Rural hospital another health care crisis victim?
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| Also listed in: Health Care for All Colorado | Southeast Colorado Progressives |
(x-posted variously)
At the end of January our area hospital, Prowers Medical Center in Lamar, Colorado, officially announced they were in trouble. They ended up over a million dollars in the red for 2007, part of a downhill financial slide that has been going on for some time.
Like most hospitals, PMC uses a management company, Quorum Health Resources. Quorum helped PMC come up with a '100 day plan', which started with laying off 12 workers (only 2 of whom were not clinicians of some kind). (No one actually asked, but how much do you bet Quorum gets their fee off the top every time a payment period comes around? I'm just sayin'.)
Naturally this announcement and action kicked the local rumor machine into high gear. So on Tuesday night an open meeting was held to let the public ask questions and find out what was being done to meet the crisis.
The Cultural Events room at the library was packed, with dozens of people lining the walls. Members of the current hospital board gave a presentation of current findings before opening the floor to questions.
We were told PMC had to write off approximately $2 million in charity/unpaid charges for 2007. Only about 1/3 of the patients it sees have private insurance. Medicare pays only 1% above cost on the bills charged to it, and Medicaid pays a mere 35% of what is billed to it. The average cost of a patient's hospital treatment has doubled over the past few years to $10K. Therefore the basic problem is that most of the self-paying and Medicaid patients that the hospital treats represent a loss that private insurance payments and current government funding can't cover. Hence the bleeding of red ink.
So you might think it was GOOD that the average number of hospital patients on any given day has dropped to under 12. But that's not the case. Although some patients from the region are treated elsewhere because they get "flighted out", others make a choice to seek care elsewhere. Maybe because of a perceived drop in patient care quality here, maybe because they need special care PMC can't offer. But it doesn't take a genius to figure out that it's the private payers who can afford to make that choice. The ones who stay here to be treated are the patients who are on Medicare/Medicaid or who (like at least 40% of all US citizens) have NO insurance coverage.
The way I see it, the current hospital board went wrong mainly by being way too optimistic way too long. Someone at the meeting actually stated that people are not coming to PMC for treatment as much because the local population is HEALTHIER than it used to be. Also, 'more people are being treated at home instead of in the hospital.' (See what I mean about the overly optimistic viewpoint?)
Later they did touch on some more realistic problems. Lamar lost 4 doctors in 2007 to retirement or relocation. That's four docs not treating people and sometimes admitting them as patients. Lamar has also not yet recovered from losing the bus manufacturing company NEOPLAN and its 300-400 jobs which offered insurance benefits.
Other issues NOT addressed that I personally feel add to the problem are the declining US economy and the lack of health insurance coverage which affects thousands in Prowers County and millions nationwide. I don't quite see how the PMC board has missed hearing about these two situations -- it's been in all the papers -- but there was no mention of either at the meeting. And seriously, they are in deep enough trouble with the citizenry that they should be offering all the excuses they can come up with, in my opinion.
One of the things PMC is doing to try to help its bottom line is to raise its rates, the same way many medical places are these days. This look at the overall numbers of just one rural hospital shows clearly that this only works because it will bring in more from the insurers. Who will in turn raise their rates, causing more people to be unable to afford insurance...bubble financing, anyone?
I do agree with board member George Gotto, who said the PMC board is "all good, decent people trying to do something for the community." To their credit, they are standing up to take responsibility for the current crisis, and trying to do something about it (besides raise rates, which is a temporary stop-gap at best). For instance, they've found ways to cut costs for supplies, for up to $500K in savings over a year's time. Another proposal is to start a walk-in clinic that sees people on evenings and weekends, so someone with an inconveniently timed health problem won't have to go to the expensive ER for help.
There is also an election upcoming in May for new board members. Twelve people have stepped up to run for three open seats, and the current board is requiring them to sit in on the interviews of the six finalists for the currently vacant CEO job, so whoever is elected will have some idea of what needs to be be expected from the new CEO.
The bottom line is that, contrary to the rumors, they aren't closing the hospital down YET. Whether that will happen in the future, though, is anybody's guess.
I hope many of the people who were at Tuesday's meeting will take George Gotto up on his suggestion and start making it a habit to attend the open meetings of the hospital board. I'm going to try to, I know. It's no longer smart or sensible to just laze back and assume Someone is looking after all the situations that affect our daily lives.
If it ever was. But that's another rant for another day.
At the end of January our area hospital, Prowers Medical Center in Lamar, Colorado, officially announced they were in trouble. They ended up over a million dollars in the red for 2007, part of a downhill financial slide that has been going on for some time.
Like most hospitals, PMC uses a management company, Quorum Health Resources. Quorum helped PMC come up with a '100 day plan', which started with laying off 12 workers (only 2 of whom were not clinicians of some kind). (No one actually asked, but how much do you bet Quorum gets their fee off the top every time a payment period comes around? I'm just sayin'.)
Naturally this announcement and action kicked the local rumor machine into high gear. So on Tuesday night an open meeting was held to let the public ask questions and find out what was being done to meet the crisis.
The Cultural Events room at the library was packed, with dozens of people lining the walls. Members of the current hospital board gave a presentation of current findings before opening the floor to questions.
We were told PMC had to write off approximately $2 million in charity/unpaid charges for 2007. Only about 1/3 of the patients it sees have private insurance. Medicare pays only 1% above cost on the bills charged to it, and Medicaid pays a mere 35% of what is billed to it. The average cost of a patient's hospital treatment has doubled over the past few years to $10K. Therefore the basic problem is that most of the self-paying and Medicaid patients that the hospital treats represent a loss that private insurance payments and current government funding can't cover. Hence the bleeding of red ink.
So you might think it was GOOD that the average number of hospital patients on any given day has dropped to under 12. But that's not the case. Although some patients from the region are treated elsewhere because they get "flighted out", others make a choice to seek care elsewhere. Maybe because of a perceived drop in patient care quality here, maybe because they need special care PMC can't offer. But it doesn't take a genius to figure out that it's the private payers who can afford to make that choice. The ones who stay here to be treated are the patients who are on Medicare/Medicaid or who (like at least 40% of all US citizens) have NO insurance coverage.
The way I see it, the current hospital board went wrong mainly by being way too optimistic way too long. Someone at the meeting actually stated that people are not coming to PMC for treatment as much because the local population is HEALTHIER than it used to be. Also, 'more people are being treated at home instead of in the hospital.' (See what I mean about the overly optimistic viewpoint?)
Later they did touch on some more realistic problems. Lamar lost 4 doctors in 2007 to retirement or relocation. That's four docs not treating people and sometimes admitting them as patients. Lamar has also not yet recovered from losing the bus manufacturing company NEOPLAN and its 300-400 jobs which offered insurance benefits.
Other issues NOT addressed that I personally feel add to the problem are the declining US economy and the lack of health insurance coverage which affects thousands in Prowers County and millions nationwide. I don't quite see how the PMC board has missed hearing about these two situations -- it's been in all the papers -- but there was no mention of either at the meeting. And seriously, they are in deep enough trouble with the citizenry that they should be offering all the excuses they can come up with, in my opinion.
One of the things PMC is doing to try to help its bottom line is to raise its rates, the same way many medical places are these days. This look at the overall numbers of just one rural hospital shows clearly that this only works because it will bring in more from the insurers. Who will in turn raise their rates, causing more people to be unable to afford insurance...bubble financing, anyone?
I do agree with board member George Gotto, who said the PMC board is "all good, decent people trying to do something for the community." To their credit, they are standing up to take responsibility for the current crisis, and trying to do something about it (besides raise rates, which is a temporary stop-gap at best). For instance, they've found ways to cut costs for supplies, for up to $500K in savings over a year's time. Another proposal is to start a walk-in clinic that sees people on evenings and weekends, so someone with an inconveniently timed health problem won't have to go to the expensive ER for help.
There is also an election upcoming in May for new board members. Twelve people have stepped up to run for three open seats, and the current board is requiring them to sit in on the interviews of the six finalists for the currently vacant CEO job, so whoever is elected will have some idea of what needs to be be expected from the new CEO.
The bottom line is that, contrary to the rumors, they aren't closing the hospital down YET. Whether that will happen in the future, though, is anybody's guess.
I hope many of the people who were at Tuesday's meeting will take George Gotto up on his suggestion and start making it a habit to attend the open meetings of the hospital board. I'm going to try to, I know. It's no longer smart or sensible to just laze back and assume Someone is looking after all the situations that affect our daily lives.
If it ever was. But that's another rant for another day.