A growing consensus in Augusta to use revenues from the state’s liquor business to pay the debt owed to Maine’s hospitals is good news, said Lincoln County Healthcare President and CEO James Donovan.

However, more important than the debt repayment plan is the state and the federal government’s commitment to MaineCare and Medicare, the government insurance programs that cover most of Lincoln County Healthcare’s patients, said Donovan.

As Lincoln County Healthcare invests in new models of care designed to keep patients well, being able to count on stable reimbursement rates from Medicare and MaineCare will be increasingly important as those programs cover a greater percentage of the state’s population.

A plan now being hammered out in Augusta would pay back about $186 million in outstanding MaineCare debt accumulated between 2009 and 2012. It would free up roughly $298 million in federal matching funds for a total of around $484 million.

Because Lincoln County Healthcare serves a relatively small percentage of MaineCare patients (about 10 percent of patients at Miles Memorial and St. Andrews hospitals are covered by MaineCare while about 50 percent are covered by Medicare) Miles will receive about $3.2 million of that $484 million while St. Andrews will have to give a small amount back to the state.

However, at the same time the state is making plans to pay its debt, the Maine Legislature is considering a number of cuts to Medicaid that will impact Maine hospitals over the next two years. Significant cuts to Medicare have already been approved by Congress.

Of those two categories of reductions, the federal budget cuts will have a much larger and longer-term impact on Maine hospitals, particularly Lincoln County Healthcare, which serves a county with one of the oldest populations in Maine.

Cuts that are part of the federal sequester will drop Medicare reimbursements by about 2 percent while cuts contained in the Affordable Care Act would reduce payments to Maine hospitals by about $900 million over the next ten years. President Obama’s budget includes Medicare cuts for both providers and people covered by Medicare.

When those reductions and the likelihood of additional cuts to the federal healthcare programs are taken into account, it is clear that small rural healthcare providers like Lincoln County Healthcare will have to change how they deliver care.

Change will not be easy, Donovan said, but as part of MaineHealth, the largest integrated healthcare system in Maine, Lincoln County Healthcare is investing now in technology and new models of care that will keep patients healthier and, over the long run, make healthcare less expensive.

“Technology is the infrastructure for these new services, but the heart of Lincoln County Healthcare has always been our providers, and the relationships between our providers and their patients will only be more important as we move forward,” he said.

A new type of primary care practice, called the Patient-Centered Medical Home, will provide better coordinated and more accessible care, including extended hours and same-day appointments.

With more providers available in primary care practices, including doctors, nurses, educators and counselors, patients will have access to more therapies and information when they visit their doctor.

When they go home, a new electronic medical record system currently in place at all Lincoln Medical Partner practices will allow patients with chronic conditions like diabetes or heart disease to electronically share health information with their doctor so any changes in their condition can be quickly addressed and they can avoid the medical crises that result in expensive hospital stays.

“Our vision is to provide healthcare that is better for our patients by being more accessible and affordable,” said Donovan. “By building on the strong relationships between our providers and the community, we believe we can make Lincoln County one of the healthiest counties in Maine.”