Does the Fox Valley Really Need Another Elaborate Specialist Facility? We say NO!
On November 6th, ThedaCare, in conjunction with the Neuroscience Group and the Hand to Shoulder Center of Wisconsin, announced their plan to construct a $144 million Orthopedic, Spine and Pain Center “to meet the changing needs of the community.” Last week we posted our view of this expensive endeavor, especially in light of the new orthopedic facility in the Fox Valley proposed by Ascension and the Orthopedic and Sports Medicine Specialists of Green Bay. This blog posting focuses on related questions: what are the needs of the community and how might community resources be used to meet them?
One set of answers can be found in the Community Health Needs Assessments (CHNA) that must be completed by tax exempt hospitals every three years. A second and related set comes from the Life Study completed by the United Way of the Fox Cities. Neither one includes reference to the need for those of us in the Fox Valley to spend $144 million on this proposed facility.
On its website, ThedaCare includes their 2017-2019 CHNA and implementation plan that was completed in 2016 for each of its hospitals. ThedaCare has not posted the CHNA study done earlier this year; however, they do reference a campaign to address opioid abuse, but do not indicate the magnitude of resources they will commit to it. In contrast, Ascension St. Elizabeth has published its 2019 CHNA and cites obesity and mental health as priorities. These CHNA reports lead us to reject ThedaCare’s claim that Fox Valley health needs have changed.
The 2017-2019 ThedaCare study highlights (on page 23) mental health, alcohol and other drug abuse, chronic diseases, physical activity/nutrition, and violence as those areas that generate the most significant health needs. Furthermore, the report lists the top 10 diagnoses for those who come to ThedaCare emergency rooms (page 22). No diagnosis related to orthopedic or spine problems appears in the list. Subsequently (page 24), the priorities cited in their CHNA report follow directly from the aforementioned health needs. Please note that additional orthopedic and spine services are NOT among the services identified as needed by this community.
The most recent Life Study posted on the United Way Fox Cities website was completed in 2016 with the health priorities portion updated in 2017. The study cites infant health and diabetes, especially that related to obesity, as major concerns. To some degree, responses require more comprehensive payment (including insurance) as well as better access to primary care providers. Neither of these responses plays a role in ThedaCare’s expansion plans.
In our opinion, the proposed $144 million ThedaCare expansion will not address the primary health care needs of Fox Valley residents. Neither Medicare nor Medicaid (Badger Care) will pay more for these specialist services. Thus, given the fee-for-service arrangements that dominate payment for health care in the Fox Valley, those with commercial or self-funded insurance will have to pay the bill. Since Fox Valley residents have not seen their incomes rise anywhere near the rise in payments received by Fox Valley’s health care systems, this expansion will further exacerbate the pressures on families and the communities including providing funds for the education of their children.
The Fox Valley Health Care Transformation Initiative seeks to counter these unaffordable trends with a refocus of our health care services on primary care. Primary care providers can help reduce the unnecessary emergency room and hospital admissions for those with acute reactions to chronic disease by helping our residents both reduce the risks of chronic disease and manage these diseases once they arise. Of course, such a shift in priorities is not consistent with the priorities and expansion plans of the unresponsive hospital run health systems that serve Fox Valley residents. We need your help to resist these unnecessary and expensive expansions of specialty services which do little to meet community needs.