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CMSRulemakingCMS-2018-0078

CY 2019 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates CMS-1695-P

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Jan 28, 2019
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closed 2764d ago
League of Women Voters filings
3

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League of Women Voters filed 3 comments on this docket between Oct 2, 2018 and Oct 2, 2018. 216 other organizations filed here. The comment window closed 2764d ago.

What League of Women Voters filed (3)

Oct 2, 2018· League of Women Voters of Clallam County, Barnes, Paula--WA· CMS-2018-0078-1096

The League of Women Voters of Clallam County, Washington submits these comments on behalf of our community and Olympic Medical Center (OMC) located in Port Angeles, Washington. OMC is the sole hospital on the north Olympic Peninsula and is operated by a public hospital district whose governing board is elected by residents of Clallam County Public Hospital District #2. We look to OMC to solve the problems of health care access in our remote and economically disadvantaged area of the Olympic Peninsula of Washington State. While OMCs inpatient facility is located in Port Angeles, it has made substantial investment in out-patient services in the City of Sequim, within its hospital district but 17 miles to the east of its hospital campus. Sequim is a retirement community with a population nearing 45% of its residents over the age of 65. Our members rely on Olympic Medical Center, for the full range of healthcare services, and our organizations mission includes the protection of access to healthcare for everyone in Clallam County. Because OMC is too large to be a Critical Access Hospital (CAH) this proposed rule change will hit both it and our community very hard. The 60% reduction in Medicare reimbursement for services delivered by OMC through its broad range of outpatient clinics will mean more than $3 million lost in 2019 and a projected loss of over $47 million through 2029. With 83% of OMCs patients currently on Medicare, Medicaid or TriCare, it is highly unlikely that OMC will be able to continue to operate its outpatient oncology, radiology and primary care and walk-in clinics in Port Angeles and Sequim under such draconian funding reductions. And, it is critical to know that OMC is the only provider of many of these outpatient services in our county. Please note also that that Olympic Medical Center has the highest percentage of Medicare patients among all non-CAHs in Washington. These proposed cuts mean fewer people will receive care, more people will end up in the emergency department and quite likely, more people will die. While the goal of site neutrality in general is a worthy one, site neutrality cannot be applied wholesale, in all communities, particularly rural ones like ours. Clallam County has a severe shortage of physicians and medical professionals, in primary care as well as specialists. It is challenging to recruit medical professionals to our county because it is rural and remote. Sequim, the second largest community in our county, is the largest city in the state of Washington that does not have its own hospital. Therefore the outpatient clinics that OMC offers in Sequim, 17 miles from the OMC main campus, are critically important. If they close, there will be no private providers to close the gap. The League of Women Voters at the national as well as the local level -understands that communities need robust local economies to thrive. A community without adequate medical care cannot attract and keep businesses that pay family-wage jobs. It is difficult to recruit teachers, law enforcement and others. Young people raised in our area cannot stay and raise their families because of the weak economy, doctors are reluctant to move here because of the weak economy, and the downward spiral will only continue. When Congress approved the site neutrality policy in 2015, Olympic Medical Center was grandfathered in for good reasons. These draconian cuts ignore the needs and challenges of our rural community, which remain daunting. Therefore the League of Women Voters of Clallam County urges CMS to deny this rule change and to save healthcare - and lives - in our community. Thank you for your consideration of our concerns. If you need more information in order to craft a relevant exemption for hospitals such as OMC, please do not hesitate to contact me. Sincerely, Paula Barnes, Vice President League of Women Voters of Clallam County

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Oct 2, 2018· League of Women Voters, Friess, Virginia--WA· CMS-2018-0078-1171

WE ARE NOT IN FAVOR OF THIS CHANGE VIRGINIA AND ALBERT FRIESS

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Oct 2, 2018· League of Women Voters/, Anonymous Anonymous--WA· CMS-2018-0078-1175

Proposal to switch Olympic Medical Center, Port Angeles, to site-neutral status/basis. Several new clinic buildings have recently been built in Sequim, Forks and Port Angeles, with the expectation of reimbursement, etc. These locations are very necessary when there is such a huge Medicare/Medicaid population scattered around Clallam County. Having access to these local clinics reduces time to reach medical help. In Sequim alone over 60% of the population are over 65. This is a very high percentage of people who may not have access to speedy transportation which is necessary in many urgent situations. Emergency room at OMC Hospital in Port Angeles is already overflowing and will be even more impacted if Walk-In clinics are closed. If OMC is switch to site-neutral there will be many distressing impacts to local residents. What will happen when the new clinic buildings are closed? No doubt most of them still have loans outstanding. The service currently provided is already supported by Free Clinics and Volunteer Hospice services. In consideration of these factors, I strongly ask you to reverse your decision. These local clinics provide a vital to the local population and a very necessary way for delivery of efficient medical care throughout Clallam County. Many local people have jobs in the health care industry and it would put many of them out of work, causing economic difficulties and the possibility of moving to another area thus reducing the staff available to serve Clallam County residents. It would seem that our affiliation with Swedish Hospital in Seattle does not count our local clinics as satellites of Swedish Hospital. Please leave things as they are now in Clallam County - we have an efficient and very much appreciated medical delivery service.

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CY 2019 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates CMS-1695-P (CMS) — League of Women Voters | OpenPolis