A recent analysis from Kaufman Hall shows hospitals and health systems saw significant decreases in patient volumes and revenue in April.
Hospitals and health systems are still struggling to rebound from the winter omicron surge as they experienced significant decreases in patient volumes and revenue in April, with expenses barely easing for the month, according to the latest National Hospital Flash Report from Kaufman Hall.
One of the biggest factors at play in this downturn is the patients who have been delaying care amid various COVID-19 surges and concerns about the overall seriousness of their illnesses keeping them from seeking care. However, there are solutions available for CFOs to help combat the financial challenges associated with unstable patient volumes.
Despite a slight rebound in both revenue and volumes in March, median operating margins were in the red in April. The median change in operating margin was down 38.1% from March to April 2022, and down 76% from April 2021. Additionally, patient volumes and days spent in the hospital were down by 5.7% in April, compared to March. Adjusted patient days dropped 6.5% from March to April but were up 1.8% compared to April 2021, according to the Kaufman Hall data. Adjusted discharges decreased 3.3% from March and decreased 0.3% compared to April 2021. The drop in patient volumes led to a dip in revenue for the month.
"The main driver in the revenue decline, at least in April, was a pulling back of volumes," says Erik Swanson, senior vice president of data and analytics at Kaufman Hall. "There are a few factors that might be the cause of this, and, in some ways, as we look at what happened in March as well, again, a lot has been driven there by volume. One thing to know here is that once we see these general waves or surges of hospitalizations primarily attributable to these COVID-19 cases, as those waves begin to rise, you tend to see a bit of a pullback on volumes."
What's Driving Pullbacks?
Those pullbacks are due in large part to a behavioral component among patients, he says. Patients might have concerns about the rise in COVID cases and will ultimately choose to postpone care. Another behavioral factor he suggests is contributing to the decline in volumes is that patients may feel as though they are not sick enough to need to visit the hospital.
"The other thing to note though is that as we look back, the first few months of this year were decimated by the impact of the omicron wave, but as the omicron wave subsided, we had a bit of a rebound in those volumes, and that's what you saw in March," Swanson says. "However, it wasn't a rebound to the full historical volumes, and that is again because of that wave. But then we saw that pullback and so what we see a lot of in this data and when it seems to reflect is primarily driven by these volume ebbs and flows."
As a result of these fluctuations in volume, hospitals and health systems also felt more pressure when it came to their overall expenses in April. Gross operating, inpatient, and outpatient revenues all dropped approximately 7% from March levels; however, all are up year-to-date compared with the same period in 2021—with gains of 6.6%, 5.3%, and 8.5%, respectively, according to the Kaufman Hall data.
Expenses dropped 4.3% from March but remain high compared to 2020 and well above pre-pandemic levels. Labor shortages and supply chain issues also contributed to the expense levels. The report shows that expenses grew 8.3% since April 2021 and 9.6% year-to-date compared with the same period in 2021.
Managing expenses has always been a challenge for hospitals, one that the pandemic has only exacerbated as more patients required unique methods of care.
"Sicker patients come with higher resource utilization, thus driving much of the expense increases as well," Swanson says. "So, not only are there some larger macro-economic factors at play on the expense side, but as the sicker patients come in, they often require more expensive drugs and supplies, more advanced care, and tend to be a bit more expensive."
Strategies to Ease the Expense Burden
Other factors negatively impacting hospital expenses include the labor shortage and supply chain issues. Fluctuations in revenue aren't something that organizations can manually manage, but with careful management of their expenses, they can ease their financial burden.
"The revenue side is a bit more challenging for organizations to control, Swanson says. "Many are looking at their internal revenue cycle, understanding where there can be improvements in their own process, improving just the performance of the revenue cycle that improves the collections rates. Many are also trying to renegotiate with payers and negotiate perhaps as aggressively as possible to get the best rates. But I think where you see much of the levers that organizations can pull is on the expense side and there are quite a few strategies at which they are taking on the expense side."
One such lever relates to the current nursing shortage, which has forced many hospitals and healthcare organizations to become dependent on contract labor and traveling nurses, which can come with exponential financial burdens. One strategy Swanson says larger hospital systems are utilizing is the internal staffing agencies that can evaluate where the greatest need for labor is across the system and send nurses and other staff already on their payroll to help in those locations.
"Finally, because a lot of these challenges are due to these ebbs and flows in volumes, many organizations are also looking to see how they can embrace more data-driven predictive type models to look at volumes and think about how they can optimize their workforce to better handle these ebbs and flows of volume," Swanson says. "This very often includes thinking about the appropriate size of float pools, the number of times that you need to pay overtime versus hiring new individuals, so many organizations are taking those approaches to bend the cost curve. There are quite a few levers that organizations are pulling to bend this cost curve down to ultimately improve their margins overall."
Part of the settlement includes a five-year corporate integrity agreement subjecting the organization to a yearly financial review.
Steward Health Care System—a Dallas-based private for-profit healthcare network with over $180 million in revenue—has agreed to pay over $4 million to resolve allegations of fraud.
Steward and some of its affiliates have agreed to pay $4.7 million to settle a lawsuit claiming that relationships it had with several physicians and physician practice groups violated federal law, including the False Claims Act, which makes it a crime for a person or organization to knowingly make a false record or file a false claim relating to a federal healthcare program.
Steward is one of the largest, private for-profit healthcare networks in the U.S. and owns several hospitals in Massachusetts, including the for-profit hospital Good Samaritan Medical Center. The settlement agreement states that in 2011 Good Samaritan Medical Center entered into an agreement with Brockton Urology Clinic in which Brockton would administer prostate cancer centers of excellence at Good Samaritan Medical Center. However, Good Samaritan Medical Center has admitted that since January of 2012, they had no such centers of excellence. It is alleged that from April 2011 through December 2017 Good Samaritan Medical Center paid Brockton Urology pursuant to the agreement and Brockton Urology referred patients to Good Samaritan Medical Center.
"This case is about fraud, waste, and abuse by Steward at the expense of the American taxpayers,” United States Attorney Rachael Rollins said in a release announcing the settlement. "When hospitals like Steward violate the law, we will work tirelessly to recover from them taxpayer money in order to ensure that Medicare and Medicaid funds are going to treat patients instead of supporting fraud."
The U.S. and Brockton Urology had reached a separate settlement in February of this year. Brockton agreed to pay $100,000 to resolve allegations it violated the False Claims Act.
"This settlement should serve as a warning to hospitals that they should not pay referring doctors for services that they did not provide,” Joseph Bonavolonta, Special Agent in Charge of the FBI Boston Division, said in the Good Samaritan Medical Center statement. "Here a hospital paid referring physicians under the guise of a bogus cancer center. The FBI is proud to work alongside our partners to make sure hospitals follow the law and to root out fraud anywhere in the system."
As part of the settlement Good Samaritan Medical Center has signed a five-year corporate integrity agreement with the Department of Health and Human Services, Office of Inspector General. As part of this agreement each year Good Samaritan Medical Center will be subjected to an annual review of its financial arrangements to ensure compliance with the Anti-Kickback Statute and the Stark Law.
"Financial and referral arrangements between hospitals and physician practices that violate federal health care laws undermine the integrity of crucial medical decision-making," Phillip Coyne, Special Agent in Charge of HHS-OIG said. "This settlement is an example of the government’s combined efforts to protect Federal health care programs and their beneficiaries from those who are alleged to have violated these laws."
Phil Wheeler assumed the position of Chief Financial Officer and he will be supported by Clarice Cable, the newly appointed assistant vice president of finance.
Atrium Health Floyd, a healthcare system for northwest Georgia and northeast Alabama has appointed two new executives to lead the organization’s financial strategies.
Phil Wheeler assumed the position of Chief Financial Officer on May 31, making the move to Floyd after serving as CFO for Wellstar Atlanta Medical Center since 2019.
"We are delighted that Phil is joining our team and look forward to the knowledge and experience he will bring to us," Kurt Stuenkel, CEO of Atrium Health Floyd, said in a release.
Wheeler will report to CEO Stuenkel and Anthony DeFurio, who serves as the executive vice president and chief financial officer for Atrium Health. Atrium Health and Floyd completed their combination in July of 2021, to improve patient access to care in the northwest Georgia and northeast Alabama regions. The two healthcare providers announced their partnership back in 2019, but the COVID-19 pandemic had stalled their efforts.
Clarice Cable is also moving up within the Atrium Health Floyd community. She has been promoted to assistant vice president of finance at Atrium Health Floyd. She has served as Interim CFO at Atrium Health Floyd for the last two years as the health system navigated the pandemic and the strategic combination with Atrium Health.
“We want to recognize Clarice for the great job she has done," Stuenkel said. "She will give support to Phil as he transitions into his new role and will continue her excellent work."
There were two shootings at hospitals in the U.S. on the same day this month, leaving some wondering if organizations are putting enough financial support behind their security efforts.
Security has always been a priority for healthcare leaders but in the wake of the mass shooting at a Tulsa, Oklahoma, hospital that left four people dead, and a second hospital shooting that occurred on the same day in Dayton, Ohio, executives realize there are gaps in their safety strategies that must be addressed.
Increasing security measures at hospitals can come with significant financial and logistical challenges, but there are actionable steps and investments healthcare leaders can take to ensure the safety of the staff and patients within their organizations.
Mass shootings are common in the United States, with 233 such events taking place in the first six months of 2022, according to data from the Gun Violence Archive. Hospitals, however, have not always been primary targets for active shooters. There were 28 active shooter incidents in 2019, according to FBI data collected by the American Hospital Association, but only two of those took place at healthcare facilities.
"The mass shootings in Uvalde, Texas, and Buffalo, New York, have traumatized many Americans and reinforced the need for action on what is clearly a public health crisis," Northwell Health CEO Michael Dowling said in a statement. "As the CEO of New York's largest healthcare provider and private employer, I've long maintained that healthcare professionals are uniquely positioned to rise above the political fray by addressing the nation's gun violence epidemic through a public health lens."
The recent shootings have raised concerns about hospitals and other healthcare organizations becoming soft targets—much in the same way schools have—especially when considering that the Tulsa shooter was allegedly motivated by anger with his doctor because of his back pain, which he claimed was not alleviated following surgery.
"Workers who dedicate themselves to saving lives deserve a safe environment—free of violence and intimidation—in which to deliver care," Rick Pollack, president, and CEO of the American Hospital Association said in a press release. "The surge in assaults against the healthcare workforce cannot continue and we must do everything we can to protect them. Our workforce is enduring historic levels of stress and violence as they continue to provide compassionate, quality care throughout the pandemic. We will not let up in ensuring that all hospital and health system workers feel safe in the vital work they perform."
Northwell Health's vice president of corporate security recently said in an interview with News12 Long Island that the organization drills "constantly" to be prepared for and prevent an active shooter or another violent incident. All visitors to the system's 23 New York City–area hospitals must sign in with a government I.D., which is checked against a patient database, and utilize a visitor I.D. card to go through turnstiles within the building. Other safety measures Northwell has invested in include armed guards with posts throughout the hospitals and enhanced employee training on safety and identifying potentially dangerous individuals.
The costs of security investments will vary depending on location, budget allocation, and the types of measures organizations want to take. On average, incidences of hospital security breaches, whether they are physical or digital, can cost hospitals $810,000 per incident, per year, according to research from MeriTalk.
"There definitely needs to be investments made in the protection component of the healthcare program," says Brine Hamilton, CHPA, president of the International Association for Healthcare Security and Safety. "It is going to look different at every facility, but it is going to involve things like threat assessment, understanding your weak points, leveraging technology, and training your staff."
There are organizations that hospitals can use as resources to determine where their security efforts need to be improved and the best ways to train staff for an active shooter or other incidents of violence. Training is where hospitals will want to make their biggest investments, Hamilton says. Hospitals need to invest in programs that train every employee within the organization on how to be prepared for any emergency, both natural and manmade.
Another option for hospitals to pursue, that won't have a financial impact on the organization, is to make connections with the law enforcement agencies within their communities. Through these relationships, hospitals and law enforcement can collaborate on ways to make organizations safer and come up with response plans and contingencies for when a violent incident takes place at the facility.
"One of the unique challenges with a healthcare facility versus any other type of facility that is used by the general public is that people from all walks of life will at some point need access to that facility," Hamilton says. "That is everyone in our general public and that includes individuals who may have bad intentions."
When it comes to securing hospitals as people enter, Hamilton says investments in specific technology can go a long way in keeping people safe. Visitor management technology are customizable tools that can help hospital security know who is coming in and out of the building, centralize visitor information, and screen visitors against watchlists so security is aware of any potential threats. Metal detectors at each entrance are another option for hospitals, as well as more subtle gun detection solutions.
"There's not going to be any one silver bullet that's going to prevent these events from happening," Hamilton says. "But by taking the measures you're at least improving your odds of being able to prevent these incidents or address them quickly."
Eric Salmonson has stepped into the role of chief financial officer, as Allen Anderson prepares to become CEO.
Eric Salmonson is now officially the chief financial officer for St. Anthony Regional Hospital, an Iowa-based healthcare organization with over $186 million in net patient revenue.
Salmonson has been with St. Anthony Regional Hospital since June 2021, when he served as assistant controller, he became interim CFO in March of this year before taking on the role permanently in May.
"I am excited to take on my new role as Vice President and CFO of St. Anthony Regional Hospital," Salmonson said in a release announcing his appointment. "I truly care about Carroll and the surrounding communities that St. Anthony serves. It’s a privilege providing quality care alongside all of the staff at St. Anthony."
Salmonson’s appointment comes as CEO Ed Smith prepares to retire following 34-years with St. Anthony Regional Hospital.
"With Eric’s analytical skills and attention to detail, he will excel in his new role as Vice President and CFO," Smith said in the release. "As my career is concluding, I am confident in the leadership team of St. Anthony, and Eric will be a great asset to the organization."
Under Smith’s leadership, St. Anthony Regional Hospital says it saw significant growth in community healthcare services, employees, physicians, and financial stability. Staff at the hospital has grown to 750 full and part-time employees which has doubled since 1988 when Smith became CFO. He has served as CEO for the last 10 years.
"It’s been a rewarding 34-year career at St. Anthony working alongside a great staff providing quality healthcare to our patients," Smith said in a release. "I am looking forward to spending time with my wife, Vicki, our children, and three grandchildren."
Smith’s retirement was announced earlier this year, he will be succeeded by Allen Anderson, former CEO of Avera Tyler Hospital in Tyler, Minnesota. Anderson will step into the role of CEO on July 1, 2022.
"I am honored to accept the position as the President and CEO of St. Anthony Regional Hospital and am looking forward to working closely with employees, providers, and leaders to continue upholding the mission of providing quality care for our patients and communities,” Anderson said. "St. Anthony Regional Hospital is a healthcare leader, and it’s an honor to join such an outstanding organization."
Limbocker will step into the role in October as he takes over for retiring CFO William Woeltjen.
Sarasota Memorial Health Care System will be appointing a new CFO this fall when 20-year healthcare industry veteran Jeff Limbocker takes over for retiring CFO William Woeltjen. The change will take effect on October 3, 2022.
Woeltjen has spent 12 years as Sarasota Memorial Health Care’s CFO, he is retiring at the end of this year but will remain part of the executive team as he helps Limbocker transition into the role.
"Bill has been an invaluable member of our leadership team whose contributions have strengthened our health system and benefitted our entire community," David Verinder, president, and CEO of Sarasota Memorial Health Care System said in a release announcing the change. "We have two very big shoes to fill, and I want to thank Bill for his dedication and strategic guidance over the past 15 years and his ongoing support as we welcome Jeff, another longtime financial executive, to our organization and community."
As CFO Woeltjen helped facilitate the system’s largest expansion in its almost 100-year history when Sarasota Memorial Health Care opened its new hospital in Venice and the Oncology Tower on the Sarasota campus last year. Woeltjen was also able to help the system navigate rising costs and staff challenges that cropped up due to the COVID-19 pandemic.
Limbocker is currently working with the Franciscan Missionaries of Our Lady Health System, where he has held several leadership roles since 1995. He has also served as executive vice president and chief financial officer of the not-for-profit, multi-hospital system for the past three years. Prior to that Limbocker spent a decade as regional CFO for the health system's Baton Rouge market and Lady of the Lake Medical Center.
"I feel very fortunate to have worked for one great mission-based health system for many years, and to be continuing my career at another great mission-based health system," Limbocker said in the release. "I am looking forward to joining the Sarasota Memorial team and the opportunity to help guide the health system as it continues to evolve and meet the needs of this growing region."
Four people were killed when a man opened fire on the St. Francis Health System campus in Tulsa.
The American Hospital Association has called for bipartisan legislators to take swift action to address the mass shootings currently plaguing the United States. The latest in a string of these events took place on the second floor of the Natalie Medical Building on the St. Francis Health System campus in Tulsa, Oklahoma on Wednesday.
Four people were killed when a man opened fire in the building with an AR-15-style weapon that he had acquired that same day. The gunman was reportedly looking for a doctor at the hospital who had recently performed surgery on him to treat his back pain.
Two doctors, a patient, and a receptionist were killed in the attack. Reports also say the gunman died of a self-inflicted gunshot wound.
"Yesterday was another unfortunate example of gun violence in our country," Rick Pollack, president and CEO of the American Hospital Association, said in a statement addressing the shooting. "This latest incident was in a medical facility, a place of healing, on the campus of Saint Francis Hospital in Tulsa. We grieve with the victims and their families, as well as the entire Saint Francis Health System team, as they mourn the loss of four members of their community. This further reinforces the need for action to be taken to stop these tragic events. Legislators are working on a bipartisan effort to address gun violence, and we urge them to act quickly. "
The CEO of the Federation of American Hospitals, Chip Kahn, also released a statement commenting on the Tulsa shooting, urging the government to make substantial changes to U.S. gun laws.
"Enough is enough. This must stop. Hospitals are pillars of our communities—the places people rush to when they need help, they shouldn’t be crime scenes, " Kahn said. "Patients and caregivers deserve to feel safe and secure when they enter our nation’s medical centers. It is mission-critical for Congress to act now. We hope the bipartisan negotiations happening on Capitol Hill will result in legislation that will have a real impact on the scourge of gun violence."
The American Medical Association is also demanding critical action be taken to stem the increasing flow of gun violence in the U.S.
"As we have said repeatedly since declaring gun violence a public health crisis in 2016, gun violence is out of control in the United States, and, without real-world, common-sense federal actions, it will not abate, " AMA president, Gerald Harmon, MD, said in the statement. "The House Judiciary Committee is taking an important first step today by considering the Protecting Our Kids Act, and we urge Members to approve life-saving measures and policies endorsed by the very physicians tasked with caring for victims of gun violence. In a letter to the chairman and ranking member of the House Judiciary Committee, the AMA highlighted specific, common-sense measures in H.R. 7910, the Protecting Our Kids Act, the AMA supports to curb gun violence."
Last week the AMA released a statement regarding a separate mass shooting in the U.S. On May 25, 2022, the organization had previously asked lawmakers to address this prevalent issue, after 19 children and a teacher were killed in a mass shooting at a Texas elementary school.
"The shooting yesterday at an elementary school is horrific and sadly—and unacceptably—all too familiar in the United States," Harmon said in that statement. "A week after Buffalo, 10 years after Sandy Hook, 23 years after Columbine; the places and cities change, but the story is the same—too-easy access to firearms, inaction on wildly popular, common-sense safety measures like background checks, and countless lives lost or changed forever. "
There have been 233 mass shootings in the U.S. in 2022, according to data from the Gun Violence Archive.
"As physicians, our mission is to heal and to maintain health," Harmon continued. "But too often the wounds we see in America today resemble the wounds I’ve seen in war. More and more it is clear no place is safe—malls, schools, movie theaters, places of worship, and grocery stores have all been targeted. Firearm injuries and deaths are preventable. And while the ideal time to act and find common-sense solutions and common ground might have been years ago, the best we can do now is act today. We call on lawmakers, leaders, and advocates to say enough is enough. No more Americans should die of firearm violence. No more people should lose loved ones. "
The search is underway to find the non-profit healthcare provider's next CFO.
Baptist Health Chief Financial Officer Steve Oglesby has announced he will be retiring following 30-years with the non-profit health system at the beginning of next year. Oglesby’s retirement will take effect on Jan. 6, 2023, and Baptist Health will conduct a nationwide search to find his successor.
"I have been very blessed personally and professionally to work under incredible leaders over the course of my career at Baptist Health, " Oglesby said in a statement announcing his departure. "The faith-based mission of caring for others is what drew me to healthcare and kept me involved as a servant leader to provide financial and business guidance to the clinicians who fulfill our mission to our patients. "
Oglesby, 60, joined Baptist Health in 1993 where he served in a variety of roles including vice president of financial strategy and integration, and assistant vice president of finance. Oglesby was named CFO of Baptist Health in 2016 and his efforts in leading the financial strategy of the organization were recognized in 2018 when he was named among the "Best in Finance" by Louisville Business First.
"Under Steve’s leadership, Baptist Health has successfully executed key strategies and demonstrated our ability to continuously strengthen our financial position while expanding access to our healthcare facilities, " CEO Gerard Colman said in the announcement. "Baptist Health now has an operating revenue of nearly $4 billion and has earned its highest-ever ratings from key bond rating agencies, with an A+ rating from Fitch and an A1 rating from Moody’s. Steve has set us on a positive course for the future. "
Michael Sunday Jr. recently connected with HealthLeaders to discuss his new role, his goals for Pardee, and how hospitals can move their organizations into the future.
Pardee UNC Health Care—a North Carolina–based nonprofit community hospital with $190 million in net patient revenue—has recently promoted Michael Sunday Jr. to the position of vice president and CFO.
Sunday was promoted to the position after serving as Pardee's controller since June 2019 and will lead the organization's financial operations and supporting functions such as revenue cycle, accounting, internal audit, system budgeting, capital planning, and decision support. Before joining Pardee, Sunday was the director of accounting and finance for Onslow Memorial Hospital in Jacksonville, North Carolina.
"Mike is well respected among his peers and has proven to be a steady and committed leader within our organization," Jay Kirby, president and CEO of Pardee UNC Health Care said in a release announcing Sunday's appointment. "He is a welcome addition to our leadership team."
Leading the financial strategy for a hospital or health system has been more difficult since the onset of the pandemic. The great resignation, flooded COVID-19 wards, and a perpetual lack of funding for some organizations all contributed to the struggle. These issues have presented unique challenges that require CFOs to think creatively about how they can move their organizations forward.
A recent blog offers suggestions on how CFOs can ensure they have quick access to necessary financial resources. Some options include "talking with banks and other potential sources to build liquidity resources in the face of rapidly deteriorating cash flows." And "working to closely monitor and track incremental COVID-related expenses, as well as COVID-related losses. This will help in securing government assistance, in quantifying the pandemic's impacts to boards, executive teams, and other stakeholders, and in identifying the financial gap for the organization."
As Sunday steps into his new role as CFO for Pardee UNC Health Care, he'll have these and other concerns on his plate as he works to improve the organization's financial resources. He recently connected with HealthLeaders to discuss his new role, his goals for Pardee, and how hospitals and health systems can move their organizations into the future.
HealthLeaders: What drew you to the CFO role at Pardee?
Michael Sunday: I was drawn to the role of CFO at Pardee in large part because of the leadership team and the growing organization. This is a supportive team who takes an active role in the organization and brings out the best in its team members. It's a rewarding experience to watch as Pardee works to bring care closer to home from expanding our service lines, including the cardiac care team, and becoming STEMI-certified to doubling our primary care service line.
HL: How will you help shape the organization's financial strategy going forward?
Sunday: Our team is developing a five-year plan based on the organization's strategies to ensure the stability of the financial well-being of the hospital. We are in the midst of creating a meaningful dashboard for the organization that shows real-time tracking of revenues and costs, as well as developing ongoing monthly and yearly forecasting, so if an issue arises, we can adapt quickly.
HL: What are the biggest challenges hospital CFOs are facing right now? And how can we solve them?
Sunday: Today, hospitals are facing multiple issues in the healthcare industry, including the rising cost of labor, a labor shortage, rising costs of supplies due to inflation, pandemic spikes, and reductions to Medicare and Medicaid reimbursements. To take on these challenges, we are first looking at ways to not rely on contract labor. That could mean creating a hospital contract labor pool to reduce the impact of contract labor. Other steps would include hiring in-house recruiters to help bring qualified employees into the organization and finding ways to reduce costs, including the reduction of waste and energy consumption. Charge capture is also important to ensure all documentation is being captured on the front end to reduce the likelihood of denials from insurance companies.
HL: How has the great resignation impacted Pardee?
Sunday: Pardee is not immune to the staffing shortages that hospitals and health systems across the country are facing. The shortage of the labor force and the growth of contract labor has made it increasingly difficult to manage hospital expenses. This continued growth is not sustainable, and hospitals have to adapt and find creative ways to hire staff, for example, offering sign-on or referral bonuses to employees.
HL: Where should hospitals and health systems be making the biggest investments? M&A? Workforce? Technology?
Sunday: The largest investments hospitals should make are in their workforce. Certainly, technology and new equipment are important, but without the doctors, nurses, and support staff to take care of the patient, we can't provide the quality care that our communities expect of us. Like everyone else in today's job market, but especially in healthcare, ensuring we have a qualified workforce is a top priority. Today's competition for the workforce is forcing systems to invest more in this area.
HL: What are the biggest trends CFOs should watch in the healthcare finance space?
Sunday: For North Carolina, one of the biggest trends CFOs should be on the lookout for in the finance space is Medicaid expansion. North Carolina has not yet expanded Medicaid but appears to be poised to do so. It will be interesting to see how this expansion would impact healthcare and our hospital system.
Also, we are almost one year into NC Medicaid Managed Care (or Managed Medicaid); we're still evaluating how it has impacted our reimbursements in healthcare.
Finally, even though we're in a new phase of the COVID pandemic, all healthcare systems will be monitoring what exactly this new phase and associated spikes, treatments, and workforce issues will mean for finances.
Trinity will be breaking ground on the new facility this summer and the $12 million project is expected to be completed in 24-months.
Trinity Health System—which is part of CommonSpirit Health, a nonprofit, Catholic health system—has secured the funding and property needed to expand its presence in the Midwest with the construction of a 20,000 square foot neighborhood hospital in St. Clairsville, Ohio.
Since 2019, three of the five hospitals in and around Belmont County—where St. Clairsville is located—have closed, severely limiting healthcare access to the people in that community. The closest emergency room is about 20-minutes from St. Clairsville, according to Trinity Health System CEO Matt Grimshaw. The organization saw an opportunity to bring ER and other needed medical services to this underserved market.
"We started looking at the different models of care out there and wanted to figure out what the sweet spot in the new world of healthcare would be," Grimshaw says. "What we learned we needed was ERs, CT scanners, overnight beds, and surgery access. In modeling out the efficiencies you can gain in a small state of the art facility, we think this is a great model for cost effective care and access."
Trinity will be breaking ground on the new facility this summer and the $12 million project is expected to be completed in 24-months. Funding for the hospital is coming from the Trinity Health System Foundation, which relies on outside donations to help improve the facilities within the system and offer greater access to care.
"Building a small footprint neighborhood hospital that doesn’t have all of the overhead and space of the legacy buildings spread across the country really is geared toward the future of healthcare," Grimshaw says. "Fewer and fewer services are requiring long hospital stays. The future of healthcare is convenience, it is not giant hospitals. It is telemedicine, it is improved access, and it's finding cost-effective ways to deliver care in a world of scarce resources.”
