State Hears Arguments for Approval
Speaker after speaker from Central Maine Healthcare—the sponsor of the ambulatory surgical center (ASC)—described the value and potential of the project, which would be the 17th ASC in Maine and the first and only ASC affiliated with a health system but untethered to hospital facilities or high costs. The roster of speakers also included representatives from insurance companies, employers, business leaders and independent physicians.
In what might be another first, the “virtual” hearing by the State of Maine’s Certificate of Need unit was conducted via the Zoom platform.
“The community has asked us for this service, which would provide much more affordable outpatient surgery and procedures close to home,” said Jeffrey L. Brickman, FACHE, CEO of Central Maine Healthcare. “We’ve been in the Mid-Coast for more than a dozen years and this is a natural progression of the care we offer the community.”
Currently, CMH is represented in three locations in Topsham, including the multi-disciplinary Topsham Care Center, Maine Urgent Care and Topsham Family Medicine.
The need for an ASC exists because while outpatient surgeries are provided at a local hospital, those procedures are billed at nearly 50 percent more than those at a typical ASC. Many patients face the choice of paying the high prices charged in hospitals or traveling long distances to receive care elsewhere.
Dr. David Salko, who has practiced at Topsham Family Medicine for 12 years and lives locally, told the state officials of patients who have made the choice to forgo important screening exams and surgeries because their health care deductibles and or co-pays are high.
The $14 million ASC would be constructed at the Topsham Fair Mall adjacent or nearby the Care Center and the urgent care site.
The facility would:
- Be housed in a 20,000 foot building with two operating rooms and four procedure rooms
- Offer care from top-flight CMH providers
- Offer cancer care and reconstructive surgery, Ear, Nose and Throat, Gastrointestinal procedures and Urology care.
- Provide care to MaineCare and Medicare enrolled patients as well as the insured (CMH also provides a disproportionate level of free or charity care throughout its system).
The project has won the endorsement of:
- Anthem, the largest private insurer in Maine.
- Harvard Pilgrim
- The Healthcare Payers Alliance of Maine (representing employers and business owners)
- Martins Point (the largest group of primary care providers in Maine)
- The Board of Topsham Development Inc., the municipal economic development panel
“The Midcoast needs additional alternatives to support models premised on consumer choice,” said Denise McDonough, president of Anthem in Maine. “Looking to greater Portland, as well as New Hampshire and other markets, we see that hospitals can successfully coexist with ASCs as the delivery system seeks to meet the choice, access and affordability needs of patients.”
Nationally, in-hospital surgeries are projected to decrease over the next decade as patients increasingly turn to the convenience and safety of ambulatory centers. And, as the government and insurance companies scrutinize costs and push toward more value-based care, outpatient surgery is expected to increase by 11 percent in the next two years. The federal government has responded by adjusting Medicare payment policy to be more neutral regarding ASCs.
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