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Rural doctor talks success, health care

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Articles - April 2010
Wednesday, March 24, 2010
Grande Ronde Hospital CEO Jim Mattes

Jim Mattes marked his 25th anniversary as Grande Ronde Hospital’s CEO this January, making him the longest-serving hospital CEO in Oregon. The National Rural Health Association honored Grande Ronde Hospital in 2009 with its Outstanding Rural Health Organization award, and it’s the first hospital in Oregon to use a robot allowing specialists to consult with patients remotely. Mattes is a native Oregonian who has been the CEO of small Oregon hospitals since he was 25.

What’s the biggest change you’ve seen at the hospital?
Our facility, when I arrived here, had 84 acute-care beds. Today we operate as a critical- access hospital with 25 acute-care beds. It’s a change in the business model from inpatient to outpatient care driven by technology and pharmaceutical advances. It’s made a radical change in how services are provided in hospitals. It’s a good thing. Patients spend more time at home.

Since you began at Grande Ronde, the hospital has eliminated long-term debt and revenues have increased substantially. How did you do that?

We’ve increased our market share over the years by expanding the scope of services. People are staying home for health care perhaps more than what we’ve seen historically. That translates into increased revenues. We are a very low-cost facility. We’ve kept our prices well below our peers’.

How can innovations such as telemedicine and the robot Grande Ronde uses improve the quality of rural care?
Telemedicine is not bound by states. We can have a relationship with any medical system in the country. We use the robot to consult with [sub-specialty physicians] and they assist our physicians with the management of extremely complex patients who otherwise would have to be transferred…or worse yet, if they were too sick to be transferred and if they have to stay here, they might have expired in the past. Having that sort of relationship with sub-specialty physicians improves the quality of care overall because it brings to the bedside of that patient specialty medical care that is not available in rural America.

Your thoughts on health insurance reform?
It looks like what’s going to evolve, if anything, is something significantly stripped down, which I’m not sure if it’s in anyone’s best interest. The bills that did pass the House and Senate didn’t go far enough in terms of reforming Medicare. With the bankruptcy of Medicare imminent, it seems that should have been a central part of what’s happening in Congress. Health care reform is going to have to happen. What I’ve seen in my career, unfortunately, is increased regulation, which has created enormous inefficiencies. I don’t see anything on the horizon that will change that.

What do you think about Oregon’s efforts to provide health insurance to every child and expand the Oregon Health Plan?

It’s a very positive and good thing. The dilemma for Oregon is funding — how to pay for what you want to do in a state that is running a deficit and struggling to cut costs. The state is going to find it very difficult to sustain some of the promises that have been made.

Other big challenges?
Electronic health records. I’m really awestruck at how expensive and draining it is on an organization to go through that transition. We had no idea when we started going down that path what it entailed. The sophistication of the software is lacking. There are lots of bugs and no standardization from one hospital to the next.

Planning another 25 years as CEO?
(Laughs.) If I live that long.


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