Two Clatsop County health care heavyweights weighed in Wednesday night, March 22, at the Seaside Civic and Convention Center. It wasn’t a boxing match, instead it was an evening of celebration, collaboration and a little uncertainty at the fifth-annual Clatsop Economic Development Resources business awards, where keynote speakers Erik Thorsen, CEO of Columbia Memorial Hospital, and Kendall Sawa, CEO of Providence Seaside Hospital, discussed the current state of affairs at their hospitals.

Rising health care costs and staffing struggles are among the chief concerns facing rural hospitals. Despite having 600 employees — the second most in Clatsop County — Thorsen is calling for more staff to address a growing need.

“We see about 28,000 emergency room and urgent care visits a year, that’s about 80 people a day,” he said.

Sawa said, “I think that’s a sign of the need for more primary care physicians in our community.” Decreasing reimbursement and rising healthcare and pharmaceutical costs are plaguing Providence Seaside Hospital.

“It’s a challenging reimbursement environment right now,” he said. While the coast is a desirable destination to visit, enticing and retaining employees at a rural hospital is another hurdle for both hospitals.

“We continue to have challenges with recruiting providers to our coast,” Sawa said.

“We’re hopeful. It’s a great place to live and be.” Despite the staff shortages, Sawa doesn’t anticipate any changes, but positions in primary care have been particularly needed.

“We’ll continue to plug at it and make sure we’ll continue access to care for our communities,” he said.

Attempts to repeal the Affordable Care Act by the Trump administration have raised concerns about potential changes to healthcare coverage.

“We’re concerned — concerned with not really knowing what the future design is going to be, but we’re sure watching it very closely, ” Sawa said.

“I’m confident we’ll be able to manage any decision that’s made.” Changes in Medicaid are also possible, particularly with coordinated care programs.

Thorsen added, “I’m hoping that the current rhetoric at the federal level does not affect our state’s ability to continue the CCO model.

“It is a potential that’s out there, but hopefully it won’t.”

A major issue for area hospitals has been an influx of mental health patients ending up in emergency rooms.

“In early 2016, we really started to talk about the behavior health crises that exists in our community and we partnered together to start a coalition,” Thorsen said. In 2016, a collaboration of local health care providers purchased a house in Warrenton and converted it into a crisis respite center.

“They might be waiting for a mental health bed to open up in Portland, and they end up waiting in the emergency room,” Thorsen said.

“It’s the wrong place — and the most costly place for a person to wait.”

Providence Seaside and CMH have consolidated and reshuffled resources to better streamline their services.

“CMH made the difficult decision to close their home health and allow Providence to assume their patient load,” Thorsen said. “The decision was made to make the best use of our resources.”

Columbia Memorial’s Lower Columbia Hospice, meanwhile, provides hospice care for the entire county.

“We worked and collaborated to make sure we have strong programs by each of our organizations and we’ve seen a lot of success,” he said.

The two hospitals have also combined resources by conducting joint community needs assessments rather than doing them individually, which had been costly and duplicative.

Since 2012, hospitals and behavioral health organizations across Tillamook, Clatsop and Columbia County hospitals have been convening to share ideas on how to improve care in the community.

“The first thing was getting us all in a room and getting to talk about how we can improve care,” Thorsen said.

“The key point is bringing the organizations together in a collaborative way to start to break down barriers that have existed and potentially driven up the cost at a lesser quality.”

New technology will allow doctors to diagnose breast cancer more successfully in Seaside.

“We recently purchased a tomosynthesis, which is a new way to do breast mammography,” Sawa said.

“It prevents the chance of false negatives, so less chance of error.” The new advanced imaging technology will be unveiled the first week of April and is “the only one on the coast” according to Sawa. The next closest is in Portland.

Meanwhile, the new, two-story, 18,000-square-foot state-of-the-art cancer treatment center in Astoria is projected to open next fall.

“We currently run medical oncology on our campus, but this will bring radiation and allow us to expand our program,” with Oregon Health & Science University, Thorsen said.

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