Change is the key aspect of the new federal Affordable Care Act, but Wadley Regional Medical Center at Hope officials have kept pace with the development of the new law and its impact upon small, rural hospitals, and doctors. Wadley parent spokesperson Shelby Brown explained that the expansion of health insurance coverages under the new law are anticipated in the way the Arkansas General Assembly approached its connection with Medicaid. “The Medicaid expanded coverage should make primary care available to the newly added enrollees,” Brown said. “We would hope that coverage for needed diagnostic tests would encourage enrollees to take charge of their health and have them done in order to become healthier.” That also means that Wadley-Hope anticipates providing more types of out-patient services. “With the 100% coverage for cancer screenings such as mammograms, we hope that once we are able to offer this diagnostic service (in the next few months) that we will see good usage,” Brown said. Staffing at Wadley-Hope is also likely to see some change, depending upon the patient usage generated under the new law. “Wadley-Hope utilizes staffing standards with patient-to-staff ratios so if there is a sustained increase in patient utilization, we would staff accordingly,” Brown said. “Providing quality care is our ultimate goal; therefore, assessing and adjusting staffing is a routine operational objective.” One thing that Wadley-Hope patients can expect is continued timely delivery of healthcare services, Brown said. “Again, we strive to provide quality care in a timely manner and this would remain our goal,” she said. “There should be no change in the timeliness of care provided nor limiting of existing services.” Emergency room operations are not expected to be affected, as well, Brown said. “There should be no change in the operation of the ER at Wadley-Hope in dealing with emergent conditions,” she said. “Non-emergencies are referred to primary care physicians for treatment and follow up since the ER is not the appropriate setting for routine care.” Wadley also operates the Wadley Rural Health Clinic adjacent to the Wadley-Hope ER, which is staffed by a family practice physician and a nurse practitioner. “With preventative care benefits available, covered individuals should seek routine services from their primary care physician which is the most cost effective care,” Brown said. Physicians will be concerned more with the implications of the ACA upon individual practice, Dr. George Garrett, Hope general practitioner said. “The only problem is for the doctors in that there is a doctor shortage,” Dr. Garrett said. “There is only so much you can do, and just so many patients you can see per day. I think that will be more of the problem rather than the hospitals.” Garrett sees hospital usage as improving under the ACA. “I think it will improve cases in that regard because people will have insurance that have never had it,” he said.