FARMINGTON — A group of about 50 state legislators heard about complex regulations, bad debt and opportunities in preventive care at a presentation Thursday morning on challenges and opportunities in rural health care.

Speakers with Franklin Community Health Network addressed the lawmakers, many of them newly elected, at Franklin Memorial Hospital as part of a three-day bus tour designed to inform the legislators on various issues about which they will be asked to make policy decisions. Sponsored by the nonpartisan Maine Development Foundation, the tour included stops at other institutions, such as schools and businesses.

Speakers in Farmington noted that many of the health care regulations they cited are imposed by the federal government.

Newly elected Rep. Andy Buckland, R-Farmington, said after the talk at Franklin Memorial Hospital that the events were all part of a learning process. He said the presentation showed different creative problem-solving strategies used in Franklin County.

“Some of what they showed us seems to be very successful and may serve as models for other places,” he said.

Also in attendance was Rep. Scott Cyrway, R-Benton, who said he is concerned about the cost of people receiving government-paid health care.

Cyrway said complicated health care regulations have pushed and pulled people sometimes in directions they don’t want to go, citing an incident in which a constituent of his was told to travel out of county to get a test that was available locally, but at a price his insurer didn’t want to pay.

Rebecca Arsenault, president and CEO of Franklin Community Health Network, told the group that her network successfully has helped people become healthier, but said the nature of the health care economy means the network tends to lose financially when programs work.

“When we do the right thing, we are punished as an organization, usually financially,” Arsenault said.

For example, over the last several years, Arsenault said, the hospital emergency room has reduced visits by 7 percent by redirecting non-emergency patients to primary-care doctors. While those changes saved patients and insurers money and patients got the level of care they needed, Arsenault said the hospital lost out on money that would have been paid for expensive ER visits “and the revenue for this hospital has plummeted.”

Another challenge, Arsenault said, is an increase in patients needing charity care. In the last fiscal year, the hospital was not paid for about $7.7 million in care. About $4.2 million of the total was for charity care and $3.5 million was in bad debt, bills the hospital couldn’t collect. Franklin Memorial’s annual budget is about $70 million.

Arsenault said most people who received uncompensated care were ages 58 to 64, were uninsured and had chronic, acute medical problems.

The county’s demographics pose particular problems, Arsenault said. She said Franklin County hasn’t experienced meaningful population growth in a decade, about 17 percent of residents live in poverty, about 17 percent have disability status, 20 percent did not graduate from high school, and the community’s elderly population is expected to increase in proportion over the next decade.

The health network is also the largest employer of primary-care doctors in the county and hires them at a financial loss, Arsenault said.

Kaitlin Schroeder — 861-9252

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