BY Molly Matthews
Contributing Writer, Delta Business Journal

  New laws, a new lease, and other positive changes continue to improve the healthcare landscape in the Delta.
  Sam Cameron, president of the Mississippi Hospital Association, says the Delta could soon see funds funneled into the area, considered by the federal government as a Medically Underserved Area, that would provide much needed infrastructure changes in health care services.
  “One of the problems that hospitals in the Delta are faced with is the continued negative impact the 1997 Balanced Budget Act has had on hospitals in general, particularly in the Delta because of the high percentage of Medicare/Medicaid patients the hospitals treat,” Cameron says. “In addition to that, smaller facilities located in the Delta are probably more at risk than other hospitals, again, because of these dynamics. The ability of those hospitals to continue to provide services is in jeopardy. The hospitals have been working together to see what could be done collectively to address the needs to care for the populations that they serve. There’s a lot going on concerning how some of government initiatives could help the Delta region. I’m hoping that health care will be a recognized component as one of the infrastructures that the Delta must have.”
  For example, the Medical Education Scholarship Program will attract new physicians to the Delta. The program, authorized by the legislature earlier this year, will provide a free medical education for up to 20 recipients at the University of Mississippi Medical Center in Jackson. After graduation, recipients must practice in underserved rural areas, such as the Delta.
  Another law passed earlier this year includes the state licensure of physician assistants.   “Physician assistants and other types of healthcare providers on the primary healthcare services level will benefit the Delta, working in conjunction with the nurse practitioners and the physicians,” Cameron says.
  Jean McCarty, executive director of the Mississippi Association of Home Care, says changes in the home health prospective payment system (PPS) would change the way home health services are billed in the Delta.
  “The Balanced Budget Act of 1997, as amended by the Omnibus Consolidated and Emergency Supplemental Appropriations Act of 1999, called for the development and implementation of a PPS for Medicare home health services,” McCarty says. “Medicare already pays for inpatient hospital and nursing home services under a PPS. The BBA put in place the interim payment system until the PPS could be implemented. Beginning Oct. 1, 2000, the home health PPS will replace the IPS for all home health agencies. The PPS proposed rule was published on Oct. 28, 1999, with a 60-day public comment period, and the final rule will be published by July 2000.”
  The home health PPS is composed of six main features that includes payment for the 60-day episode, case-mix adjustment, outlier payments, adjustments for beneficiaries who requires only a few visits during the 60-day episode and for beneficiaries who experience a significant change in their condition, and for those who change HHAs.
  “Under the PPS, a HHA must bill for all home health services which includes nursing and therapy services, routine and non-routine medical supplies, home health aide and medical social services, except durable medical equipment,” she says. “DME was excluded from the BBA established consolidated billing requirement by the BBRA. The law requires that all home
health services paid on a cost basis be included in the PPS rate. Therefore, the PPS rate will include all nursing and therapy services, routine and non-routine medical supplies, and home health aide and medical social services.”
  Delta children will receive better Medicaid benefits, including the waiver of a six-month waiting period for children eligible to participate in the Medicaid-funded health program. Under the Children’s Health Insurance Program (CHIP), and other expansions with Medicaid, eligibility benefits are expanded to increase the poverty level, aged and disabled beneficiaries from 100% to 135% of the federal poverty level. Up to 20,000 new eligibles are expected on the Medicaid rolls, with a large portion in the Delta.
  The Mississippi State Department of Health recently named the Delta Regional Medical Center as one of five hospitals in the state to be designated as a Level II regional trauma center, the only Level II designated center in its 19-hospital region.  The centers are part of the newly created Mississippi Trauma Care System, a statewide trauma care system authorized by
the 1998 legislature.
  Also in April, Brentwood, TN based Province Healthcare Corp. signed a 40-year lease on Bolivar Medical Center in Cleveland, a move that means positive changes for the previously county-owned medical facility.
  “Province is a publicly traded company, where we’ve been a county hospital,” says Barbara Levingston, marketing director. “It’s very hard for a community hospital to survive these days because of all the federal cutbacks from the Balanced Budget Act, and we’ve already seen positive changes since they took over.”
  Province Healthcare, with the rising sun as its logo, owns and operates 16 acute-care hospitals in non-urban markets and manages 48 primarily non-urban hospitals throughout the U.S.
  “We’re getting ready to send out employee satisfaction surveys,” Levingston said. “The company places a lot of emphasis on employee and customer satisfaction. Right now, Province is hooking us up with computers so we can be on the intranet with all of their hospitals. This will provide us with a lot of networking opportunities within the company. Because of
this (change of ownership), a lot of good things are happening.”
  Several Delta healthcare facilities, such as Northwest Mississippi Regional Medical Center, have ongoing commitments to community service. NMRM’s outreach program has been exemplified in its recent evaluation with community focus groups.
  Rena Booth, MA, CCC-A, audiologist with Memphis Hearing Aid, who works in the Greenwood office once a week, says 24 million Americans have a degree of hearing loss that affects their ability to communicate, which is one reason why the company has included Greenwood in its weekly rotation for the last 15 years.
  “At Memphis Hearing Aid, our staff of audiologists are working to educate and identify people with hearing loss,” Booth says. “In recent years, there have been many advances in hearing aid technology, from computerized hearing aids to digital processing. These advances have improved patient satisfaction tremendously.”
  Greenwood Leflore Hospital, with a support network of more than a dozen primary care clinics, the state’s largest cancer treatment center, a new 12,000 square foot outpatient physical rehabilitation center and the hospital’s busiest emergency room in north central Mississippi, continues to expand.
  Bob Barrett, executive assistant director of Greenwood Leflore Hospital, said construction is scheduled to begin on June 10 on a new wing that will house a major expansion of the radiology department and the hospital lab. Clinical space and support functions, including the storage of medical records, will also be added to the 260-bed medical facility.
  “We simply do not have enough space in our physical plant to provide and grow the services the way we want to,” Barrett said. “This will give us the wherewithal to expand our services locally so people in the Delta will not have to go to Memphis, Jackson or Birmingham.”