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Caring for the elderly a focus in North Dakota

One of the healthiest states in the nation, North Dakota is also known for providing high-quality healthcare at a low cost, according to the Executive Director of North Dakota Medical Association Courtney Koebele. Healthcare Finance News Associate Editor Kelsey Brimmer spoke to Koebele recently about some of the biggest healthcare issues in North Dakota.

Q: What do you think residents of North Dakota believe are the important healthcare issues in the state?
A: We have a large Medicare population here. We have approximately 108,000 people on Medicare in North Dakota - and in some specialties as many as 50 percent are Medicare patients. So what we're looking for is support on the federal level of the Medicare program and fully funding physicians and hospitals on payments for Medicare patients because that's a program that is not going to go away. I think people in our state do realize there's a cost to that, however, and I think that it's an issue of balance

Q: North Dakota is one of the healthiest states in the nation and among those in which people tend to live the longest. How does this affect healthcare in the state?
A: We are a healthy state. It goes back to the large population on Medicare as well. It's also one of the top in quality and top in full-utilization of Medicare funding. We're one of the states that gets the least in Medicare funding but one of the top in quality, and we're very proud of this fact. Our physicians and hospitals are very judicious in their use of the resources.

We do have an older population. It's frustrating sometimes because we're at the lowest point in Medicare reimbursement. It's a fight we've been having with the Frontier Amendment (which) was an amendment unfortunately contained in the healthcare bill. I say unfortunately because the healthcare reform bill has a bad name here in a lot of circles. The Frontier Amendment brought our reimbursement rate for Medicare up to 1.0 - we used to be below 1.0 in reimbursement because of the rural nature of our state and other factors. It's frustrating for me as an advocate for healthcare in North Dakota because we are top in quality, low in usage, but we don't get paid at the same rate as some other states.

Q: Can you tell me a little bit about where North Dakota stands as far healthcare IT?
A: We are very active in the North Dakota Health Information Exchange (NDHIN) – our state's health information network (HIN), which we are in the process of establishing. The state provided funding for NDHIN the first couple of years and as a state, we're very engaged with many physicians interested in the process. I think we're one of the leaders nationwide as far as how our state's HIN is going forward. We have concerns about wanting to always have the physicians' and patients' safety and well-being at the forefront at all times, but we're working very well with the NDHIN.