IMPORTANT HEALTH CARE INFORMATION
Do you purchase an individual health care plan through MNSure marketplace?
Is your premium increasing dramatically? Is your network changing?
There is a new plan on the market place that will limit a persons network.
We at the Center for Specialty Care value all our patients and want to
continue to provide you the quality care you deserve. If you are impacted
by this network change, call our office at (507) 238-4949 and find out how
we can work with you to continue to provide your care in 2018.
Dr. David Chang, Neurosurgeon
Now Seeing Patients at the Center for Specialty Care
Dr. David Chang is a Board Certified Neurosurgeon who will see patients at the
Center for Specialty Care beginning November 2016. He received an M.D. and
Ph.D. from John Hopkins University School of Medicine. He completed residency
in neurosurgery at the Mount Sinai Hospital, and neuro-oncology fellowship at
the National Institute of Neurological Disorders and Stroke.
Dr. Chang provided clinical assessment and treatment for patients with spine and
Dr. Chang began his career as a neurosurgeon at Regions Hospital in St. Paul, MN.
He has also practiced at St. Luke’s Hospital in Duluth, Rochester Brain & Spine, and
(most recently) Baptist Hospital in Columbus, MS.
In his spare time, Dr. Chang enjoys photography, playing chess, reading history and
spending time with his wife and son.
To schedule an appointment with Dr. Chang call the Center for Specialty Care
at (507) 238-4949.
BCBS contract change affects northeastern Minnesota
SARTELL — It’s been an emotional few years for Sarah Gill.
In 2013, at just 22 weeks pregnant with her youngest child, Gill’s son was diagnosed with congenital diaphragmatic hernia — a condition that causes a hole in the muscle between the chest and the abdomen.
“He was given only a 50 percent survival rate,” Gill said.
Having a pediatrician that would be available, responsive to a concerned parent and able to foster a personal relationship took on another meaning for Gill.
That’s when the Oak Ridge Elementary School teacher discovered Dr. David Smith, founder of Sartell-based Sartell Pediatrics, 111 Second St. S.
“Sartell Pediatrics is like a second home to my family,” Gill said. “We have weekly appointments here for my youngest. We are here all the time.”
Gill, who suddenly lost her husband in 2014, can’t imagine starting a search for a new pediatrician.
But that very well may be a reality come Feb. 1 when one of the state’s major insurance providers terminates its contract with a representative of some independent area clinics.
Blue Cross and Blue Shield of Minnesota has terminated its relationship with Duluth-based Integrity Health Network. As a result, Blue Cross and Blue Shield patients may have to pay out-of-network costs to receive care at IHN-affiliated clinics.
IHN President Jeffrey Tucker estimates approximately 30-50 percent of the patient base across IHN-affiliated Minnesota clinics will be affected.
Locally, those clinics include Sartell Pediatrics and Dr. Christopher Wenner’s practice in Cold Spring.
Tucker said IHN negotiates insurance provider contracts with independent physician practices primarily across northern Minnesota and northwestern Wisconsin. Tucker said this allows the physicians to focus on treating patients. The IHN network has about 200 physicians in 47 independent clinics in 23 communities.
Blue Cross Blue Shield is working on securing “separate and customized agreements with all of the individual doctors and clinics currently represented by Integrity Health Network,” according to a statement provided by BCBS Senior Public Relations Specialist Shelley Lange.
“Blue Cross believes that continuing to negotiate rates through a third party is not in the best interest of our members,” the statement said. “Additionally, having separate agreements provides greater opportunity to address rising health care costs while ensuring that local health care options remain affordable.”
But that solution offered by Blue Cross may not be feasible for clinics like Sartell Pediatrics.
“Our ability to drive a fair market rate lies in that network,” said Jill Smith, Sartell Pediatrics administrator. “At the network level, we are better able to negotiate a contract.”
Sartell Pediatrics is a small practice, with one doctor, a physician’s assistant, a pediatric nurse practitioner and a licensed psychologist.
“When I think about the future (of our clinic), this will be impossible to maintain,” she said. “And right now, we are not in a position to take on a clinic level contract.”
Tucker said Blue Cross and Blue Shield made the decision about IHN in late August. It has not been posted on the Blue Cross and Blue Shield website. However, letters have been provided to insurance brokers indicating the decision to end the contract with IHN.
Tucker said the decision affects almost all Blue Cross policies, including Medicare Advantage, supplemental Blue Cross products, employer-sponsored insurance and medical assistance plans.
Blue Cross patients make up about 30 percent of the approximately 1,500 patients treated at Sartell Pediatrics.
“From a business standpoint, losing 30 percent of your customers in any industry segment is very difficult to overcome,” Smith said. “This is difficult anywhere, but especially in this region, in an area that has been hit hard over recent months and (where) there are very few primary care options available.”
The idea of forcing patients to find other options does not sit well with Dr. David Smith.
“We are all working toward the same goals as far as making sure that the patient gets good health care for a reasonable cost,” Smith said. “And so that’s the conversation that needs to occur. How can we come to some sort of agreement where the contracts are mutually agreeable and we can continue to see these patients? It benefits both of us obviously as a practice and as patients to be able to have access to those providers that they wish to see.”
Tucker said calls to open negotiations between Blue Cross and IHN were rejected as recently as Nov. 8
After being notified, Gill still isn’t sure what to do. Her employer only provides insurance through Blue Cross and Blue Shield. And without access to other insurance providers, she is faced with the idea of parting with Dr. David Smith and his team who have worked so closely to help care for her children.
All in the hopes of avoiding large out-of-network medical costs.
“It’s scary,” Gill said. “I don’t want to think that it’s a possibility, honestly.”
Group of independent clinics loses Blue Cross Blue Shield contract
A Duluth-based network of specialty clinics and primary clinics, located mostly in small towns in Minnesota and Northwestern Wisconsin, will be out of Blue Cross Blue Shield’s insurance network as of Feb. 1
“Blue Cross Blue Shield of Minnesota is cutting off access to good health care providers in order to pad their bottom line,” said Jeffrey Tucker, president of Integrity Health Network, during a news conference on Tuesday in the auditorium at the Fitger’s Brewery Complex.
Integrity represents more than 200 doctors and providers in 47 clinics and facilities located in 23 communities. Among them are Orthopaedic Associates of Duluth and the Lakewalk Surgery Center in Duluth; the Human Development Center in Duluth and other communities; Raiter Clinic in Cloquet; and the Cromwell Medical Clinic.
Integrity Health handles quality improvements, cost-of-care contracting, health plan and group purchasing negotiations and some “back-office operations” on behalf of all of the providers in its network, Tucker said.
Integrity does not represent Essentia Health or St. Luke’s.
The consequences of Blue Cross Blue Shield cutting ties with Integrity will be devastating for her clinic, said Teri Shelton, administrator at the Cromwell Medical Clinic. It serves about 2,000 patients, more than half of whom have some form of Blue Cross coverage, she said.
“From a clinic standpoint, the potential loss of over 50 percent of our patients would be hard to overcome,” Shelton said.
It also would be hard on patients, she said, because there’s no alternative close to the Cromwell facility — particularly considering that Raiter Clinic also is part of Integrity. Clinics in Moose Lake and McGregor — neither of which is part of Integrity — each are about a 25-minute drive away, she said.
Dr. Kenneth Ripp, who practices at the Raiter Clinic, said the insurer’s decision “would be a great hardship for our patients and our community, and it would compromise our practice philosophy. We could see the loss of many patients … many of whom have multiple problems, who I’ve been caring for for decades.”
Anne Dugan has been Ripp’s patient for only two years, but said, “I’ve been incredibly impressed with the care I’ve received. It’s incredibly efficient. I call, I get responses and I just feel like I’m a person there.”
Dugan, who lives on a farm near Wrenshall with her husband and young child and is expecting a second child in February, said she couldn’t afford the cost of out-of-network coverage. Although she directs the Duluth Art Institute, making medical appointments in Duluth would be “really, really difficult,” Dugan said.
“I’m frankly sad and a little panicked that Blue Cross Blue Shield would ignore rural Minnesota,” she said.
In a statement, Blue Cross Blue Shield said it was working to secure separate arrangements with the individual doctors and clinics represented by Integrity Health Network.
“Blue Cross believes that continuing to negotiate rates through a third party is not in the best interest of our members,” the insurer said in its statement. “Integrity Health Network is free to continue working with these clinics and doctors as a consultant group, which is standard practice within health insurance.”
Shelton wasn’t impressed by that argument.
“It’s because of the partnership that we have with Integrity Health Network that we’re able to provide the high quality of care that we have been providing,” she said.
She and Tucker also complained that Blue Cross Blue Shield hadn’t updated its website to advise patients of Integrity Health network clinics that they wouldn’t be covered after Feb. 1.
“And when you call customer service, Blue Cross Blue Shield representatives are telling their patients that absolutely we’re in network for 2017,” Shelton said. “But what they’re not telling us is that they may only be in network for one month. And at that point, they will not have the opportunity to change their insurance.”
The News Tribune was not able to obtain a response from Blue Cross Blue Shield to that contention in time for this story.
Tucker held out hope that there might be a legislative fix for the loss of the Blue Cross Blue Shield contract.
But state Rep. Jennifer Schultz, DFL-Duluth, who was aware of the situation, said there’s little, if anything, that state government can do.
State regulations require the insurer to have adequate coverage in the areas they serve, she said. But as long as Blue Cross Blue Shield meets those requirements, there’s nothing the Legislature can do to prevent them from dropping providers.
She has met both with the insurer and Integrity, Schultz said, and Blue Cross Blue Shield officials have said Integrity doesn’t offer the best value.
“A lot of these folks … complain about too much government regulation,” Schultz said. “And here they’re asking: What can the government do? We can’t. … If you want the private markets to work, this is what happens in private markets.”
Blue Cross Blue Shield of Minnesota also pulled out of the individual insurance market with MNsure this year.
Knee Pain to be addressed by the Center for Specialty Care
Jay Grabinoski, right, was sidelined from officiating high school football last year due to knee pain and stiffness. The OsteoArthritis program at Center for Specialty Care put Grabinoski back on the field within one week. Jay is pictured with Athletic Trainer Brant Boekelman who assisted Jay with his recovery.
A new procedure at the Center for Specialty Care in Fairmont, Minnesota may be just what the doctor ordered for individuals struggling with knee pain.
The OsteoArthritis program is designed for persons experiencing stiff knees, knee joint pain and/or grinding, knee joint pain with changes in weather, knee pain requiring over the counter medication, and decreased activity due to knee pain. Symptoms typically are worse in the morning or at the end of the day.
The program requires eight weeks of physical therapy in conjunction with Hyaluronic Acid injections, which are administered in the knee over a period of five consecutive weeks. A specialized knee brace is also part of the program.
What sets this program at the Center for Specialty Care apart from other programs is a specialized xray machine that, when used with a dye injected into the knee, pin-points the knee joint. According to athletic trainer at Center for Specialty Care Brant Boekelman, one-third of all knee injections given without xray or ultrasound guidance miss the knee joint.
Hyaluronic Acid is FDA approved and bonds with the joint fluid naturally to create a lubricating and cushioning layer in the knee. Reducing pain, inflammation and swelling of the joint, allowing the patient to enjoy everyday activities. The injections can be given every six months and there is no limit on how many times a patient can go through the program.
The OsteoArthritis Program is covered by Medicare® and most major insurance programs and the staff at Specialty Care will take care of the recertification process.
This non-surgical approach can have positive effects on persons with knee pain. The patient should regain normal knee function, restoring their lifestyle, and allowing them to return to the life they had given up on.
In 2015 the Center for Specialty Care performed the OsteoArthritis Program on eighty patients, with only eight of the patients ultimately needing knee replacement surgery.
Presentations on the OsteoArthritis Progam will take place at Heritage Town Center in Buffalo Center on Thursday, November 3 from 12 noon – 1 p.m., Armstrong Community Center from 12 noon- 1 p.m. on Thursday, November 10 and at Main Street Manor in Swea City from 12 noon – 1 p.m. on Thursday, November 17.
Anyone having additional questions or wanting to schedule an appointment should call the Center for Specialty Care at (507) 238-3383.
Reprinted with permission from the Armstrong Journal. Published October 26, 2016.
CSC is proud to announce the arrival of the
Hitachi AIRIS Elite
How the Hitachi AIRIS Elite provides an overall improvement in patient/provider satisfaction:
- Comfort for claustrophobic patients as well as larger body habitus
- 23% faster scan time than our previous MRI
- RAPID coils that offer the capabilities to decrease the scan time and increase image resolution
- The chances of re-scanning due to patient movement has been greatly reduced due to the allowance for more slices to be used at an expanded coverage of the anatomy being imaged
- Fat Separation is a new feature on the AIRIS Elite that makes use of the system’s stronger gradients and additional shim coil to give more of a “true” picture of the joint or other body part being imaged, minus the fat
- A noticeable clarity improvement makes the AIRIS Elite stand out over other open-sided MRI’s
- The updated scan applications of the AIRIS Elite provide increased contrast to images while decreasing the appearance of the artifacts (such as hardware implants) providing an overall improvement in image quality and patient/provider satisfaction
Call the Center for Specialty Care today to schedule an MRI by calling (507) 238-3379.
CSC presents Fairmont Cardinal Booster Club
with $640 Donation
The Center for Specialty Care, the area’s leading provider of sports medicine, is giving back to the community with a donation of $640 to the Fairmont Cardinal Booster Club.
“We, at the Center for Specialty Care, take great pride in supporting FHS athletics,” said Dr. Corey Welchlin. “We appreciate the importance of the sporting events and competition to the athlete, the school, and the community. At the Center for Specialty Care our goal is to keep the athlete safe and get them back in the game as soon as possible.”
One of many ways the Center for Specialty Care is supporting Fairmont’s athletic program and area athletic programs is by offering sports physicals at the reduced price. “Many medical evaluations have a charge of 100 to 200 dollars,” said Dr. Welchlin. “We do the sports exam/physicals, performed by sports medicine providers, at a great discount. We charge only $20, and then donate 50% of the money back to the school to support their sports program. We know participation is expensive for families. We want to help the school and the athlete to succeed.”
Athletic Director, Mat Mahoney, accepted the donation on behalf of the Cardinal Booster Club, stating, “We appreciate the support given by the Center for Specialty Care through their participation in our sports program and the receipt of this financial gift which will be designated for sports uniforms.”
Pictured LtoR above: CSC Athletic Trainer Brant Boekelman, Fairmont Cardinal Athletic Director Mat Mahoney, CSC Physician Assistant Tim Soelter, CSC Orthopedic Surgeon Dr. Corey Welchlin
CSC Welcomes Dr. Slater
Mayo Trained General Surgeon
The Center for Primary Care is pleased to announce the addition of Dr. Jared Slater, General Surgeon, to their team of specialists.
Dr. Slater is seeing patients for consultations at the Center for Primary Care with surgeries performed at the adjacent South Central Surgical Center.
Among the surgeries Dr. Slater is performing are: Colonoscopy, Upper Endoscopy, Hernia Repair, Gallbladder, Varicose Vein Treatment, Sclero Therapy for Spider Veins, Breast Biopsies and Breast Procedures, Wound Care, Skin Cancers, and Port-A-Cath for cancer patients.
To schedule a consultation with Dr. Slater call the Center for Primary Care at (507) 238-9533.
The Center for Primary Care is pleased to announce that Dr. Kevin Kimm is now accepting new patients at both our Blue Earth and Fairmont locations.
If you need a primary care doctor, Dr. Kimm has been taking care patients of all ages from the past 25 years. Diagnosing and treating diabetes, hypertension, chronic obstructive pulmonary disease are just a few of the conditions Dr. Kimm manages with his patients. Helping you get healthy is his main focus.
He is available for walk-ins and same day appointments!
For an appointment with the Center for Primary Care call
(507) 526-5191 (Blue Earth) or (507) 238-9533 (Fairmont).
Center for Specialty Care in Fairmont is proud to announce that they are now an accredited facility of OsteoArthritis Centers of America. OsteoArthritis Centers of America is a CLINICALLY PROVEN program offering safe, effective, NON-SURGICAL treatment of joint pain caused by osteoarthritis, EXCLUSIVELY provided through Center for Specialty Care in Fairmont!!!
We are now accepting patients! If you have knee pain, stiff knees in the morning, knees hurt when going up and down stairs, call Center for Specialty Care to schedule a consultation today at 507-238-4949.
Only $20 and half goes back to your school!
If you are unable to attend one of our sports physical clinics, Center for Specialty Care still offers sports physicals for area athletes at our Fairmont and Blue Earth Offices. The cost is $20, paid on the date of service, with half of the fee donated back to your school’s athletic department. Timothy Soelter, PA-C, and Holly Kotewa, C-FNP, perform the evaluations. To schedule your appointment call 507.238.4949.