'That's a problem'
Each of these primary care and hospital challenges has its own ramifications.
In an effort to avoid high hospital costs, mining and other large employers contract with surgical management companies to coordinate treatment outside the city, often in Salt Lake, to save money. Patients with means travel on their own.
Doctors say this is exacerbating the region's shortage of specialists. Many of the best-insured patients are leaving the city, so it's hard to attract doctors who can give people with good insurance a reason to stay.
“Basically, this eliminates the possibility of a new gastroenterologist coming in and installing their own shingles. 'Well, wait, the payment part of the procedure is now going to Salt Lake. .So all that's left is Medicare and no one else,” says Dr. David Hogle, a primary care physician in private practice in Elko.
Access to some specialty care may improve after an out-of-state company opened an outpatient surgery center in town in March. Angela Browning, the center's office manager, said the center accepts insurance and surgical management plans provided by Mine, Medicare, Veterans Affairs and Indian Health Service benefits, and eventually includes Medicaid. He plans to accept all plans.
Kevin Lutz, executive vice president of healthcare operations, policy and research at Community Health Development Partners, said the company chose Elko for its first surgery center because of the community's needs and high commercial insurance rates. He said it was for. Lutz said there is no need for people to travel for care that the community can support.
“The good thing about Elko, and probably most mining communities, is that there are good profits and that keeps the business solvent,” Lutz said. “If you only have 80 percent Medicaid or Medicare, you can’t have surgery.”
Rather than compete with hospitals, surgery center staff said they are trying to recapture the population leaving town for surgeries. But Ackerman, assistant dean of rural health at the University of Nevada, Reno School of Medicine, worries that could happen. For example, if fewer people go to the hospital for outpatient cardiac care, there is less reason to have a cardiologist on staff who can also provide emergency cardiac care, something a surgical center cannot do, of course.
“At some point, there will be an emergency in this region. Just like in the past when there was a bus accident in a mine, the services you expected at the hospital suddenly become unavailable. Dealing with emergencies Please, it’s not there,” Ackerman said. “That's a problem, but I don't know what to do about it.”
