Fill­ing in

Adding ser­vices bal­ances gov­ern­ment short­falls

Modern Healthcare - - From The C-suite - Melissa Bruntlett

In my role as the chief fi­nan­cial of­fi­cer of a small com­mu­nity hospi­tal in cen­tral Mis­sis­sippi, I’m re­quired to take a lot of leaps of faith when mak­ing de­ci­sions, sim­ply be­cause those de­ci­sions at times in­volve in­tan­gi­bles that ex­tend far be­yond fi­nan­cial data. Over the past eight years, one cer­tainty of the ever-chang­ing land­scape of health­care is this: If your de­ci­sions are guided by what is best for pa­tients over the long term, it is likely the out­come will be ben­e­fi­cial to your or­ga­ni­za­tion.

At 58-bed Magee (Miss.) Gen­eral Hospi­tal, we’ve con­tin­ued to re­main prof­itable dur­ing a time when many hos­pi­tals are clos­ing their doors. We’ve out­per­formed many hos­pi­tals with sim­i­lar pa­tient de­mo­graph­ics by adopt­ing stan­dards re­lat­ing to pa­tient safety, fis­cal ac­count­abil­ity, growth and ethics. Ini­ti­at­ing th­ese stan­dards has not been without chal­lenges.

At the top of the list, I would place the re­cent cut­backs by the Medi­care and Med­i­caid pro­grams. Re­ceiv­ing re­im­burse­ment for the ser­vices that we pro­vide to our pa­tients is cer­tainly a ma­jor chal­lenge for us, as it is for most hos­pi­tals in the na­tion. Medi­care and Med­i­caid, as well as pri­vate in­sur­ance, are very im­por­tant sources of rev­enue for us. When re­im­burse­ment falls short of the cost of care, it im­pacts many as­pects of our op­er­a­tions. We con­tinue to op­er­ate in a proac­tive mode by plan­ning for fu­ture cuts and re­act­ing quickly to the cur­rent cut­backs at a time when cost of sup­plies and re­sources con­tin­ues to in­crease.

We’ve coun­ter­acted the cuts by im­ple­ment­ing cost-sav­ings mea­sures in all ar­eas. The over­all sav­ings from th­ese mea­sures will, we hope, be suf­fi­cient to al­low us to pro­vide ba­sic ser­vices to pa­tients while up­dat­ing our fa­cil­ity to bet­ter ac­com­mo­date physi­cians. In 2009, we were forced to re­duce em­ploy­ees’ hours for eight months. This mea­sure, which was ac­cepted by em­ploy­ees as a way to ul­ti­mately pro­tect their jobs, proved to be a prof­itable move in nu­mer­ous ways. It re­sulted in a siz­able cost sav­ings and al­lowed us to avoid lay­offs while con­tin­u­ing to pro­vide ma­jor pa­tient ser­vices.

An­other chal­lenge has been in the area of un­com­pen­sated care—an­other cost that has in­creased sig­nif­i­cantly at most U.S. hos­pi­tals as the econ­omy has taken a down­ward spi­ral. A ma­jor source of as­sis­tance in the area of in­di­gent care has been our char­i­ta­ble foun­da­tion, Health Trust. In only its fifth year of op­er­a­tion, the foun­da­tion has raised more than $3 mil­lion and helps pro­vide funds for in­di­gent med­i­cal care as well as state-of-the-art equip­ment and tech­nol­ogy the hospi­tal might or­di­nar­ily go without.

A ma­jor source of ad­di­tional rev­enue is brought in through our in-house med­i­cal spe­cialty clinic, staffed on a ro­tat­ing ba­sis by physi­cians rep­re­sent­ing more than 20 spe­cialty ar­eas in in­pa­tient and out­pa­tient ser­vices, in­clud­ing gen­eral surgery, oph­thal­mol­ogy, car­di­ol­ogy, urol­ogy, gy­ne­col­ogy and neu­ro­surgery. Th­ese spe­cialty ser­vices elim­i­nate the need for pa­tients to travel to one of Mis­sis­sippi’s metropoli­tan health­care fa­cil­i­ties for the care they need.

To fur­ther en­hance th­ese ser­vices, two years ago the hospi­tal pur­chased one of the most tech­no­log­i­cally ad­vanced MRI sys­tems and opened a sleep cen­ter now fully ac­cred­ited by the Amer­i­can Academy of Sleep Medicine.

Our goal for the past sev­eral years has been to cre­ate a cam­pus on which we of­fer fam­ily med­i­cal clin­ics, re­ha­bil­i­ta­tion, imag­ing and di­ag­nos­tic ca­pa­bil­i­ties, an area for out­pa­tient med­i­cal ser­vices and same-day surgery; and pro­fes­sional in­pa­tient care. By of­fer­ing all the con­ve­niences of “one-stop” med­i­cal care in an area that is 50 miles from the near­est large city, we have re­al­ized a sig­nif­i­cant in­crease in our pa­tient base and rev­enue.

As we en­ter a new decade, we re­al­ize that no mat­ter how well you do some­thing or how suc­cess­ful a pro­gram has been, for a slightly larger in­vest­ment, you can usu­ally do it bet­ter. How do we grow and then al­lo­cate our re­sources among the many in­no­va­tive med­i­cal tech­nolo­gies and ser­vices con­tin­u­ally be­ing in­tro­duced in the health­care field? That is the new chal­lenge that we will seek to con­quer in 2010. <<

Melissa Bruntlett is chief fi­nan­cial of­fi­cer of Magee (Miss.) Gen­eral Hospi­tal.

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