By Molly • Molly Walker • 

Hospital seeks to boster primary care contingent

Ordyna is coordinating with the Virginia Garcia Memorial Health Clinic, Physicians Medical Center and the West Hills Healthcare Clinic in his recruiting campaign. In his view, the ideal mix would be two internists, one pediatrician and one family practitioner, all working by the end of the year.

Recently departing were Robyn Dreibelbis and Mike Jaczko, to teach at the Western University of Health Sciences’ new College of Osteopathic Medicine in Lebanon; Marion Hull, to practice elsewhere; and Francis Kenyon, to retire. The local primary care count to 40, including nurse practitioners, who are not full-fledged physicians but are authorized to prescribe medication. 

“For various reasons, we have some key primary care providers leaving the area,” Ordyna said. “That puts more concentration and pressure on those who remain, which is important for us to sort out as the various stages of health care reform ... are put into place.”

He said, “Going into health care reform, that primary care base is essential for a successful delivery model.” That’s because the new system seeks to guarantee every citizen access to a primary care provider.

Ordyna said that would be the goal even if it weren’t mandated. Otherwise, the hospital emergency room becomes the physician’s office of last resort, running up exorbitant costs the hospital largely has to eat.

“The key to optimum health is a robust primary care home,” he said.

Another problem plaguing the health care system is inadequate Medicare and Medicaid reimbursement, which leads a growing number of physicians to limit or refuse patients under those programs. He said one element of the local recruitment package will be incentives designed to encourage practices open to all patients, regardless of age or income.

“Physicians generally want to take care of all patients,” he said. But given Medicare and Medicaid reimbursement rates, they can’t afford to have their practices tilt too far that direction.

Ordyna said the hospital is also taking steps to address a lack of incentives for keeping people well.

Under the present system, doctors are compensated only for treating the sick. And all too frequently, the healthy end up picking up a goodly portion of the tab.

He said a financial model is being developed that will reimburse doctors on a capitated per-patient basis. That way, they will be compensated not only for the care they provide when patients are sick, but also their success in keeping members of their patient load healthy enough so they don’t need costly care.

“We’ve got to make the system more cost-effective,” Odyna said. He said it needs to produce better outcomes at less expense, the ultimate goal being to ensure that “everyone receives amazing care every time.”

He said Yamhill County’s newly formed Coordinated Care Organization, mirroring CCOs being formed in counties around the state, is aimed at lining up primary care providers for Medicaid patients. That’s a worthy goal, he said, but health care reform requires all patient populations be addressed, not just those qualifying for subsidized care.

That situation is bringing everyone in the medical community together like never before, Ordyna said.

“There’s a lot less competition and a lot more collaboration taking place,” he said. And when everything has fallen into place, he said, “I think people are going to be very satisfied and pleased.”

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