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Flat Patient Volume Adds to Fiscal Concerns for 2012

Karen Minich-Pourshadi, for HealthLeaders Media, December 28, 2011
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Federal budget deficit. We’re very concerned about this. They have to take money out of Medicare and, related to that, take it out of the support for state Medicaid. With the economy as it is now … when the federal government reduces funding to the states, we are all going to have to figure out what to do about it.

Generally, we have a robust strategic planning process that dovetails into our budget process. Our budget is accompanied by a five-year forecast. We expanded that forecast to a 10-year one. We’re also doing “most likely” and “worst-case” scenario plans for a five- to 10-year period. You really want to try to gauge the scope of these issues and get your arms around them the best you can. If things change, you can make decisions in a timely manner. You can’t afford to look in the rearview mirror and say, “I wish I made the decision earlier.”

What areas are you analyzing for growth opportunities?
Patient retention. As a system, we know that we are still losing business in our service area. Our greatest revenue growth is fundamentally providing access—especially in service areas where we know people are traveling out of the service area [to be treated]. So for us, it’s more a “retention of business” strategy. We want to keep every patient and to have the services close to us.

What do you see happening with payer-provider relationships in 2012?
Collaboration. Commercial payers are really important to us, and we are really important to them. We have a good relationship with our primary payers, and in the coming year I think it will lead to a partnership approach in redesigning incentives for providers within the health plans. We expect to have a very collaborative partnership approach in the next year—I think that’s been coming for three or four years now.

Marlene Weatherwax
CPA, Vice President and CFO
Columbus Regional Hospital,
Columbus, IN

Total net revenue 2011:
$204.6 million (projected)
Total net revenue 2010:
$196.4 million
Total licensed beds:
325

What are the key areas you believe will affect your hospital in 2012?
Technology. We’re changing over our information technology system. We wanted an integrated platform, and we still needed to meet meaningful use, ICD-10, and get the CPOE [computerized physician order entry] piece in place. It was just as cost-effective for us to replace our entire system as it was to upgrade it.

Value-based purchasing. I think value-based purchasing will have a negative impact on our reimbursements simply because we aren’t doing as well on CMS’ scores as we had been in the past. We haven’t actually lost ground on raw CMS points, but because other systems have improved and our scores have stayed at the same percentage, we have moved down in percentage rankings. Our clinical people are really struggling to get used to the HCAHPS survey and what we need to do in order to get better patient feedback; with Press Ganey, we had been in the 90th percentile.

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