Bresnahan, Dr. Oz survey the state of healthcare in Northeast Pennsylvania

NORTHEAST PENNSYLVANIA — Rep. Rob Bresnahan (R, PA-08) brought Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services (CMS), to Scranton on December 5, there to meet with local health care leaders and to hear their needs and challenges. 

The visit came in a year of major national changes to the landscape of health care, including a budget bill that stripped nearly $1 trillion from the Medicaid program, an addition which created a $50 billion fund for rural health care and a political showdown over the upcoming expiration in expanded health insurance tax credits. 

Speaking to the press following a closed-door roundtable discussion with local leaders, including representatives from Wayne Memorial Hospital and from Pike County, Bresnahan said the discussion had been “fantastic.”

“The concept of today’s roundtable [was] to hear from all different perspectives and ultimately give me marching orders to go back to Washington DC and find out intuitive ways that we can enhance health care for people in northeastern Pennsylvania,” said Bresnahan. 

Dr. Linda Thomas-Hemak, president and CEO of the Wright Center, said it would take “unprecedented collaboration” between stakeholders to get to everyone’s preferred future, and expressed enthusiasm for the spirit of collaboration evidenced in the day’s roundtable. The Wright Center trains health care professionals and operates primary care centers throughout Northeast Pennsylvania. 

“There was a humble acknowledgement of [how] we have a really complex debacle in front of us, which is American health care,” Thomas-Hemak said. She added that solutions to the problem would only be found by close cooperation between the federal government’s oversight and the people on the ground doing the work. 

Wayne County

Wayne Memorial Hospital CEO Jim Pettinato said that the roundtable had helped him get a better understanding of some of the priorities of the federal administration. These priorities had been communicated in writing, but it was nice to get to communicate about it, he said. 

In addition, Pettinato said, the roundtable allowed local health care leaders to explain to Oz their specific positions and to describe the health ecosystem of the area. 

That made for an interesting takeaway, according to Bresnahan: Wayne Memorial, as a smaller hospital system, couldn’t do the same things that, say, Scranton’s Geisinger Community Medical Center could, in terms of information technology deployment and the like. He said it would be important not to penalize smaller hospital systems with the metrics imposed by the federal government. 

Bresnahan has been working to shape the Rural Health Transformation Fund (RHTF), a $50 billion program to upgrade rural health across the country. The fund got included in the Big Beautiful Bill as a means of garnering support from legislators concerned about the bill’s overall impact on health care, including Alaska’s Sen. Lisa Murkowski. 

Oz said that the program worked by giving money to the states to work with, rather than having the federal government hold it; the states’ governors and legislatures knew better how to improve their own health care systems than did the federal government, he said. 

Speaking with the River Reporter, Pettinato said the RHTF wouldn’t necessarily assist Wayne Memorial specifically, but that the money it put into the health care would help make changes to systems in ways that would make life easier for the hospital, such as through improving health information exchanges.

Pike County

“Pike County holds the unique statistic that we’re probably the only county in the state that has no hospital and no urgent care,” said Pike County Commissioner Matt Osterberg. “Talk about underserved communities—we are truly underserved.”

That has ripple effects throughout the rest of Pike County’s services, Bresnahan said. There’s an incredible “amount of wear and tear on their EMS providers—sometimes three or four hours they are out of service where they are repositioning their patients, sometimes to Wayne Memorial or to one of the Geisinger facilities.”

Pike has attacked its health care issues by putting money into its EMS providers. Osterberg said the county has a matching system in which its municipalities put in $2.2 million for EMS and the county puts in $2.2 million of its own money to match. 

Pike is also looking to attack the issue on another front, by partnering with Northwell Health to build out a health care system in the county; see sidebar for more. 

Rural health care models

Oz said that the RHTF money would help develop new systems for delivering care in rural America, which in turn could inspire solutions for urban health care. 

Oz praised the Wright Center for its ability to train practitioners in a rural setting. Practitioners didn’t like coming to work in a region they wouldn’t want to hang out in, said Oz—big-city doctors will likely stay in the big city, but doctors trained in a rural area will be more likely to put down roots and to stay. 

Providing quality care was important for a number of reasons, Oz said. Bad care was expensive—it cost the health care system both to provide and, later, to fix. 

“By providing quality care, you both reduce the cost to care in aggregate, but you also boost productivity,” he said. “When people are healthy, they work longer, they work better, and that increases the productivity of our nation, and for reasons like this, it’s mission critical.”

Pettinato said that health care systems both support the health of individuals and provide economic benefits to their areas. 

“It’s not only about the health of the individuals, but it’s the health of the community, and I think the administrator [Dr. Oz] was very attentive to that,” Pettinato said. 

Health insurance

One of the projected impacts on health care systems locally and across the country is the potential expiration of Enhanced Premium Tax Credits. 

These tax credits, introduced during the COVID pandemic to help subsidize health insurance purchased through the individual marketplace, are set to expire at the end of the year. According to the Robert Wood Johnson Foundation, that would mean around a 110 percent increase in costs for holders of the mid-tier silver plan in House of Representatives districts NY-19, covering Sullivan County, NY, and PA-08, covering Wayne and Pike counties.

The federal government looks set to vote on an extension to the credits, which Democrats in Congress required as a condition for voting to end the government shutdown. Exactly what plan will be voted on—and whether it will have the support needed to pass—remains unclear. 

Bresnahan said that he has been part of several different conversations. He would support a two-year extension with reforms implemented both in years one and two.