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Great River Health System outlines Medicaid concerns, Epic rollout and limits on local emergency services
Summary
Michael McCoy, CEO of Great River Health System, told Keokuk council members the federal 'HR1' changes could reduce Medicaid funding beginning in 2028, praised a $50 billion rural transformation fund, and described a systemwide conversion to the Epic electronic health record scheduled for June 6, 2026; he said Insight's ownership of emergency bed licenses constrains immediate plans for a full ER in Keokuk.
Michael McCoy, CEO of Great River Health System, gave a status update to the Keokuk City Council on Oct. 16, emphasizing potential federal changes to rural health payments, a major electronic health record conversion, and local service priorities.
McCoy said legislation referred to in the meeting as "HR1" represents a significant change in how rural hospitals are reimbursed and warned that projected reductions in federal Medicaid spending could pressure margins for rural providers; he noted implementation is delayed until 2028 and praised congressional efforts that also secured a rural health transformation fund to help mitigate impacts. "Medicaid is a critical lifeline to many of our patients," McCoy said, noting Great River serves tens of thousands of Medicaid members in its region.
He outlined a major IT project: converting the system’s electronic health record to Epic. McCoy said pre-implementation began in spring 2024 and that the system will go live on June 6, 2026; he highlighted expected benefits including unified "MyChart" access across regional partners, improved scheduling and billing, and opportunities to use technology for efficiency and quality improvements.
Council members pressed about prospects for emergency-room services in Keokuk. McCoy said Insight (an entity exploring ownership/operations of local beds) currently holds the relevant license to beds in Keokuk; until those licensing decisions are clarified, Great River cannot plan to expand into a full 24/7 emergency department. He added that staffing and volume considerations make operating a 24/7 ER or urgent-care model challenging without clear licensing and sufficient provider availability.
McCoy said Great River remains committed to expanding local clinic services, adding specialists and prenatal care where feasible, and continuing engagement with state and federal partners as the policy landscape evolves.
