In a new era of challenges, SNMH explores more partnerships | TheUnion.com
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In a new era of challenges, SNMH explores more partnerships

In an effort to address economic changes happening throughout the community, new collaborative programs are being discussed by leaders from SNMH and Nevada County Public Health. Shown here, from left, Stephanie Kreiter, SNMH Community Benefit; Jill Blake, Nevada County Public Health Director; Dr. Ken Cutler, Nevada County Public Health Officer; and Dr. Brian Evans, VP of Medical Affairs at SNMH.
Submited photo |

This is the second of two reports on the economic impact Dignity Health Sierra Nevada Memorial Hospital has on this community, its financial challenges, and how the hospital’s board is exploring new business strategies and partnerships designed to manage future health care services while remaining financially viable.

Like hospitals across the nation, Dignity Health Sierra Nevada Memorial Hospital (SNMH) is striving to cope with insurance payments that do not cover the cost of care, and new challenges associated with the Affordable Care Act (ACA). The hospital’s board and leadership believe that partnerships among health care providers are more and more indispensable to meeting ongoing health needs in the community.

SNMH has begun working closely with Nevada County Public Health officials to develop new programs and collaborations. Already, the two organizations have created a new multi-agency team to address substance use, as well as the Nevada County Crisis Stabilization Unit at the SNMH Emergency Department.



The Substance Use Disorder Community Collaboration project provides training to medical, law enforcement, education and other professionals for dealing with a growing crisis in heroin and opiate pain medication misuse, and to support early interventions. The four-bed Crisis Stabilization Unit, which opened in January and is staffed by the county, provides specialized care for individuals in need of more advanced mental health care. The unit has improved treatment while reducing holding time by half for these patients and easing congestion and turmoil in the ER.

These solutions may signal a new approach to meeting local health care and preventive health needs, according to Edward Sylvester, president of the SNMH board of directors. The board’s Strategy Committee is meeting with local health care organizations to explore the possibility of other partnerships that might enhance services while sharing costs and leveraging the ability to find funding, he said.




The effort was inspired by a recent economic impact analysis that documented the hospital’s major role in the local economy, while also underscoring the economic challenges of the health care environment created by the ACA, and a continued ratcheting down of reimbursement rates by government and private insurances.

“Our biggest problem is that reimbursements for health care services do not compensate for the actual cost of that care,” Sylvester said. “This has been a problem for years and it continues to worsen.”

According to Carry Canady, chief financial officer for the hospital, SNMH has a legal and a mission-driven obligation to care for all those seeking emergency care.

She explained that state and federal health plans reimburse the hospital, on average, only 60 cents on the dollar toward the actual cost to provide that care. Additionally, some people are still underinsured or have high deductibles which they are unable to pay. Charity care provided by the hospital in fiscal year 2015 amounted to over $23 million, Canady added.

“We’re taking the lead in figuring out a solution, and we want other local providers at the table to see how we can all work together,” Sylvester explained.

Partnerships don’t need to be limited to local organizations, he noted. For example, the hospital’s Stroke Center is linked to neurologists in Sacramento through Telemedicine. As part of their affiliation with the Dignity Health system, SNMH has access to other technology and expertise, as well.

Sylvester said the hospital must continue to invest in new technology and services in order to meet ongoing needs and provide new treatments. “It’s critical that we offer the best kind of care and technology so we can attract outstanding doctors,” he noted. “Companies exploring western Nevada County also want to be sure the local hospital is offering the best health care, so the hospital plays a huge role in the health of the overall local economy, aside from its large payroll and heavy investments in technology and capital projects.”

Katherine Medeiros, President and CEO, reflected that SNMH has always partnered closely with other local organizations for the health of the community.

“Today there is need for significantly increasing involvement with organizations and agencies that support quality of life issues, such as access to proper nutrition and transportation, and programs for substance abuse, social services, and health care for the homeless.

“We’re not just trying to shift the costs of health care around,” Medeiros said. “Together, we’re raising the bar on the quality of life and health in our community.”

The recent closure of the small hospital serving the community of Colusa adds fuel to the effort at SNMH, Sylvester said.

“We’re certainly not in danger of closing, but many small, rural hospitals have closed across the nation, partly because they couldn’t afford to continue providing expensive care while operating at a deficit. It’s our responsibility as a local board to manage costs while investing in technology, even though that gets more challenging every year. We’re local people and we want to find local solutions that will allow every health care provider to play a role, with the end result that we serve our community by working together and doing what each of us does best.”

It is also vital that the hospital and other agencies offer top quality care to encourage local people to spend their health dollars in the community, he said.

“We all benefit by having a hospital that will be financially viable over the long haul, ready to serve us when we need care,” Sylvester said.


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