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        <div id="content-top1">Page 41 - 2019 Siouxland Washington Conference Book</div>
        <div id="content-top2">P. 41</div>
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    <pre style="white-space:pre-line"><code>65th Annual Siouxland/Washington Conference

levels of accountability in the health care process by allowing the consumer to determine their level of
appropriate risk and provider choice. A national health insurance market provides increased flexibility for
insurers to move with and respond to consumer demand. Opening interstate insurance lines is only part
of the solution. Localized health insurance rules and freedom of movement into new areas to develop
provider networks are additional barriers that must be addressed to effectively impact pricing. Federal
guidelines addressing less restricted commerce for payers ultimately assists businesses and individuals
by offering increased options and negotiating power for price and quality.

Support Expansion of Conrad State 30 J-1 Waiver Program
Recruitment of a qualified workforce is one of the most critical issues for health care providers. As we
struggle to recruit and retain health professionals, it is crucial that Congress extends and expands the
State Conrad 30 J-1 visa waiver programs, which recruit foreign physicians to under-served communities.
This program is vital to the recruitment efforts of Iowa hospitals. The program should be expanded, and
visas not used by states should be put into a pool for other states to access. Our tri-state communities are
short on doctors - especially psychiatrists - and we rely on this program to fill the gaps.

Support and Infrastructure Recommendations for Telemedicine
Telemedicine offers patients improved access to indicated care and more choices appropriate to
their individual circumstance. Telemedicine offers improved care while reducing cost for chronic care
management. Telemedicine offers a boost to emergency preparedness and response especially for
underserved or rural areas.

â€¢	 Standardize parameters for licensing, credentialing, and location requirements for both provider and
     patient. Boundaries cleared by this technology must not be hindered by unclear geographical and
     legislative limitations. (i.e. Telemedicine providers are reimbursed based on their location, but state
     licensing laws generally require they be licensed according to the patientâ€™s location.)

â€¢	 Provide a unified secure technical platform for providers to utilize. Individual payers currently require
     the use of their unique telemedicine platform, causing a burden for providers and potential increased
     cost to patients.

â€¢	 Determine a clear definition for the relationship between a telemedicine provider and patient. An
     official physician/patient relationship triggers certain requirements on behalf of a physician. When is
     that relationship established in a telemedicine situation?

â€¢	 Encourage the use of telemedicine to reduce health delivery challenges like provider shortages.
â€¢	 Promote payment and service delivery models, increasing consumer and payer value when using

     telemedicine.
â€¢	 Provide Integrated Electronic Health Records/Health Information Exchange (EHR/HIE) which is critical

     to effective use of Telemedicine. Patient record access relies upon this integration.

AUTHOR(S)

Nolan Lubarski, CEO, Center for Neurosciences, Orthopaedics & Spine (CNOS),

nolan.lubarski@cnos.net, 605.217.2609

Beth Hughes, CEO, MercyOne, beth.hughes@mercyhealth.com, 712.279.2297

Suzi Gausman, Vice President of Business Development, Center for Neurosciences, Orthopaedics &

Spine (CNOS), suzi.gausman@cnos.net, 605.217.2851

Stacy Harmelink, Administrator, Midlands Clinic, sharmelink@midlandsclinic.com, 605.217.5550

Mari Kaptain Dahlen, CEO, Siouxland Community Health Center, mkaptaindahlen@slandchc.com,

712.202.1011

Deb Lemmon, Director of Planning & Advocacy, MercyOne, lemmond@mercyhealth.com, 712.294.7400

Greg Miner, CEO, Dunes Surgical Hospital, gminer@uspi.com, 605.232.3332

Jim Gobell, CFO, UnityPoint Health - St. Lukeâ€™s, james.gobell@unitypoint.org, 712.279.3949

Krista McCullough, Interim Director, Health Inc., mccullough@jencc.com, 712.252.0088

Lynn Wold, President & CEO, UnityPoint Health - St. Lukeâ€™s, lynn.wold@unitypoint.org, 712.279.3632

Ben Nesselhuff, Vice President of Resource Development, Jackson Recovery Centers,

bnesselhuf@jacksonrecovery.com, 712.234.2383

Sheila Martin, CEO, Siouxland Mental Health, smartin@siouxlandmentalhealth.com, 712.252.3871

Brendyn Richards, Director of Development & Advocacy, Siouxland Community Health Center,

brichards@slandchc.com, 712.224.1815          20</code></pre>
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