"It's been one trim or one mandate after another. It is so difficult to keep track of them," Putnam says. "It's just another thing we are going to have to provide, but a big part of our mission is community access to healthcare, so we will figure out a way to do it."
In fact, Putnam sees HIX and other reform challenges as a test of his hospital's mettle, and other community healthcare providers like his.
"We were here before Medicare existed. We've been through a lot," he says. "We are not talking about organizations that sway with the wind. We act like an umbrella. We still serve the patients regardless of which direction the wind and rain are coming from. We have a lot of history behind us that we have to adapt our organization to fit whatever the rules are and still be able to provide good care for our patients. Everybody who has been in healthcare for a long time realizes that. We walk down the hallways of this organization and have the pictures of the people in the 1930s and 1940s who delivered care and faced their own challenges. This is our time."