High
costs are a continuing challenge
With
each passing year, it becomes less necessary to travel
away from the Delta to receive world-class health care.
Expert specialists perform complex surgical procedures
in Delta medical centers, utilizing the latest technological
advances for diagnosis and treatment. The newest options
in everything from eyewear to non-surgical treatment to
retirement living choices are available in many Delta
towns.
This remains true as 2004 begins, with industry spokespersons
reporting the addition of staff and equipment, as well
as physical expansion to meet growing needs. However,
they also report old and new challenges—from sky-high
insurance premiums to new state and federal regulations—that
cause concern over the continuing availability of high-level
care for all those who need it.
River Region Medical Center in Vicksburg continues to
grow as a medical hub for the Mississippi Delta counties
and northeast Louisiana. Says CEO Phillip Clendenin, “It
is our mission to deliver and improve quality, compassionate
health care that is aligned with the communities we serve.
To meet this goal, we continually review the needs of
the Delta region and add services and recruit physicians.”
In addition to an open heart program which has established
itself as a leader in cardiac surgery, and a recently-opened
sleep lab offering diagnostic sleep studies, River Region
is offering other enhancements—such as complicated
head and neck surgeries aided by a three-dimensional imaging
guidance system—that were not previously available
in Vicksburg, Clendenin reports.
“Heart disease is the number one killer of women,”
states Baptist Health Systems spokesman Robby Channell.
“To help change this, Baptist is developing a partnership
with the Mississippi Department of Health, Mississippi
Hospital Association, Mississippi State Medical Association,
Mississippi Nurses Association, and the American Heart
Association-Mississippi Affiliate. These partners are
launching the Mississippi Heart Truth campaign in 2004.
“This awareness effort is part of the National Heart,
Lung, and Blood Institute and partners organizations’
sponsorship of the national Heart Truth campaign. The
goal is to give women a personal and urgent wake-up call
about their risk of heart disease.”
Baptist Heart Services will continue its participation
in CRUSADE—a nationwide registry of heart patients
with acute coronary syndrome (ACS), Channell reports.
The registry, coordinated by the Duke Clinical Research
Institute, continually gathers data from participating
hospitals and provides feedback to them, with a goal of
improving outcomes for ACS. In December, Baptist Heart
Services received an Outstanding Care Award from CRUSADE.
As administrator Jerry Keever points out, the Sharkey
Issaquena Community Hospital in Rolling Fork is the only
hospital located in the area. The closest hospitals are
in Vicksburg to the south and in Greenville to the north.
“We cover a wide area, and a hospital like this
is so important to a small community,” Keever comments.
“The nearest hospitals are 45 minutes away, and
in an emergency you might not have that much time. We
can’t match the big hospital systems, but rather
we try to complement them. We provide primary care, basic
lab services, and an emergency department, and have just
started a mobile MRI service.”
Tort reform remains a major issue, Keever says. “It’s
still not where it needs to be to make insurance affordable
for small hospitals. High insurance premiums are one big
reason we’re having to hold up on equipment upgrades,
for example. Insurance premiums also affect our ability
to compete in terms of compensation when recruiting qualified
nurses—and that’s true for many small Delta
hospitals. We’re having to recruit from outside
our surrounding area, and we’ve started advertising
in other communities that have hospitals.”
At the Region I Mental Health Center in Clarksdale, which
provides services for persons with alcohol or chemical
dependency, executive director Newton Dodson says adequate
funding remains the biggest challenge.
“We need matching funds,” he states. “The
state is not adequately funding programs such as ours.
The funding problems are even more serious in poor areas
like this, where many people do not have insurance.”
Dodson says there is a major need for alcohol and drug
residential care. “We stay full, and hope to be
able to add more beds,” he comments. “On the
drawing board is a program by which residents can leave
and live independently in the community with others in
recovery—this is a need we really hope to address.”
He observes that the growth of programs such as those
offered at the Center comes in part from growing public
awareness of drug and alcohol problems. “Families
are trying more to do something about the problems before
they tear the family apart. I just hope more people will
become aware of services such as we offer, and will think
of us as their first resort—not their last resort.”
Staggering advances in cancer care have vastly improved
survival rates in recent years, and medical centers in
many parts of the Delta have incorporated these advances
to provide a very high level of treatment. The future
of cancer care in the region (and elsewhere) is clouded,
however, by the high costs of the very technologies which
have produced so many cancer treatment success stories.
Dr. Guangzhi Qu, who joined the staff of Jackson Oncology
Associates this month, highlights several positive developments
in his field. “The big news in oncology is that
cancer mortality rates decreased in 2003. This decrease
was not attributed to lifestyle changes among the population,
but rather to better diagnostic tools and improved therapies.
“The incidence of colon cancer, prostate cancer,
and most other cancers was stable. In 2003, the incidence
of lung cancer decreased in men but increased in women—this
is attributable to smoking behavior in women.”
Qu adds that reports of breast cancer among women and
prostate cancer among men increased, due to increased
use of mammograms and PSA testing to detect these cancers,
leading to earlier treatment.
The North Central Mississippi Regional Cancer Clinic is
adding to its staff in 2004, according to Dr. Arnold Smith.
“We’re fortunate to have brought in a number
of people with extensive experience in their respective
fields,” he comments. “They will help us in
achieving our goals of incorporating the best of traditional
care with innovative, integrated methodologies which are
becoming more widely available.
“A prime focus area for us now is lung cancer,”
he continues. “I’m proud to say that we have
several five-year survivors who received non-surgical
care—this kind of survival rate is rare.”
Smith expresses concerns about the continuing loss of
primary care and specialty doctors in the Delta region.
“This has a clear negative impact on the health
care capabilities of the area. And, the government continues
to decrease reimbursements under Medicare and Medicaid.
The quality of the services that can be provided to cancer
patients continues to rise—biotechnology changes
of the past decade have been huge and promise to be just
as dramatic in the coming decade—but they are also
ever more costly.”
Steve Coplon of the West Clinic believes cancer care capabilities
are seriously threatened in the year ahead. “For
us, it’s the best of times and the worst of times,”
he comments. “The good news is that we’ve
opened Desoto County’s most advanced cancer care
center, and probably the most advanced in the state. It’s
a 13,000 square foot facility with comprehensive services
including research and clinical trials, all in one location.
“The bad news, however, is that Congress’
new Medicare prescription bill includes drastic cuts in
reimbursement for cancer care. Many cancer drugs will
be reimbursed at below costs by 2005. Centers such as
ours will have to seriously consider how they can absorb
these costs, and unless the policy changes, some centers
will have to close. The likely effect is shrinking availability
of cancer care, especially in rural areas, where it may
become completely unavailable.
“It’s incredible to have Congress do this,”
Coplon says. “Certainly, we support Congress addressing
the prescription needs of senior citizens, but at the
cost of cancer care? I’ve had occasion to talk with
hundreds of cancer care centers across the country, and
none of them feel they will able to maintain their present
level of service.”
Among providers of specialized medical services, there
is also ongoing effort to bring the latest trends in treatment
and options to the Delta. In one critical area, however,
it is the Delta residents who need to put forth more effort.
According to Wendy Copeland, public relations manager
for Mississippi Blood Services, January is a month in
which blood supplies have to be built up and replenished
after the holidays, a time of critical need. She says
their main challenge is the same every year—getting
people to donate blood.
“This is so important,” she states. “You
never know when you’ll need blood, but less than
four percent of Mississippians donate. We still have to
import from other states to cover our needs.
“It’s just a hard sell, especially with people
who have never been personally affected. And since we’re
regulated by the FDA, and must qualify with so many regulations
that are changing all the time, the pool of eligible donors
continues to get smaller.”
To address this, Copeland says Mississippi Blood Services
plans special marketing efforts this year, a more personal
approach which will highlight blood recipients and illustrate
how valuable available blood supplies are to individuals.
Dr. Derek Miles of the Bolivar Urology Clinic says his
facility met a major community need. “Cleveland
had never had a urologist,” he points out. “This
is a real health need in this area. I’m amazed by
the number of prostate biopsies that come back positive,
for example.”
He reports that the clinic has secured a certificate of
need and will be adding mobile lithrotripsy capabilities.
As Miles explains, this is the method of choice for the
treatment of kidney stones—a non-invasive procedure
utilizing highly focused shock waves.
“We’re also adding a urodynamics lab,”
Miles says. “It will provide better discerning of
various types of problems pertaining to incontinence,
retention, etc.”
This being the time of year when many people get annual
eye exams, Dr. Jospeh Portera reports that business has
been very good at 20 20 Eye World in Greenville. A total
eye care provider, the firm offers complete exams which
include glaucoma checks, checks for diabetes and high
blood pressure, and complete refraction testing.
“There are new technologies in glaucoma care,”
says Portera, “including both new surgical procedures
and new technology for detection. We also see ongoing
improvements in both glasses and contact lenses. One-day
disposable lenses are very popular now, and they’re
a really healthy way to wear lenses.
“Besides just getting an exam for glasses, people
should look at an eye exam as a routine annual health
care exam like any other,” he comments. “Especially
in people over forty, an eye exam might detect problems
the individual might not otherwise have a clue about.”
Meeting the needs of an ever-growing senior population
is a challenge throughout the country, and certainly the
Delta is no different. Facilities and agencies in the
region continue to offer a wide range of retirement living
and senior care options, even while grappling with the
high costs that prevent many from obtaining the care they
need.
Indywood has recently completed a 23-bed addition to its
Greenwood facility, according to Eleta Grimmett. “We
added some amenities that were not a part of the first
phase,” she explains, “including some things
our residents had asked for—such as a private meeting
room.
“There’s a need for Medicaid assisted living
beds in the area,” she comments. “I’ve
seen many instances where people ran out of money and
had to leave assisted living and go elsewhere. So we’re
considering adding a Medicaid unit to our Indianola facility.”
Educating the public that assisted living is a totally
different concept than nursing home care, with different
admissions criteria, is still a challenge, Grimmett says.
“So many people wait too long before trying to move
into assisted living, and often it’s too late to
be admitted under our criteria. You just can’t move
in whenever, like you can with a nursing home.”
Joy Lehman with Magnolia Gardens in Greenville agrees
that many senior citizens delay their decision to move
out of their own homes. “We need to educate seniors
to go ahead and make decisions on their own before it’s
too late and someone else makes the decisions, and their
only option is a nursing home.
“The economy has a lot to do with it,” she
comments. “With the stock market’s problems,
etc., many people find that their retirement funds are
dwindling. They’re scared, and often try to stay
in their own homes longer than they should, because the
time just doesn’t seem right to liquidate their
assets.”
Lehman reports that all nursing homes, hospices, and home
health care agencies must now fingerprint all employees
for national background checks—this is in response
to a rash of abuse and neglect cases around the country.
“It’s very expensive for the businesses,”
she says, “but it’s a benefit to the system
as a whole, helping ensure that the best people are taking
care of our seniors.”
Flowers Manor in Clarksdale is one of eleven senior living
campuses under the auspices of Mississippi Methodist Services.
Bill Lewis reports that a market analysis is underway
to outline their future needs.
“The needs are changing, and we’re looking
at different options, possibly to include assisted care,”
he says. “Our challenge is to continue providing
for the needs of the elderly on a personal basis, and
to try to keep care as individualized as possible.”
The parent company’s Greenhouses concept—a
level of care that moves away from the institutionalized
approach and instead provides a more home-like atmosphere—has
proven very successful since first opening in Tupelo last
year, says Lewis. “The home-type approach is a growing
trend, becoming more and more popular because people are
looking for this kind of option—an approach that
is seen as a positive move, rather than dreading the idea
of nursing home care.”
Clara Reed with Mid Delta Home Health reports some concern
among health care providers about access to care and the
ability to provide it in a cost-effective manner. “There
are still many individuals who cannot afford private insurance
but who make too much money to be eligible for Medicare,”
she comments.
“Home health care is still the cheapest form of
care, and allows the person to stay in their own home.
In fact, there are many people in nursing homes who could
be at home, and many at home who really need a higher
level of care.
“One thing I’d like to see at the legislative
level is a change that would allow money that is now used
for nursing home care to be used to allow family members
or other caregivers to stay with the person at home and
provide the care.”
Reed adds that home health care is one of the industries
which face a shortage of personnel, and that one of her
firm’s goals in the new year is to add and train
more people. “Our industry could even provide a
boost to local economies by providing employment,”
she points out.
Although 2004 presents a decidedly mixed picture, it is
clear that today’s Delta offers a level of health
care that its residents once had to look elsewhere to
find. DBJ
