The Affordable Care Act* has raised questions about how it affects our local El Camino Hospital and all hospitals and how it affects each of us individually.We turned to Tomi Ryba, President and Chief Executive Officer for El Camino Hospital, to get some answers. Ms. Ryba has served as CEO since October 5, 2011. Before joining El Camino Hospital, she served as President of United Hospital in St. Paul, Minnesota, and Senior Vice President of Allina Hospitals & Clinics.
Tomi Ryba was also our keynote speaker at the February Lunch with the League event where she shared her perspective and answered questions about the Affordable Care Act for the standing room only audience.
In a follow up interview, Ms. Ryba addressed key questions about the Affordable Care Act and how it affects our hospitals and individuals. The full interview can be found on our website Here is her perspective:
Should we expect new arrangements between insurers, doctors and hospitals? For instance, will patients have fewer/more choices in doctors, clinics and hospitals?
Answer: It’s too early to know how the Affordable Care Act will change the way people access care at El Camino or other hospitals. We will continue to collect and analyze many sources of data to help us understand what our patients need now, and what they will likely need in the coming years. The majority of our patients at El Camino Hospital are covered by Medicare or private insurance plans, usually through an employer, and that isn’t likely to change. The expansion of MediCal and the availability of insurance through the Covered California exchange is a great thing for people in our community who were previously uninsured, unable to afford health coverage, or were denied insurance due to preexisting conditions. El Camino remains an in-network hospital in most insurance plans offered through CoveredCA, and of course we accept Medicare and MediCal.1 There have been concerns about narrow provider networks in some areas of the state, but consumers have a good number of choices here in Santa Clara County. El Camino Hospital is focused on providing the highest quality continuum of care throughout the lives of our patients and their families, and so we collaborate closely with organizations like the Palo Alto Medical Foundation and with independent physicians. For example, we have an innovative program, which has reduced our hospital readmission rate to the lowest in the Bay Area that¹s an important indicator of the quality of post-hospital follow-up care and patient education. And we¹re working with schools, community nonprofits and city governments to improve physical and mental wellness and the use of preventive services.
Are there enough primary care doctors to accommodate a sharp increase in newly insured?
Answer: No, this is a concern on the national level. We need to train more primary care physicians, nurse practitioners, physician assistants and other health care workers, and we need to improve access to care in rural areas and in community clinics. Locally, the situation is mixed. Some organizations are reporting no difficulty hiring highly qualified primary care doctors while others, especially community clinics, have unfilled positions. While there are many excellent physicians in private or small group practice in our community, it is unfortunately increasingly difficult for physicians to afford to remain independent.
With more people insured, should we expect changes in availability of wellness and prevention appointments?
Answer: It¹s early in health care reform, and we aren’t sure yet how people will change their habits. We hope there is more usage of prevention appointments and wellness services‹we want to keep you out of the hospital, and we can improve the quality of life of folks with chronic illness when they see a doctor regularly. Many providers have anticipated and planned for an increase in wellness and preventative services, since all health care plans are now required to cover such services under the Affordable Care Act. El Camino Hospital will continue to be here for the most complex care—for surgery and trauma, for management of serious illness, and we happily deliver more babies than any hospital in the county. But it¹s essential that everyone have good primary care so you have better options than an emergency room when your toddler has an ear infection or you have the flu.
Will El Camino Hospital emergency room remain available to the uninsured?
Answer: By law, every hospital must provide emergency care to anyone who needs it. El Camino Hospital provides state-of-the-art emergency care to anyone who needs our help, regardless of his or her insurance status. If you don’t have health coverage, we’ll do our best to help you get covered so that you have access to medical care that fits your needs. El Camino also provides significant financial support to community clinics like RotaCare, located on our Mountain View campus. Staffed on a volunteer basis by many of the finest physicians in our community, RotaCare provides a wide variety of services to those who are uninsured or underinsured.
Does El Camino Hospital have a role in educating the community about the Affordable Care Act, or incenting the uninsured to sign up?
Answer: Yes. El Camino has used, and will continue to use, every method at our disposal to inform people about the Affordable Care Act and new health coverage options, including hosting events for healthcare providers and businesses, presentations for community groups, and by providing information through our newsletters, magazine, websites and social media. We recently hosted a Covered California enrollment event where anyone from the public could stop by, get their questions answered, find out if they are eligible for free or low cost insurance, and enroll themselves and their families in health coverage that fits their needs.
How would you complete the following statement? “A CEO’s view: The State of healthcare in the El Camino Healthcare District is….”
Answer: We have truly world class medical and hospital care available to us here—we’re very lucky. However, we must recognize that in this ³Valley of Plenty² there are a substantial number of hard working, low income people who don’t get the health care they and their children need. El Camino Healthcare District last year provided nearly six million dollars in community benefit funds to help meet those needs, and El Camino Hospital spent over fifty million dollars on community benefit programs and uncompensated medical care. Together, we can meet the challenges of preventing disease, supporting wellness at each stage of life, and helping every member of our community access medical care that meets the highest standards of excellence.
*On March 23, 2010, President Obama signed comprehensive health care reform, the Patient Protection and Affordable Care Act, into law. ObamaCare, the unofficial name for this far-reaching program, has several goals including offering people new benefits, rights, and protections regarding their healthcare and establishes a Health Insurance Marketplace where consumers can purchase federally regulated and subsidized health care insurance.