Hospital's 'What If' Scenario Becomes Reality

Then came the difficult part. Skagit Valley could only do so much internal restructuring and cost-cutting before it took a hard look at labor expenses.

It implemented a wage freeze. Each full-timer must give up 64 hours of work/pay between May 1 and December 31.

"Working with my teams, we have come up with creative ways to make this happen," Hill says. "We are on a no-lunch agreement, and during down times, staff take an hour for lunch. We may have someone leave an hour early, and the rest of us chip in to back up. These must be hours that are not covered by someone else. This is the most difficult as my team have never been on a low-census expectation."

Skagit also eliminated a number of FTEs, the majority through not filling vacancies; however, a small number of staff members did lose their jobs.

"This has been an emotional time," Hill says. "And at this point, I am spending as much time being even more upfront and center with my teams to show my personal support, leadership support, and to be aware of any issues as soon as possible so as to be able to provide assistance, or referral for more than I am able to address. … By involving the team in the decision making processes, on those things that we have power over, I have buy-in, and greater success, because they own it."

Editor's note: This is the fourth in a series of stories on HealthLeaders Media talking to revenue cycle managers about coping in a tough economy. The previous installments were:

Hospital Department Leaders Must Remain Flexible in Difficult Economy

Lessons for Hospitals in a Tight Economy

Hospitals Get Financially Smart in a Tight Economy