News Home

Concerned over national policies that raise local healthcare costs with few benefits, 75 area healthcare workers bent the ear Tuesday of Fifth District Rep. Virginia Foxx (R-Banner Elk).

The workers, all department heads at Hugh Chatham Memorial Hospital, met with Foxx for more than an hour during her “listening tour” through the district’s 12 counties.

She was elected to her first term in November, defeating Elkin dentist Jim Harrell Jr. The stop in Elkin was her eighth of the President’s Day Holiday district work week.

It was her second listening tour. The last coming just a week after the election when she visited Mount Airy and Yadkinville.

One of the consistent concerns expressed on that tour through the district was healthcare cost and accessibility. For that reason, Foxx said she decided to focus attention this tour on those concerns.

“I want to hear what you have to say,” Foxx, a former N.C. state senator, said. “I have been told that federal government policies have driven up the cost of running hospital and doctor’s offices by 25 to 45 percent in some cases. What I want to know is wasteful things that cost more and don’t add to patient care.”

Keith Titus, director of Hugh Chatham Nursing Center, said most of the requirements of the 1997 Balanced Budget Act have led to improvements in care at nursing homes, but have led to more record keeping.

“Paperwork has gone up astronomically, and that is taking time away from patient care,” Titus said. “Every minute a nurse takes time to do paperwork is one less minute she can spend on patient care.”

Don Trippel, the hospital’s chief financial officer, said that the hospital pays $30,000 to $40,000 annually for an auditor to produce a “full cost report” See Foxx, page A-10 for Medicaid and Medicare. He believes the 100-page report could be simplified or the information provided in another, cheaper way.

The same report costs the nursing home $20,000 annually. It's reimbursement is capped, and it will receive only a certain funding regardless of how much it spends. The nursing home is still required to produce the report.

Marc Wombledorf is concerned about a squeeze a Medicare rule is placing on the rehabilitation program. The rule requires that 75 percent of patient diagnoses fit into 13 categories. A patient may be in the hospital for a hip replacement and receive benefits only for that portion of the ailment. Often times older patients have a collection of health problems that relate to the main one.

"The rule is pushing patients toward home healthcare and that is good in cutting costs," Wombledorf said. "It is hard to predict the needs of every patient."

Rising premiums for medical malpractice insurance are also a concern for doctors and institutions. The premium for the hospital tripled in the last four years.

"In 2001, the premium for the liability insurance at the hospital was $180,000 with a $50,000 deductible. In 2005 it was $575,000 with a $1million, self-insured retention fund, Trippel said.

The Medicare Prescription Drug Card is a disaster waiting to happen, Dr. Paul Gulley told Foxx. The card will be purchased from contractors who will provide them with discounts on certain medications. Many contractors will offer many different combinations of drugs but not necessarily all each patient needs, Gulley explained after the meeting with Foxx. "Then in the middle of the year, we may have to give a patient a new prescription which is not supported by their card," he said.

Determining the best card to buy may be complex for seniors, he said. Health Care institutions will face the complexities of using each patient's drug card to pay for medication and having hundreds of contractors to work with. It will be complex and will likely not provide the kind of discount patients want, Gulley said.