Health official: ACA stresses patient responsibility


LEWISTON — Hospitals are making progress in managing the health of local populations, according to a speaker at Bates College on Thursday.

Cindie Rice, Central Maine Medical Center’s community health assessment and wellness manager, said the federal Affordable Care Act has focused attention on making patients take more responsibility for their care.

Rice underscored cooperation among numerous agencies in the past two years to increase their outreach and overall effectiveness. Fifteen area agencies worked to prioritize missions and tasks, and that effort is showing positive results, she told the Bates College Public Health Initiative gathering.

Data contained in the OneMaine Community Health Needs Assessment released in 2011 has been a vital tool for priority-setting by agencies in Androscoggin County in the past year. That information is available online at

Rice ran through a long list of health concerns in Androscoggin County. These are not newly identified problems, she said, but there are some new methodologies in dealing with them that are very promising.

“Historically, we have been guilty of telling people what to do,“ Rice said. Now, some of the shortcomings of that approach are being identified, and the underlying reasons that patients might fail to follow through are being identified.


Using a personal example of her elderly mother’s recent heart attack, Rice said that health professionals and family members need better understandings of what patients expect and can accomplish for outcomes.

It’s often more complicated than prescribing medication and scheduling follow-up appointments. Issues of transportation, lack of commitment to taking medication and numerous misunderstandings enter into the picture, Rice said.

Among the initiatives gaining attention are “motivational interviews” in which a physician has options for immediately calling in other professionals and family members to “negotiate” a course of action that is suitable to the patient.

Some other valuable programs cited by Rice are flexible arrangements for assistance in home settings by Androscoggin Home Care and Hospice, increased use of skills by community paramedical personnel and behavioral health coaches at Central Maine Medical Center.

Rice and Erin Guay, health promotion manager at Healthy Androscoggin, said patient advisory councils are useful. They noted that St. Mary’s Regional Medical Center and Healthy Androscoggin have an arrangement by which smokers receive prompt referrals to Healthy Androscoggin.

Reducing visits to emergency departments at the hospitals also has received attention. Rice said low income is sometimes the reason for excessive reliance on emergency departments. She said other solutions can often be found if the reasons are understood.

She said health officials are concerned about an increasing rate of asthma in Androscoggin County. An “Asthma Fair” in which Bates students will participate is planned for the spring.

Affordable Care Act 101

We break down the ACA, what it does and what it requires you to do.