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Overlake Hospital ready for health-care ruling

The recent U.S. Supreme Court ruling on health care June 28 won't be an issue at Overlake Hospital Medical Center. The facility already was moving to implement the law's requirements, hospital officials say.

"We're going to take care of people – that's what our function is," said Overlake spokesperson, Kipepeo Brown. "From our standpoint, and many of the hospitals in Washington state in particular, we were already moving towards some of those regulations."

The court's ruling declaring most of the Affordable Care Act constitutional will enable the state to enroll every individual in Medicaid or private insurance starting in 2014.

The Medicaid coverage, particularly, will be a help to Overlake. Like all other hospitals across the country, Overlake sees many uninsured patients who use the emergency room for medical care. When they can't pay, the hospital is stuck with the bill.

More insured patients means hospitals will be reimbursed for the treatment given in emergency rooms and other urgent care.

However, concerns remain for Overlake.

In the past 18 months, the medical center has established various primary and urgent care clinics in Bellevue, Redmond and Issaquah. With more people covered by medical insurance, there is a question if enough physicians will be available to see them.

According to the 2010 report on the physician workforce by Association of American Medical Colleges, Washington has one primary care physician to every 1,143 patients. That ratio is expected to increase once individuals are required to carry health insurance and may place a strain on primary care facilities.

Washington State Hospital Association spokesperson Cassie Sauer said incentives need to be given for doctors to enter primary care in order to reduce the doctor-patient ratio, including paying a reasonable amount for primary care. Many doctors no longer accept patients with Medicaid because the reimbursement is too low.

"We need to promote training, funding and legislation, if necessary, that ensures networks of physicians adequate to treat patients in the programs," said Washington State Medical Association CEO Tom Curry. The biggest challenge will be redefining what "what is access" and how care is delivered to patients.

That may not mean seeing a MD, Curry said.

Yet despite concerns, Overlake officials believe the medical center can adapt to new regulations and new patients.

Brown said the primary care clinics will add more staff if there is a sustained increase in patient use because it is important to keep people healthy before they need to get into emergency care.

"We will be watching for what impacts and what particular regulations come as a result of it," Brown said. "Quality, value-based health care is where the industry is going and we're definitely following that curve."

 

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