By Beth Bily
The chief executive of Fairview Range, which includes the Hibbing hospital and a number of clinics throughout the region, is taking on a broader role.
Fairview has divided its healthcare facilities according to region, and Deb Boardman was named its north region executive beginning April 7. In her new role, Boardman also will oversee overall operations at Fairview’s Wyoming and Princeton hospitals, which also are part of the north region.
The move by the healthcare organization, said Boardman, is being driven by healthcare reform – much of it stemming from the passage of the federal Affordable Care Act (ACA).
That means healthcare executives will be exploring different models and ways of thinking about healthcare delivery.
Significant changes at the forefront for healthcare today include the shift away from in-patient to out-patient care and a move to a reimbursement model in which providers are increasingly compensated based on performance rather than patient visits.
That’s moving healthcare delivery systems like Fairview in a direction where care is standardized. There’s also been a shift to a birth-to-death continuum of service model where the focus is on “keeping people healthy” rather than treating those who are sick.
The ACA is driving change in terms of its reimbursement model, and it’s also creating further challenge. The uptick in patient visits expected by industry experts as more individuals became insured hasn’t happened – at least not yet.
“The theory was that we would make up in volume what we were losing in reimbursements,” said Boardman. “I think everyone lauds what the Affordable Care Act was trying to do. The details, however, haven’t materialized the way that people had hoped.”
She theorized that out-patient volumes did not increase because high deductibles common with mandated insurance policies weigh heavily on patient pocketbooks.
Other long-standing challenges for rural healthcare will be factors in decision-making for Boardman in her expanded role.
Geography, or the distance between healthcare services, continues to be a factor for northern Minnesota health delivery. Physician recruitment and a shift to more “middle-level” providers such as nurse practitioners and physician assistants also are factors.
Locally, Fairview Range has focused on recruitment efforts that aim at getting students who grew up here to return and continue their careers locally. But, there are still difficulties.
“There are not enough physicians today to meet (future) demand,” she said, adding that many in the healthcare field today are more family-focused than career focused. “We’re seeing a shift to a more team-based approach to healthcare delivery.”
Boardman also asserts that technology will continue to play a leading role in healthcare in the future. The availability of self-diagnostics, such as home pregnancy tests and online resources, has been a game changer.
But, while technology may have eliminated the need for some trips to the doctor – it also creates opportunity for provider and patient.
Fairview Range is currently working to put in place tele-ICU to assist with diagnostics. The technology would electronically connect local healthcare providers to University of Minnesota specialists. The benefits are two-fold, said Boardman: 1) providing local healthcare professionals with an extra set of eyes and; 2) the patient stays closer to home.
The trend toward technology and faster delivery is only likely to increase with time.
“Technology is such a big deal in healthcare,” said Boardman. “People aren’t willing to wait three hours like they once were to see their doctor.”
In her expanded role, Boardman said she will focus on standardizing procedures and cost sharing resources – both aimed at driving down costs and improving patient outcomes.
“We’re thinking about healthcare in a whole new way,” she said.