Foster touts one way to reduce medical costs
Congressman Bill Foster spent Thursday morning exploring one possible model for a solution to reducing health care costs that exists in his own backyard. Foster met with doctors and nurses at the St. Charles-based Valley Ambulatory Surgery Center for an explanation of how they can be a less expensive, yet quality, alternative to hospitals in some instances.
The facility is a physician-owned operation that creates a hospital-lite approach to some basic surgical procedures. Patients needing an outpatient operation, such as having their tonsils removed, can undergo the procedure at the center without ever setting foot in a hospital. Doctors told Foster they can often provide cheaper, better care at their smaller facility than a much larger hospital.
"If you put the physician back in charge of health care, there will be more efficiencies," said Dr. Anthony Giamberdino, the facility's medical director.
Those efficiencies include smaller nurse-to-patient ratios, lower rates of infection and fewer incidents of patients dying in care. Giamberdino told Foster this is accomplished by spending less money on the facility and expensive equipment and more dollars on staff. In other words, why use a laser to remove someone's tonsils when the old fashioned way also works and is more cost-effective? Doctors at the center also have less difficulty moving from patient to patient and one surgery to the next as the smaller staff allows for easier coordination with nurses, Giamberdino told Foster.
But there's a reason there aren't more places like the Valley Ambulatory Surgery Center.
"We can't get paid," said Deborah Lee Crook, a nurse at the facility. Crook told Foster it is increasingly difficult to get reimbursement from insurance companies because, even through the center is licensed, there is often no insurance classification for it. As a result, sometimes the center gets paid, sometimes it doesn't. The center has even brought in top insurance company executives to tour the facility in hopes of correcting the problem, but found no resolution.
"They tell us, 'This is a fascinating concept, and it's really unique, but it's too small, and we don't really care,' " Giamberdino told Foster.
The more payments left unpaid, the less viable smaller surgery centers become.
Foster told the doctors and nurses he'd examine the federal studies of operations like the Valley Ambulatory Surgery Center to determine if they are part of the solution to the health care dilemma. Foster said the key is weeding out the physician-owned centers with doctors tainted by greed who create unnecessary referrals of patients to other medical facilities they own. Foster said, from what he could see, the Valley Ambulatory Surgery Center is an example of a physician-owned center that does it right.
"They provide low-cost care," Foster said. "This is the wave of the future."
Foster also said a turning point in health care reform will be finding a way to stop people from using emergency rooms for every medical need they have. "Emergency rooms are almost always the most expensive form of medical care. The other side is finding a way to insure everyone so they don't have to turn to emergency rooms for help.
"The question is what do you do with people who present themselves with no insurance and have no money," Foster said. "When everyone has insurance, people will stop showing up as hospital emergency rooms."