Plan unveiled for Rural Health Clinic

With continuing focus on achieving a Rural Health Clinic (RHC) in Pagosa Springs, Pagosa Mountain Hospital CEO Brad Cochennet recently unveiled a three-pronged plan that will fully utilize available space, while extending healthcare coverage community-wide.

As outlined, the clinic will occupy adjoining Pagosa Mountain Hospital (PMH) space that once housed the former Dr. Mary Fisher Medical Center. While initial services won’t necessarily occupy the full 3,000 square feet every day, Cochennet’s plan envisions several “layers” of use within the same area.

“We would like to combine the ability to have scheduled appointments for patients along with a walk-in Urgent Care capability to serve the less acute patients that don’t need full Emergency Room costs and service,” a portion of the plan reads.

By utilizing existing infrastructure and a staff of at least 50 percent midlevel providers, Cochennet claims patients will have access to more timely primary medical care, while operating expenses are spread over broader patient services.

Midlevel providers are licensed clinical professionals who examine patients, diagnose injuries or illness, and prescribe treatment under the direct supervision of a physician. They include physician assistants, nurse practitioners and certified registered nurse anesthetists.

Too, a RHC receives two to three times the federal reimbursement afforded a private primary care facility, thus expanding Medicare and Medicaid services, while reducing costs and subsequent patient charges.

An early detection function will serve as the clinic’s second layer. According to Cochennet, “Beginning July 1, 2009, we will be providing to the community the Colorado Center for Prevention of Disease’s early cardiac detection screening service.”

Cochennet suggests the service will utilize only modest space — perhaps just one office — but its presence will be significant, and an important step forward in establishing a campus image with extended community services. He added that additional early detection capabilities aimed at other diseases would be forthcoming, as funding opportunities arise.

Cochennet’s plan describes a third clinic layer as the development of specific service lines that will provide specialists and specific programs to the community. It mentions, for instance, development of sports medicine and women’s health capabilities.

Apparently, Dr. Tim Mazzola, a local physician based at Pagosa Springs Family Medicine, has a particular interest and specialized background in sports medicine, and would likely work in concert with orthopedic physicians and surgeons from Durango. Orthopedic doctors use both surgical and non-surgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors and congenital conditions.

Further in his plan, Cochennet indicates he, the hospital staff and others in the Upper San Juan Health Service District are now looking into possible development of a women’s service line in cooperation with Four Corners OB/GYN & Aesthetics.

“Through that relationship,” he says, “we’ll be able to provide more women’s services in Pagosa and coordinate the upstream specialist care. We don’t anticipate developing a birthing center capability at PMH, but can provide services that surround and support women’s care. The potential to perform gynecological procedures can also be developed that would utilize our surgical capability.”

Cochennet concluded his plan by suggesting, “When we have the clinic fully operational with the three layers of operation indicated above, we will be fully utilizing the space and will be sharing hospital and clinic resources to keep the costs low … . The ability to have the added capacity in the community, an increased depth of service capabilities and to provide early detection will position PMH in the eyes of the community as the place for medical care and related services.”

In respect to startup money in the form of a $500,000 Department of Local Affairs (DOLA) matching grant the district will apply for in July, Cochennet said, “We’ll find out in September or October, then we’ll know if we’re funded. After that, it’ll take about six months to get it (the clinic) open.”