PERSONALIZED CARE
P
ersonalized care is somewhat of a health care buzzword lately, says Carey Guhlke-Falk, a spokeswoman for Lincoln Hospital. But in rural communities like Davenport, the nurses, doctors, and health care professionals on staff often know their patients very well. “This really is personalized care,” Guhlke-Falk says. “These are our neighbors.” Steve Beckstrom, a nurse anesthetist at Lincoln Hospital, says he knows about 90 percent of the people he sees come through the hospital. “You know they’re going to go feed cows, or birth a calf in a Steve Beckstrom says, “It’s a face. week,” Beckstrom says. “It’s a face. It’s a person.” It’s a person.” YOUNG KWAK PHOTO — SAMANTHA WOHLFEIL hospitals a set monthly amount for every Medicaid patient in that hospital’s district. If and when someone comes in to use the facility, a much smaller rate than what insurers pay currently would be charged. A similar model may be applied to primary care clinics, where patients would enroll and pay a regular fee, then not pay when they come in, unless they get some
specialized services. Focusing on changing payments across the board becomes important, Miller says, because if making primary care better — and hopefully keeping people healthier — hurts the number of emergency room or hospital visits, it can create a shortfall there. “What we kind of discovered through all this was this incredible interconnection
between all the services, and it’s a domino effect,” Miller says. “You can’t just fix one thing. Everything has a cascading effect on other things.” While making regular payments whether you use the hospital or not may seem illogical at first, Miller says, it’s easy to make a comparison to other services. “The benefit is having [the hospital] there, but we pay on a per-visit basis,” he says of the way things work now. “It’d be equivalent to paying your fire department based on the number of fires they have.” Hospitals are a service that people want around when needed, so paying for them regularly, even if you aren’t using them at that moment, makes sense for the community, and will help the hospitals more reliably plan their budgets, he says. Eventually, the fixes could be scaled to larger hospitals. “These hospitals need this help maybe more severely than others do, but the kinds of things we’re talking about putting in place here are not some special fixes, only for desperate rural hospitals,” Miller says. “They actually would apply a lot to other hospitals.” n
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DECEMBER 2017 - JANUARY 2018
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