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UnityPoint Health-Allen Hospital CEO Pam Delagardelle

WATERLOO — Health care’s access and affordability have been in the limelight nationally during recent years.And the effects of a changing landscape have been felt in the Cedar Valley’s health care systems.

“I’ve been in health care for 35 years,” said Pam Delagardelle, chief executive officer of UnityPoint Health-Waterloo, which includes Allen Hospital. “Without a doubt this is the most challenging time in health care.”

Costs are on the rise for organizations as they serve a growing number of aging baby boomers. She cited concerns with the level of reimbursements for government insurance programs and the larger work force needed to treat those patients.

“What we’re ultimately trying to do is as simple as two words: helping others,” said Jack Dusenbery, CEO of Wheaton Franciscan Healthcare-Iowa, which includes Covenant Medical Center and Sartori Memorial Hospital. He noted increases in reimbursement rates for Medicare, Medicaid and private insurance are flat to very low while all other expenses a hospital deals with grow at a much faster pace. Among those are complex technology information systems used to improve care.

“The financial pressures continue to mount,” he said. “I think that pushes many health systems to consolidate.”

Such pressures are “probably going to hit the traditional hospital price the hardest,” said Gil Irey, CEO of Cedar Valley Medical Specialists, whose clinics are located across the Cedar Valley and the surrounding area. “That’s all good for the consumers of health care.” He suggested it would instill a new level of competition, which clinic settings are well positioned for.

“I think what drove it all was the unintended consequences of the Affordable Care Act,” said Irey, of the health care legislation signed by former President Obama. A direct result of that, he said, is rising insurance co-pays and deductibles as well as Iowa moving to privately managed Medicaid. Patients are going to demand price transparency and lower costs while providers “still maintain the high quality that they’re used to.”

It is key for health systems to provide the “highest quality care at the lowest price,” said Irey. “That’s what we have always done at Cedar Valley Medical Specialists.”

Delagardelle is already thinking about some of those issues, particularly regarding changes in employer benefits that are increasing costs for consumers.

“What we’ll be focusing on here is how do we become a more affordable system,” she said, including Allen’s approach to patients’ care. “We need to stop acting like a sick-care system and start acting like a health care system. Everything that you’re going to see us working on is to build the infrastructure to keep people healthy.”

More services are being pushed to clinics offsite from the hospital, which is working with partner physicians to decrease the cost of surgical procedures. Those and many other changes are needed, she said, “to really surround” people with health care options. “We get this figured out, I think it’s going to be a better solution for everybody.”

Clinics are an important part of Wheaton’s strategy, as well. Dusenbery said “we continue to look at the footprint of Northeast Iowa” when it comes to locating those facilities.

He added that it’s a “valid goal” to lower costs for patients, and efficiencies are an important part of that. Dusenbery hopes to continue finding those “now that we’ve fully integrated ourselves into a system with many other hospitals in Iowa.” Nearly two years ago, Wheaton became part of the Mercy Health Network, which includes a number of hospitals across the state.

“I look forward to working with those hospitals in ways that we can improve care,” he said. “So, that’s exciting for us. I think there’s a lot of good things that we can do.”

The organizations’ hospitals and clinics are facing challenges as their work force ages and recruitment into the medical fields remains difficult.

“We’re fortunate here with Allen College of Nursing and (the nursing program at) Hawkeye Community College,” said Dusenbery, noting major staffing problems across the country. “Throughout the nation, there’s states much worse off than Iowa, in terms of particular shortages.”

UnityPoint is “pouring a lot of resources into Allen College,” said Delegardelle. The school has more than 620 students, a record enrollment. She noted they are looking at “where are the gaps that we’re going to have in services.”

Her organization is addressing those concerns through its support of medical programs for high school students. That includes the Waterloo Career Center currently plus Cedar Falls’ Center for Advanced Professional Studies starting next fall.

“That’s going to go a long way to solve those work force needs,” said Delegardelle. “Those kinds of partnerships are key for us. We’re going to put a lot of emphasis on partnering with the community to improve health.”

UnityPoint also is getting into the health insurance business “in order to create the most affordable solution for employees and consumers,” she said. Health Partners will work with insurance carriers and local employers to create the product.

“I think we’re offering a more affordable solution,” said Delegardelle. “It reduces unnecessary tests, unnecessary duplication. There’s better coordination when we’re all working together on the same health care team.”


Education Reporter

Education reporter for the Courier

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