A small, independent midstate hospital fights on, as health care debate rages

(Lewisburg) — The Trump administration wants to get rid of the Affordable Care Act.

House Republicans recently passed the American Health Care Act to dismantle much of the ACA.

As the Senate crafts its own version, there’s plenty of uncertainty about the future of Obamacare.

Nearly every major health care group opposes the House plan.

They’re all watching to see what might come next.

Tiffany Funk owns two salons in north-central Pennsylvania – Untangled and Untangled Salon Too.

“I had cherry cola hair,” she says. “I had, yeah, the bright red, awful looking hair. Brown hair, blonde hair. I just liked playing with it. So I learned different colors and then I realized that I wanted to do it on everybody else.”

She’s always lived in the area, growing up in Northumberland County.

She remembers riding bikes in the neighborhood all day as a kid.

And the community feel is still there – her family has never moved away.

“When I first started dating my husband, he was like, who’s that, because they’d say hi to us when we’d be out. That’s a cousin. Okay. Next time we’d see somebody, and that’s a cousin again. He’d say, you can’t be related to everybody!” says Funk.

So about six years ago, when Funk was pregnant with her first son, she was looking for a midwife, and found one at Evangelical Community Hospital.

“I just love it,” she says. “It’s more like a small-town kinda place. They treat you as a small-town person, they listen, take their time. It’s probably the best part.”

A “small-town” hospital

Evangelical, or as many people simply call it – Evan – is a smaller hospital based just north of Lewisburg’s downtown.

It doesn’t have the high-level specialty care of a Penn State Health or PinnacleHealth or WellSpan Health, but it separates itself in other ways.

“We’re able to do some things from the patient experience standpoint that I feel are our advantage. You’re not lost in a large system,” says Kendra Aucker, president and CEO of Evangelical Community.

“We sort of have a model of ‘three feet and greet’. So when you walk down the hall, if you get within three feet of someone, you’re expected to say hello,” she says.

She says Evangelical has made itself into more than a place to get care.

It’s a community resource.

However, it’s faced many challenges, and they all stem from one thing: its size.

The challenges

“When you’re small, your purchasing power is less,” says Aucker. “So when you go to buy joints or when you go to buy drugs, you’re not part of a really big pool that you’re purchasing, so you don’t quite get things at the same reduced price.”

Evangelical not only misses out on those discounts but Aucker says bigger projects also put more stress on its budget, compared to a larger system.

So when it switched from paper records to the electronic health record, it was a bit of a ‘hold your breath’ moment.

“That’s why you’re seeing consolidation across the market. I always say I never know quite what’s going to happen with us.”

Latest developments

Aucker says the American Health Care Act, which is still pending in Congress, could squeeze things even more.

President Obama’s Affordable Care Act provided hospitals with a trade-off: give up some payments you get every year from the federal government to cover your costs in exchange for more people getting insured.

But if the Republican plan passes and the uninsured rate jumps up again, Aucker is bracing for a double hit – more people who can’t pay for their care, and a federal government that won’t restore payments it provided every year.

“When you do strategic planning in our world, if you can come up with a three year plan, you’ll be lucky to get through a year and be following that plan,” says Aucker.

It’s worth noting that because of their size, smaller hospitals have less wiggle room in their budgets.

Evangelical is making a healthy profit every year but still, Aucker says it walks a fine line.

It has managed to forge relationships with Geisinger and UPMC Susquehanna to help it along as well.

Aucker says, “Independence doesn’t mean isolation. We would get the box checked works well with others if we were in school.”

Hope for the future

Back in the salon, Tiffany Funk, pregnant with her third child, is hoping her first choice for hospitals manages to navigate the choppy health care waters.

“Other hospitals in the area, you have to park like a mile away,” she says. “Basketball under your shirt, it’s not helpful to walk that far and not be out of breath when you get inside.”

Funk says no one at Evangelical Community is ever in a bad mood.

Really, she said no one.

She remembers a recent trip she had to take to the emergency room after she fell and sprained her ankle.

“One of the nurses actually helped to take care of my boys when I went back to have the x-ray taken. And I just felt like they were okay.”

“They were with me, and they were okay. So I had the x-ray taken and they took care of me right away, but it’s just the fact that I could take my boys, and somebody was there to help with that. I don’t know that I would get that anywhere else.”

Meanwhile, Aucker says she doesn’t know what the future holds, but she’s hopeful Evangelical can continue to be an independent community resource, no matter what happens in Washington.