insurance for nearly one in nine of our citizens are realities we need to recognize and address.
Here in Maine, these challenges are even tougher because our population is the oldest and most rural in the country. Older adults simply require more care to stay healthy. And while we as Mainers love our state’s natural beauty and independent way of life, it’s more costly to serve a population spread out across a very large geography.
Many of Gov. Paul LePage’s budget decisions have further added to the challenges of providing high-quality care in Maine. During the past four years, hospitals have dealt with the negative impact of Medicaid (also known as MaineCare) reimbursement cuts, increased hospital taxes and narrowing MaineCare eligibility, which leads to more uninsured and needed charity care. These are annual cuts of $55 million that were imposed when Maine’s Medicaid program had a significant deficit in 2013. Hospital payments have been reduced by more than $200 million since 2013 because of these initiatives. Additionally, the hospital tax was increased. The Eastern Maine Health Systems total hospital tax resulted in an annual net negative impact of $5 million.
As a result, since 2012, an average of 18 Maine hospitals have reported negative operating margins each year. This is not sustainable.
EMHS is doing what it can to keep local access to affordable, high-quality care by organizing doctors, hospitals and other providers into a coordinated system of care. By working together, we are able to more consistently follow clinical best practices, get better discounts on expensive medical equipment and supplies, avoid unnecessary and costly duplication of services, and invest in and benefit from a strong set of common support services. This leads to excellent care close-to-home, and to a seamless and coordinated transfer to other system facilities and resources when this is required.
We have also fully embraced what is known as “accountable care,” delivering better coordinated care to our patients. Providers work together to address quality, engagement and the overall cost of care while supporting Maine’s most vulnerable residents, many of whom are living with a chronic disease. This has helped reduce medication errors, unnecessary emergency department visits and has increased individual responsibility for adhering to tailored plans of care.
Along with improving the cost and quality of care to individuals, EMHS also looks out for the health of Maine’s communities. This is done through partnerships with community health and social service groups, and public health organizations across the state. A few examples of the community benefit in our 2016 fiscal year include:
EMHS provided $29.1 million in free or reduced price care to Mainers who qualify under our financial assistance policy.
EMHS hospitals partnered with our communities to improve health outside the walls of our facilities, investing $3.8 million in programs such as health education; community-based clinical services, such as blood pressure, cholesterol, bone density, glucose and other screenings; health care support services, such as Sebasticook’s courtesy van that provides free transportation from qualifying patient’s homes to the hospital or doctor’s appointments; and social and environmental improvement activities such as providing healthy food options by collaborating with community partners to address needs in our communities.
EMHS provided nearly $2.7 million in funding for clinical, community health and health care delivery research that can be shared with the public to improve health care.
EMHS invested $730,000 in community building activities that address the root causes of health problems such as homelessness and provided more than $435,000 in cash and in-kind contributions to community partnerships that advance the health of the communities we serve.
EMHS members were also instrumental in forging plans to combat the opioid abuse that is rampant in Maine. In the Portland, Bangor, Down East and Aroostook regions, EMHS hospitals and other members worked alongside police and sheriffs and other health care providers on this timely and concerning issue.
EMHS partnered with colleges and universities to provide training for jobs in health care for Maine’s younger generation, which also will help meet the state’s health care needs going forward, investing $2.6 million in such programs.
Health care is in a transformative time. Access to high-quality and affordable care is critical to the individuals and communities of our state. EMHS is an important community asset and partner. By coordinating health care as a system, EMHS is doing the right things toward not only preserving but improving high value health care.
Evelyn S. Silver has served on the Eastern Maine Healthcare System board of directors since 2006. She has served as chair of the board since June 2014. After 25 years with the University of Maine System, she retired in 2011 from the position of senior advisor to the president of the University of Maine in Orono.