Twenty years ago Drs. Ken and Darrell Carter looked for ways to ensure the continued successful delivery of health care to Granite Falls. They spent many hours examining their options, and concluded that partnering with ACMC offered the best hope for success for viable health care delivery, maintaining the health of the clinic and hospital but most importantly, the health of the people in Granite Falls. Drs. Art Rillo and Mark Eakes joined them and have continued to serve their community.
FACT: Granite Falls Municipal Hospital does believe we have dedicated providers and appreciate all they have given to the community and organization. The decision to do a provider based clinic does not have to change our relationship with the current providers.
On August 4, Granite Falls Municipal Hospital administrators met with our ACMC Granite Falls physicians and told them they had hired a physician, planned to hire more and were opening a “provider based clinic.” The physicians were given three choices: “leave ACMC and join us, fold the ACMC clinic into our new one or keep your clinic the way it is and compete with us.” They were given 30 days to decide.
FACT: Granite Falls Municipal Hospital Administration met many times with ACMC to discuss provider based and other options. Those dates include:
• March 22, 2016 – Tom, Val, Patty, Allen met with Steve Gerberding, Cindy Firkins-Smith, and Tom Rozendaal to discuss the current leases and provider based. ACMC said no to provider based. However, they did say let’s discuss further in June as they were struggling to figure things out in Benson.
• June 13, 2016 – Granite Falls Municipal Hospital Administration, Granite Falls Municipal Hospital Board of Directors, ACMC Physicians, and Steve Gerberding met for a board education put on by Chris Champ from Eide Bailly and Tom Schroeder from Faegre Baker Daniels with a topic of provider based, among other topics. ACMC did not want to discuss.
• June 23, 2016 – Tom Kooiman and Cindy Firkins-Smith met to discuss provider based. ACMC said no to provider based for various reasons.
• August 4, 2016 – Granite Falls Municipal Hospital Administration and ACMC Physicians met in Granite Falls to talk about the hospital’s vision and let them know that they were giving ACMC 30 days to decide on the future relationship (buyout, provider based, or separate clinics).
• August 5, 2016 – Granite Falls Municipal Hospital Administration, Board Chair LaVonne Koenen, ACMC Physicians, Steve Gerberding, and Cindy Firkins-Smith met to provide the latter two with the same presentation that was presented to the physicians with a 30 day timeline. After much discussion, ACMC stated a reverse PSA might be an option, or else wanted to look at some sort of Joint Venture. They would digest and come up with concrete options that we may not have thought about. Again, they reiterated that provider based was not an option.
• August 16, 2016 – Granite Falls Municipal Hospital Administration and Steve Gerberding, Cindy Firkins-Smith, Tom Rozendaal, and John Wittenberg met in Willmar to see what options ACMC was able to provide. Nothing was provided. It was in fact at this point that Granite Falls Municipal Hospital Administration had a finger pointed at them saying, and I do quote, “We will compete and we will win!” Again, provider based was not an option.
We recognize that when hospital leadership changes there are pressures to make things happen quickly but thirty days isn’t much time for physicians who have given their lives to serving their community to decide the best direction, particularly when that decision affects so many people’s lives. Patients depend on their physicians to decide wisely. The Granite Falls Hospital is not in financial crisis; we believe a more thoughtful approach would serve both well. ACMC physicians asked the Granite Falls Hospital administration to extend the deadline for discussion to 90 days and during that period we would work together to seek common ground and identify joint ventures that would benefit all. Twenty days into the 30-day timeline, the Granite Falls Hospital administration released a press release signifying an intention to proceed with its provider based clinic and indicated, inaccurately, that ACMC did not support the hospital.
FACT: Granite Falls Municipal Hospital & Manor is not interested in extending the timeline. In fact, if you go back to the March 22, 2016 date, and all subsequent date, we feel ample time for dialogue was given to discuss options for collaboration and solutions.
If someone had asked us, they would learn that this is simply not true. We support the Granite Falls Hospital and all our local hospitals. We are not only physicians; we are patients as well. We want the Granite Falls Hospital to provide the absolute best care to its community. We know that Granite Falls needs a new hospital facility and we want to work with them to make sure it’s designed for health care needs of the future.
FACT: Granite Falls Municipal Hospital does not question the providers’ dedication to our community.
We recognize the need to recruit new physicians to the community, and to grow services locally so patients don’t need to travel far for the care they need, and we know the importance of retaining good health care jobs in the community. We also understand the challenges that both hospitals and clinics are facing in today’s health care system with decreasing and changing reimbursement and less inpatient services. We think we will be better off working together with our community hospitals to create joint solutions where we can share services, improve access, provide benefits to our community and deliver the best health care to our patients at affordable costs.
FACT: Granite Falls Municipal Hospital and ACMC tried to jointly recruit. We presented them with a potential candidate and let them take the lead, but with the understanding that we would be an integral part of that process. Granite Falls Municipal Hospital was cut out of the process, and they lost the candidate as a result.
FACT: We believe patients shouldn’t need to travel at all, let alone not needing to “travel far.” The hospital believes 90% of healthcare should stay local.
However, we differ with the new Granite Fall’s hospital administration about the reliance on a Provider Based Clinic model to achieve these goals, because the first thing a provider based clinic does is increase cost to patients. Part of our commitment is to decrease costs, not to increase costs to patients.
What does a provider-based clinic mean to me?
According to Granite Falls Hospital CEO, Tom Kooiman, one of their goals in establishing a provider based clinic is to pass savings along to their patients. However, in June 2016, the Department of Health and Human Services Office of the Inspector General (“OIG”) issued a report criticizing provider based clinics and their billing practices and reaffirmed its recommendation that provider-based clinics be eliminated.
FACT: Granite Falls Municipal Hospital understands provider base may not be here forever, but that does not mean we cannot and will not have a clinic to operate. It is also a fact that Granite Falls Municipal Hospital understands critical access hospital and provider based billing and its effects on its community.
FACT: Granite Falls Municipal Hospital & Manor is one of the few critical access hospitals in MN that does not have a provider based clinic. Ironically, those hospitals that do not have a provider based clinic that we are aware of are affiliated with ACMC.
The OIG’s study found that the typical Medicare patient’s out-of-pocket cost for an office visit in a provider based clinic versus a free-standing clinic doubles from $14.90 to $28.61. The same thing typically occurs when patients have private insurance. Most patients do not want to see their cost for care double for the exact same services they were receiving locally prior to the hospital instituting a provider based clinic.
FACT: The cost of care is not doubled as described in this situation. Granite Falls Municipal Hospital has not established a pricing structure.
ACMC agrees. We don’t think anyone wants to pay more for health care, we think they want to pay less. We are working hard on demonstrated higher quality and lower costs for patients and we strive constantly for excellence. This is the future of health care.
FACT: Granite Falls Municipal Hospital agrees. We don’t want anyone to pay more for healthcare. We believe healthcare services should be provided as safely and as locally as possible.
First and foremost, about our patients.
ACMC is committed to the community of Granite Falls, the hospital our Granite Falls physicians and our patients. We are committed to hiring providers who are of the highest quality and who are also dedicated to the long-term care of this community. We are not interested in competing with the Granite Falls Hospital. We think that is bad for patients. No one will win. We believe a longer period for a robust and open discussion will us to create better ideas together. We want to collaborate with our hospitals on viable solutions that do not increase costs to our patients and results in high quality care locally.
FACT: As stated in another FACT, they told us “we will compete and we will win.” What changed their position to no one wins?