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Regional healthcare commission closes two-day meeting Wednesday


WATERTOWN - Closing out two days of work in Watertown, the North Country Health Systems Redesign Commission outlined the high financial stakes of coming changes to the region’s healthcare system for medical providers.

“You’re going to adapt to these imperatives, because that’s where we’re putting money, that’s where we’re putting policy, that’s where we’re putting in rate reform,” said Commission Chairman Daniel Sisto.

He added providers that reject change face increased scrutiny of their care and operations, and possible state takeover if they run into trouble. In talking about healthcare, commission members compared the current business model to companies like Kodak and IBM, arguing they transformed in order to stay alive.

“All industries go through these economic transformations, and healthcare in America is probably the last industry to undergo this tumultuous kind of transformation,” Mr. Sisto said.

The commission, again meeting at the Best Western Carriage House Inn on Washington Street, is charged with improving health care in the nine-county region stretching from Jefferson to Washington counties.

The commission’s meeting included another breakdown of the medical challenges facing the region.

Among the points brought up by Colleen McLaughlin, public health manager for the Office of Primary Care and Health Systems Management, was a higher percentage of avoidable emergency room visits compared to the rest of the state and a lack of dentists and providers that accept Medicaid.

The commission also started a general localization of the pillars to the State Health Improvement Plan, which includes improving access, integrating care, making costs transparent, paying for quality, not volume, of care and promoting population health.

Earlier in the day, the commission was updated about Medicaid reimbursements in the area, including the state’s wait to learn about a $10 billion Medicaid waiver from the U.S. Department of Health and Human Services.

No matter what recommendations the commission makes, they could find a long list of people to win over.

In a brief public comment period to start the afternoon session, Dr. Michael P.M. Pond, medical director of Mountain Medical Urgent Care Services, said many of the changes were not relevant to him in the Lake Placid area, and as an urgent care provider.

“If you want to fix the system, you got to get us all,” he said.

Dr. Pond said the push for telemedicine was ineffective as he could not get access to high speed internet without large costs. Years of effort to recruit new people were ineffective, he said, due to concerns of applicants about the area itself, not pay levels.

After the meeting, Mr. Sisto said he was optimistic about what the commission could do.

“We’re feeling our way through, but we’re accelerating,” he said. “We need to flesh it out.”

One fear the chairman said he had was that the Affordable Care Act and Medicaid redesign had fatigued providers and patients as the commission crafts its own recommendations. Despite the potential skepticism, Mr. Sisto assured that the committee’s work would have an positive impact.

“This time it’s not a fad, it’s a tidal wave,” he said.

The commission will next meet on Feb. 18 and 19 at Clarkson University. The commission must submit its recommendations to the state health commissioner by March 31.

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