Veterans Memorial Hospital posts record-setting month of October; New year will bring change to provider staff and on-call system

by Brianne Eilers

The month of October was a record setting month, financially, for Veterans  Memorial Hospital (VMH) in Waukon, with a net income of $240,024, which made a 14.1% profit margin for the month. Year-to-date, VMH has a net income of $322,223, which translates to a 5.7% profit margin.
VMH Administrator Mike Myers noted that while acute patient days were down 10 percent for the month, skilled patient days were up six percent, year-to-date. Myers also noted that on the outpatient side of things, surgeries were up and outpatient lab was also up. Outpatient physical therapy was down, but he said that was due in part to the fact that most insurance companies require pre-authorization now.
“Our bad debt and charity care are also down,” Myers said, explaining that this is due to the fact that with the Medicaid expansion, more individuals have insurance to cover medical issues. “This is being reflected statewide,” he added.
The number of days in accounts receivable has jumped way up to 102, but Myers anticipated that should be getting “straightened out” soon. The high number is due to several factors, including the time required to pre-authorize procedures and that VMH has been locked out of the Medicare website, but is working to remedy that situation. Myers also noted that a position has been created, and filled, to deal with the pre-authorization process. Currently, one individual is responsible for pre-authorizing procedures and coding.
VMH’s cash reserves are down to $2,268,000, and Myers noted that the hospital has been paying cash for many of its purchases. Myers also noted that the sleep study program numbers at VMH are up.
In other matters, the hospital continues to work out the bugs in the system with its new electronic medical records program. Myers and other staff members attended a Press Ganey meeting in Florida last month. He noted that one of the big issues in health care right now is transparency in hospitals, and he said VMH is looking at ways it can be more transparent to the public. “With these high deductible (insurance) plans, that first $2,500 or whatever is out of our pockets, and we’re going to go where ever they have the best price,” Myers said, meaning that the public is wanting to make more informed decisions about where they receive their health care services to get the best value for their dollars spent.
Beginning January 1, 2015, VMH will be changing the way it does its call system for its provider staff. Myers pointed out that currently the physicians who are the provider staff for VMH are responsible for being on call in the emergency room, as well as trying to perform deliveries and also seeing their patients in the clinic. Myers said the hospital has been busier, as well as the clinics, and many hospitals no longer have their primary care physicians doing double duty at the hospitals and the clinics, which can cause patients in the clinics to have appointments delayed, due to the doctors being called to the emergency room.
VMH has contracted with Emergency Contracted Associates to provide nurse practitioners and physicians’ assistants to work in the hospital during the week days, and they will be backed up by the physicians in the local clinics here. Weekend on-call staffing will be mainly done by the local Gundersen Lutheran and Mayo Clinic doctors. “It’s time to give their patients in the clinic a break and it’s time to give the providers a break from being pulled in all those different directions,” Myers said. He also speculated that this would make recruiting new physicians easier in the future.
Myers noted that the annual Christmas Fantasy was a success, but the numbers had not been available to him by this meeting. He also noted that with the changes coming in the on-call plan, the hospital has contacted Northeast Iowa Behavioral Health and told them that the hospital will not be able to provide them with a room beginning January 1, 2015. VMH will need to make a room for the on-call physicians to be able to use when they are not treating patients.
 

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