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Certificate of Need Bills Move to Full Medical Affairs Committee
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A subcommittee of the Senate Medical Affairs Committee met Thursday morning to finish hearing testimony from those signed up to speak during a previously meeting that ended before everyone could be heard. Those who spoke this week all spoke against S. 1077, which would remove the CON requirement for a Level II perinatal center to become a Level III NICU facility.
The subcommittee discussed the bills and, at the recommendation of the subcommittee chair in consultation with the full committee chair, moved all three bills forward to allow the full committee to decide which bill moves forward. The three bills are S. 990, S. 1077, and S. 1093. They have been placed on the full committee agenda for next week.
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Senate Panel Discusses Hospital Consolidation
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A Medical Affairs subcommittee met Thursday morning to hear testimony from hospitals on S. 1014, a bill by Senator Scott (D-Richland) which would require all hospitals to complete a strategic plan about how they would ensure no decrease in access or increase in cost of care in the event of a merger, acquisition, or other organization change, and tie the plan to licensure.
First to speak was Mark O'Halla, CEO of Prisma Health. He shared that Prisma is the largest healthcare provider in the state, covering nearly two-thirds of the state geographically. Prisma has physical presence in rural counties including Laurens, Oconee, and Sumter and has created the rural health residency program in Sumter as well as the Mobile Health Clinic Unit to reach individuals in their community. He shared about the Certificate of Public Advantage that Prisma Health has, which has overseen the terms and expansion of the system, including pricing, proof of cost-reduction, and moving into areas that need a bigger footprint, like lower Richland County.
The subcommittee asked many questions of Mr. O'Halla, including about the recent reduction in force that was announced and whether more of layoffs would be expected during the acquisition of additional hospitals. While acknowledging it is a possibility, O'Halla said he cannot comment for certain on what may or may not happen. As far as a position on the bill itself, Prisma would oppose more bureaucracy to do things they are already doing, and more discussion was had about what might be a better direction to take the legislation in order to address the issue and preserve rural health access.
Dr. Pat Cawley, CEO at MUSC Health spoke next, sharing concerns for the language of the legislation and sharing that public disclosure of private business discussions would prevent some of the deals from happening, and said that would have likely been the case in a recent acquisition of a couple rural hospitals by MUSC. He added that the economics of healthcare are changing so quickly now and there has been a lot of consolidation - some good and some poorly executed.
He went on to say that MUSC is in full agreement that hospitals have to commit to a new rural model of healthcare delivery and MUSC is committed to doing that and bringing more resources to communities that haven't had them in the past. Senator Davis (R-Beaufort) asked about the role of telemedicine in getting healthcare in rural areas. Dr. Cawley said that telehealth is a big component of changing the healthcare model, as is expanded scope for advanced practice providers which the General Assembly has done over the past few years. He added that there is no material difference in the quality of care received by telemedicine when it is done correctly.
McLeod Health executive, Will McLeod, spoke on behalf of the health system, sharing that they have acquired many rural hospitals, having now a total of seven facilities. He noted that many of the hospitals were in a financially bad place when McLeod acquired them. He expressed concern over tying a strategic plan report to facility licensure and shared that having a think tank or the hospital association convene a group together to discuss this is a better approach.
The subcommittee adjourned without taking action, citing concerns over the legislation as written. They made it clear they expect hospitals to work together to find recommendations to ways to provide oversight into the acquisition process and ensure safeguards are in place for rural communities.
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Intros of Interest
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- S. 1161 (Jackson, et al): A bill to require health insurance providers to waive cost-sharing requirements for coronavirus tests. The bill was referred to the Senate Banking and Insurance Committee. Later in the week, it was revealed that the insurance providers in South Carolina are already voluntarily waiving the cost-sharing requirements for coronavirus testing.
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March 13, 2020
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