Klamath Open Door Family Practice’s Commitment to Quality Healthcare for All
Recently we had the privilege of visiting with members of the leadership team at Klamath Open Door Family Practice in Klamath Falls, Oregon.
[ Pictured L to R: Jones & Roth FQHC Advisor Mathew Hamlin, CPA with Klamath Open Door’s Quality Officer Amanda Blodgett, CEO & CFO Signe Porter, and COO George Olson. ]
Klamath Open Door operates as a Federally Qualified Health Center (FQHC). The organization’s 120 employees serve patients throughout the Klamath Basin in the areas of primary care, behavioral health, dental, preventative care, and wellness.
The health center started in 1997 with two nurse practitioners who saw a need for increased healthcare access among the uninsured or underinsured population in the Klamath Falls community. They were granted FQHC status shortly after and the clinic was off and running.
Today, Klamath Open Door is the second largest medical provider in the Klamath Basin offering the community access to culturally appropriate, high quality, and affordable primary and preventative health care from clinics in Klamath Falls and Chiloquin, Oregon.
We sat down with three of their leaders in a question and answer style conversation to discuss the organization and the dynamics of leading and operating an FQHC in Southern Oregon. The discussion included Chief Executive Officer & Chief Financial Officer Signe Porter, Chief Operating Officer George Olson, and Quality Officer Amanda Blodgett.
We came away with a profound sense of this team’s passion, dedication, and absolute devotion to the mission of providing healthcare services to the underserved. The impact to the community they serve is significant and it promises to be a model that shapes the way healthcare services delivery is provided to smaller communities.
Signe, how did you land in the position of leading an FQHC in Southern Oregon?
Signe: “I grew up in Klamath Falls. I went away for college to attend Oregon State University in Corvallis and studied finance and accounting. After college, I returned to my hometown. My husband was a physician serving on the Klamath Open Door board. I had become familiar with the organization and adopted a passion for the mission. Eventually, I was called in to work as the CFO.”
How do you see your role at Klamath Open Door?
Signe: “I am trained in finance and I manage the CFO role. George and I divide the CEO duties between us, it’s worked out very well. We have experienced challenges with others in the CEO role in the past and this arrangement has been a great solution.”
George, how about you? What brought you to Klamath Open Door?
George: “My healthcare background started in the Navy. I worked on a specialized team that developed the High Fidelity Simulation Lab. After serving 13 years in the Navy, I spent some time working in this area at Oregon Health & Science University in Portland. I realized that I had a passion for healthcare and a gift for leadership. This led me to pursue a bachelor’s degree in healthcare administration and compliance at Pacific University. When I became familiar with Klamath Open Door, it became clear that they needed me and I needed them.”
Amanda, you joined the team this year. What framed your decision to take on this role?
Amanda: “I also have a military background, I served in the Air Force as a Financial Manager. My husband was in a significant accident and he needed multiple surgeries over a short period of time. I became his patient advocate. This experience led me to understand how to negotiate the complex healthcare provider and payer systems and I developed great empathy for the patient experience. This experience led me to work in a local Coordinated Care Organization. From there I landed at Klamath Open Door.”
How do you approach your role in the organization?
Amanda: “The Quality Officer role is new for us. Today I spend a great deal of time in general patient advocacy. As I develop our systems and the new role, my goal is to spend more time working with quality improvement, wellness, and prevention initiatives.”
Signe: “Amanda has been recognized for launching a new movement in the community for adolescent wellness. Recently she worked with Klamath County to declare the month of July as Adolescent Wellness Month.”
Tell me about the community that you serve.
Signe: “We serve over 10,600 patients per year. The patient mix is 50% Medicaid, 32% Medicare, 12% Private Insurance, and 6% Self Pay (sliding fee). We are open to seeing anyone, with an emphasis on the underserved and underinsured.
What are some of the biggest operational challenges that you face today?
George: “One challenge is operating under the expanded compliance manual for FQHCs. The regulations keep changing and we have different regulation bodies wanting different things, which are often in conflict. Regardless of this, we are committed to providing the best care, without being constrained by regulations that often seem like a moving target.”
What current opportunities are on your radar?
Signe: “Currently we are benefitting from both grant revenue and payer reimbursements under the Affordable Care Act. We see this as a window of opportunity to expand and grow and to position the organization for future success. We may not always be in this advantageous revenue environment.”
George: “The Alternative Payment Methodology (APM) looks like an opportunity. It is both exciting and scary. For APM to work, the Electronic Health Record must work. We must have accurate clinical information to rely on. This has led us to understand the need to create a data analyst team. Most organizations assign IT types to this role. We believe that we need data science professionals in this role. We have created two positions on our data team. This is essential to maximize the effectiveness of EHR and to facilitate the successful management of APM. Additionally, we are in development of an EHR Handbook to guide each team in successfully utilizing our EHR application.”
What trends in the FQHC space are you seeing?
George: “One trend we’re seeing is scribes. We believe that scribes are the future. Though there are recruiting and retention challenges, because most scribes are using this experience to get through medical school or other healthcare training, the operational efficiencies of scribes cannot be ignored.”
Tell me about your staff. Has recruiting and retention been challenging?
Signe: “We have been very successful recruiting providers and dentists. Nursing positions and front office roles have been more challenging to get the right people in the right chair.”
George: “We are now to the point where we can be more selective in hiring providers. We have developed a profile. Folks who do well here tend to be young and adventurous and share the mission to be a healthcare advocate for everyone in the community. Their commitment to the mission is primary, it must be authentic.”
Signe: “We have also found that our providers attract other providers who fit our criteria. This has been the most successful model for recruitment. We have also found that the profile must include those who are willing to work the extra hours as needed. We wonder if the next generation coming up will be willing to make the extra sacrifice that is often required of all roles in an FQHC.”
You have worked with Jones & Roth’s FQHC Team on your financial statement audit for many years. How would you describe this relationship?
Signe: “We learn something from every audit. The Jones & Roth team is knowledgeable and they challenge us. They know our team and they reduce the anxiety of going through an audit.”
George: “I appreciate that Jones & Roth validates the improvements that we have been working towards. They present to our board an unbiased assessment of the fiscal health of the organization. As we go through the audit process, they challenge us, we challenge them. That’s the way it should be. They have also become a valued partner as we budget and plan for the future. Jones & Roth approaches our audit with a consultative perspective. We use the outcome of our audit to improve the organization.”
Where do you see Klamath Open Door on a 3-5 year horizon?
Signe: “As I have said, we want to take the current window of opportunity to expand. We are hoping to add 30,000 square feet to our facility. We are planning to add services in the area of physical therapy, ophthalmology, nutrition, and wellness. Also on our wish list is to have a presence at the local military base. The population there needs our services. This would be the first outside healthcare system inside of a military base. We are working towards this.”
What do you want your community to know about you that they don’t already know?
Signe: “That we are not competing with anyone. That we are open for all. We are here to fill in the gap for those who need healthcare services without regard for their ability to pay or the reliability of their insurance coverage.”