We’re Here When You Need Us

April 18, 2017

The thinking behind the Affordable Care Act and the expansion of Medicaid was mainly about expanding health care access without breaking the bank. This discussion continues and is still not resolved, but it has affected hospitals in a number of ways.

While cost remains a key issue, the discussion also involves many related concerns including lack of insurance coverage and coverage limitations, such as for pre-existing conditions; inability to receive preventive care services; delays in service that can worsen medical conditions; and the overall societal cost of dealing with patients only when they become critically ill.

Today, access remains a critical concern for small hospitals like SVH where the financial issues involved may be smaller in scale, but often have a large impact on the bottom line.

We serve a relatively small patient population representing widely divergent demographic groups. Our patients depend on us because the closest hospital is 20 minutes away and many have mobility constraints due to age or income. The situation is complicated by the outsized impact that government insurance has on our financials, with most of our patients depending on Medicare and Medi-Cal which reimburse us at lower rates each year.

Despite this, we’ve made progress in expanding access in recent years. Let me cite two areas.

Fundamental to quality care is ready access to physicians. The situation in the Sonoma Valley with primary care physicians has admittedly been tight, and we’ve worked with Prima Medical Group and our local medical community to address this. Prima has recently added a new physician, Dr. Doreen Marino, who is accepting new patients, and a new Nurse Practitioner. A new concierge physician, Dr. Guy Delorefice, has also moved here and is accepting patients.

In addition, we’ve worked to bring in new specialists who have either moved their practice to the Valley or visit regularly to see patients, and the Hospital has opened two timeshare offices to accommodate them. The good news is it’s working. In recent years, we’ve welcomed new specialists in such areas as Pain Management, Urology, Colorectal Surgery, Podiatry, ENT, Ophthalmology and Nephrology, and more will be announced soon.

Emergency services are another critical aspect of access to quality care. We’re proud that our Emergency Department time-to-doctor is better than national averages and our patient satisfaction scores remain high. This also is an area that’s working well, and patients seem to agree as we’ve seen a 20 percent increase in ED visits in the past two years. We’re also addressing the question of accessing emergency services appropriately – helping patients who should turn to a primary care physician for routine health issues rather than the ED.

Maintaining an Emergency Department is complex and costly. It requires board-certified Emergency Physicians and Hospitalists, emergency trained nurses, and 24/7 access to such services as Surgery, an Intensive Care Unit, Radiology, Laboratory and Respiratory Therapy.

Clearly, the discussion about access is far from over and it will remain a concern for some time for hospitals both large and small. I can assure you that we will continue to do our best to ensure our entire community can access quality care here in the Sonoma Valley.

In good health,

Kelly

Kelly Mather
President and Chief Executive Officer
Sonoma Valley Hospital