Healthcare leaders and local legislators gathered for a public forum hosted by the Mount Pleasant Chamber of Commerce’s Government Relations Committee to discuss pressing issues facing the healthcare system in Southeast Iowa.
Dr. Mike McCoy, President and CEO of Great River Health, and Teresa Colgan of Henry County Health Center provided an update on critical healthcare concerns, including workforce shortages, Medicare Advantage programs, and hospital capacity issues.
Medicare Challenges and Administrative Burdens
One of the primary concerns raised was the administrative burden imposed by Medicare Advantage (MCO) programs. Healthcare leaders noted that these programs often create complex, inconsistent rules that hospitals must navigate, leading to delays and inefficiencies in processing claims.
“We have some that just automatically deny claims, regardless of what the claim is for, which leads to unnecessary appeals and reprocessing,” Colgan explained. “It doesn’t add value and creates a challenge for both healthcare providers and consumers.”
Due to these challenges, some health systems have chosen to drop low-volume insurance plans that failed to meet operational expectations. While this impacted a small number of patients, Colgan emphasized the need for patients to carefully evaluate insurance plans to ensure they meet their needs.
Hospital Capacity and Patient Transfers
Healthcare facilities in Iowa are also struggling with hospital capacity issues, particularly when it comes to transferring patients to higher levels of care. Dr. McCoy highlighted that major hospitals, including the University of Iowa, are often at full capacity, leading to delays in patient transfers.
“Patients are sometimes boarded in emergency rooms for days while waiting for an available bed,” McCoy said. “This is especially challenging for patients with mental health diagnoses, including adolescents, who often face the longest waits.”
The issue is particularly pronounced in rural hospitals, where options for patient transfers are limited. While some patients can be sent to West Burlington more easily than Iowa City, capacity issues remain a statewide concern.
Severe Healthcare Workforce Shortages
Workforce shortages continue to be one of the most significant challenges facing rural healthcare providers. According to McCoy, Iowa ranks 44th out of 50 states in physicians per capita and is last in the country for the number of OB-GYNs per capita.
“If you don’t have enough physicians, you don’t have a service line, and if you don’t have a service line, people are forced to travel farther for care,” McCoy explained.
The problem is even worse in rural areas, where 70% fewer physicians practice compared to urban parts of Iowa. Currently, only 38% of counties in the state offer labor and delivery services, forcing many expectant mothers to travel long distances for care.
To address these shortages, McCoy highlighted ongoing efforts at the state level, including Governor Kim Reynolds’ rural healthcare workforce bill. The proposal aims to consolidate loan repayment and recruitment programs while increasing funding from $4 million to $10 million. Additionally, the state hopes to expand residency training programs, which could add 150 new residents per year over the next four years.
“There’s a lot of data showing that where medical students complete their residencies significantly impacts where they choose to practice,” McCoy noted. “So increasing training opportunities in Iowa is key.”
Addressing Rising Cancer Rates and Preventative Care
The discussion also touched on concerns over rising cancer rates in Southeast Iowa. Lawmakers and healthcare leaders acknowledged that limited access to medical care, including cancer screenings, may contribute to the trend.
“There’s evidence that Southeast Iowa has some of the highest cancer rates in the state, and part of that could be due to patients not getting diagnosed early enough,” McCoy said.
During the pandemic, many elective procedures, including colonoscopies, were postponed, creating a backlog of patients needing screenings. Healthcare providers are now working to address the delay and encourage the use of at-home screening kits.
Looking Ahead
While many of the challenges discussed are long-standing, healthcare leaders remain hopeful that legislative efforts and new policy initiatives will help address workforce shortages, improve access to care, and streamline administrative processes for providers.
As discussions continue, local hospitals and legislators emphasize the importance of community awareness and advocacy in shaping healthcare policies that best serve Iowa’s rural populations.