September 20, 2017

Summer Town Hall Q&A – Jackie Medland, President/CNO, Highlands-Cashiers Hospital

By Jackie Medland
President/CNO, Highlands-Cashiers Hospital

As President of Highlands-Cashers Hospital, it is my goal to work with everyone who has a stake in our future – from patients and nurses to physicians, CNAs, therapists and Board members.

To that end, one of my top priorities is driving a continuing dialogue with the community through a variety of forums: quarterly Town Hall Meetings, my monthly newspaper columns and this Q&A page.

Here, I present the questions I hear most from our community and provide timely, fact-based answers. The content will change as our services and programs grow. I’m grateful for your support of Highlands-Cashiers Hospital, the Eckerd Living Center, and our community practices, and I look forward to partnering with you to create a stronger and healthier community.

Q: What is the latest information on the Mission Health/BCBSNC contract negotiation?

A: Each year, we face rising costs for care, including wage increases and higher drug, supply and medical device costs. We are asking for a mid-single digit increase from BCBSNC. However, they are offering us a “0 forever” increase. This is not sustainable. For timely information on contract negotiation status, please refer to the website, which is updated continually.

Q: Our community is growing – how is Highlands-Cashiers Hospital responding to this growth?
A: First, we need to determine what type of growth we’re experiencing – seasonal or year round residents, young families or older adults? We are currently gathering this data by analyzing zip code information and existing demographics.

Q: What is the hospital doing to address the issue of physician stability?
Recruiting and retaining physicians has historically been a struggle. We now have a total of eight providers across the Highlands and Cashiers communities; we are also being approached by many physicians who either are looking to relocate or provide temporary support to Highlands-Cashiers Hospital during times of high demand, like the summer.

Q: We need more specialists – like cardiologists, pediatricians, etc., whose services can meet the demand that our growing communities present. Are Highlands-Cashiers Hospital and its community practices planning to acquire more specialty physicians?

A: We can no longer afford full-time specialists entirely dedicated to serving Highlands-Cashiers Hospital. We intend to investigate specialty satellite clinics as a way to make these resources available to the community. I also regularly connect with our sister hospitals, Angel Medical Center, Transylvania Regional Hospital, and Mission Hospital, for resources to address this issue. For example, cardiologist Dr. William Wharton of Mission Hospital is available one full day, every other week through Mission Primary Care at Highlands-Cashiers Hospital. When in doubt about the availability of a service, call (828) 526-1DOC.

Q: It seems like doctors are having to see more and more patients per day; how many patients, on average, do your physicians see in a day?

A: The average number of patients seen by our physicians is 18-20 per day, but this varies based on the individual patient conditions.

Q: Some community members have experienced long wait times for ambulances – can this be resolved?
A: Previously, our small fleet was stressed due to a lack of available vehicles and the vast areas they were required to serve. With the addition of a new Macon County-based ambulance to the fleet, we anticipate that wait times will be reduced. We monitor this data carefully each month.

Q: How does Mission Health strengthen Highlands-Cashiers Hospital – what are the advantages to being part of Mission Health System?

A: There are many: If Highlands-Cashiers Hospital patients need to be transported to Mission Hospital for procedures or services we don’t offer, such as complex stroke treatment, they can be flown via MAMA to Mission Hospital within 30 minutes; our status as a member hospital also allows us important access to specialty expertise via virtual care and telemedicine. Mission Health strengthens us as a rural Critical Access Hospital.

Q: How has the role of the hospital Board changed over the last several years?
A: Historically the Board assumed much greater responsibility in the management of the hospital’s operations. Highlands-Cashiers Hospital President Jackie Medland now oversees this work. The board now acts as an advisory body that represents the community’s interests, and ensures the quality of healthcare.

Q: What role does the Highlands-Cashiers Hospital Foundation play in the life of the hospital?

A: It is difficult to operate the hospital at a “break even” level, primarily due to our season-driven patient volumes. We rely on the Foundation to support our operational losses and sustain healthcare for this community. Last year we received $1.4 million from the Foundation to offset operational losses, for which we are very grateful.

Q: Care navigation is a unique issue for Highlands-Cashiers Hospital patients who may live just half the year here. How can patients, especially those with complex medical needs, such as Alzheimer’s, ensure that they get the most coordinated care possible?

A: Patients should make sure they establish a relationship with a primary care physician here, even if they do not spend the majority of the year in the Highlands-Cashiers area. We are currently evaluating how best to shore up the gap that exists when care is delivered across multiple states.

Q: Does Highlands-Cashiers Hospital plan to expand its health and wellness programs?

A: Absolutely – robust health and wellness programs address the whole individual, and we are interested in preventing, as well as diagnosing and treating disease. We’ll be expanding our focus on health and wellness, with offerings such as nutritional counseling and alternative therapies.

Q: What are the most important services Highlands-Cashiers Hospital and its community practices offer to our community members?

A: As a rural Critical Access Hospital, we provide primary care, emergency care, and basic diagnostic tests. We also have access to specialty services through Mission Health.

Q: Mission Health is repeatedly referred to as a “Top 15” health system. What does this mean?
A: In order to be named a “Top 15” health system, as defined by Truven Analytics®, a health system must provide high quality care at lower cost. Other “Top 15” characteristics include better survival rates, shorter ED wait times, fewer complications resulting from hospitalization, and shorter patient length of stays when compared to other hospitals.

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