Vidant Health execs hit State Treasurer’s plan, endorse Medicaid expansion
For people in Dare County, the dominant health care provider is Vidant Health, which, among other things, operates the Outer Banks Hospital in partnership with Chesapeake Regional Healthcare. As its competitor, Sentara, has been shrinking its footprint locally, Vidant has been moving to fill the gap, such as bringing in resources to try and accommodate some of the estimated 2,000 patients who had been clients at Sentara’s Family Medicine Physicians practice on Roanoke Island that closed last year.
Centered on eastern North Carolina, Vidant Health operates eight hospitals, employs more than 12,500 people and serves more than one million residents of 29 counties. To talk about the state of health care — locally, regionally and even nationally — the Sentinel recently sat down to talk with Vidant CEO Dr. Michael Waldrum and Outer Banks Hospital President Ronnie Sloan.
Sentinel: What’s the latest update on the new urgent care facility in Kitty Hawk? (It is replacing the Vidant facility in the Marketplace in Southern Shores).
Sloan: We will be moving in...the end of January. We moved there obviously because of the increasing demand after Sentara closed their urgent care facility in Kitty Hawk ...We’ve got about one thousand more square feet in it…So this will give us really convenient parking, will give us more space, and will give us a lot better patient flow because we’ve now built it from scratch.
Sentinel: You have been vocal in your opposition to N.C. State Treasurer Dale Folwell’s State Health Care Plan proposal. How do you view this? (The proposal, designed to cut costs for plan members, would reduce revenue for hospitals, possibly costing Vidant about $40 million.)
Waldrum: I think that the treasurer and the State Health Plan liability issue is a real issue. But it’s been built up over thirty or fifty years of having a benefit plan for state employees. And to have the solution to that problem be dictated by one person with the stroke of a pen is not the way to solve a problem that’s been built up over that period of time. And the repercussions of the plan are significant and have significant detrimental impacts primarily in rural communities…North Carolina is the second largest rural population in the country. Our market has 1.2 million people, primarily rural.
Sentinel: Where are we in the debate and discussion over that proposal?
Waldrum: We’re trying to stop the train. We would like the legislators to take action. [The treasurer] has the authority, but I believe that having one person who can dictate prices in health care for a program this large and disrupt contracts and other things is not appropriate…And if Vidant Health takes a forty million dollar haircut, we’re going to survive. We’re just going to have to change things and take things away and move things, and we think there’s a better solution to the problem.
Sentinel: Are there unique or particularly acute health issues related to the population that Vidant serves?
Waldrum: Yes. So rural North Carolina is like rural America…There are what I call ‘structural issues’ that are real…One is that rural communities are shrinking generally…They’re clearly elderly, and because of the aging of the rural population, [there is] a higher burden of the diseases that affect those — dementia, heart disease, strokes, cancer. And so, Eastern North Carolina is highly burdened with advanced cancers, cardio vascular disease…They have higher uninsured rates.
Sloan: One of the things that concerns me [about possible cuts in the Folwell proposal]…is the strides we’ve made [in areas such as early detection of cancer] all of a sudden have to go away, and we turn back the clock for later diagnosis of cancers, poor outcomes for cancers in our community.
Sentinel: For many Americans, the health care system is confusing and financially challenging. If you had one wish about how to start fixing things, what would it be?
Waldrum: These are entrenched complicated things that take systematic problem resolution from people who understand the system. [There is a] new model called ‘population health,’ which is how do we prevent, head off, identify and take care of people more efficiently, lower costs at a higher quality…Part of health is having hope and opportunity, good education and good health habits…We just have to live through the transformation and we need our payers — Blue Cross and the State Health Plan — to be with us in that transformation and not bring us down. And I would just ask our citizens frankly, who do they trust more to make those kinds of decisions…Is it a CPA that lives in Raleigh or is it our doctors and nurses and our health care administrators who live in our communities?
Sentinel: How would you assess the value and the effectiveness of the Affordable Care Act?
Waldrum: I think at the end of the day, getting Medicaid expansion is a good thing. (North Carolina is one of 14 states that have not implemented Medicaid expansion, a crucial element of the ACA)…It fascinates me that if you think about that, ninety percent of it is covered by the feds…We’re North Carolinians and we pay federal taxes. So now, we are subsidizing the [Medicaid] expansion states. So why does it make sense for us to do that? The economic environment improves in the state that expanded. The only systematic intervention that has been shown to deal with the opioid crisis has been Medicaid expansion.”
Sentinel: The political landscape has shifted in N.C. somewhat after the November elections. Do you think there’s hope for Medicaid expansion?
Waldrum: We do think the political environment has changed in North Carolina enough to really make a move. Yeah, I think we’re hopeful. I’m the incoming chair of the North Carolina Hospital Association and if they want me to be chair, we’re going to make a push…Let’s look at creative ways of doing this.”
Sentinel: If you were to make a prediction about something in your industry that will change significantly in the next decade, what would it be?
Sloan: Technology. Today we can pick up the phone and talk to the doctor online and get a prescription. [There are] mobile monitoring systems to monitor our patients from home and to be able to send instantaneous data back to physicians and nurses to make care happen quicker. Preventive care happens faster…We’re starting a brand new program, a voice interpreter program, where you can use an applet so that when you’re working with folks who speak different languages, you can have an interpreter right there on the phone wherever you are. It’s pretty cool.
Waldrum: “We’re in this incredible time…We remember the late '80s came when AIDS came, and we didn’t know what it was…And essentially, now AIDS is cured and now we cure Hepatitis C…From my perspective as a doctor and health care administrator, the one thing I know that won’t change is that it is a human endeavor…It really is about humans taking care of humans. And the essential role of a physician, a nurse, a provider is about the human interaction. And that’s never going to change.”
Questions and answers edited for space and clarity.