VMH experiences stronger February, prepares for April 1 MMC start date

by Brianne Eilers

Discussion at the Tuesday, March 22 meeting of the Veterans Memorial Hospital (VMH) Board of Trustees revealed that the month of February ended on a positive note financially for Veterans Memorial Hospital in Waukon with a net income of $162,459. Looking at the year-to-date statistics, VMH is showing a loss of $22,469.
The number of days in accounts receivable are at 86.1, compared to 83.7 at this time last year. “There is a little bit of a bump from the ICD-10 coding,” VMH Administrator Mike Myers said. “We are working to get that number down.”
Expenses were held within 0.1% of the budget. On the revenue side, acute patient days are down, as are deliveries. Total surgeries are also down, but the outpatient services are continuing to show an increase over the numbers from last year. Myers did point out that March is not looking strong financially.
VMH is continuing to work closely with Athena Health on electronic medical records (EMR). Myers said the company has been looking at what kinds of things the hospital orders for patients and how they order it, and Myers thinks that Athena Health is looking to begin at VMH in April.
On the Medicaid Managed Care (MMC) front, the hospital is getting ready for the April 1, 2016 start date, and is looking to sign contracts with all three of the managed care organizations (MCO). “We are already seeing issues in trying to refer these patients,” Myers said. He further explained that at VMH, they are used to being able to send patients to specialists in Wisconsin or Minnesota, which they may not be able to do anymore.
He explained that an oversight bill had been passed, mainly by State Democrat senators, but had been rejected by the Iowa House of Representatives. Myers did note that there appears to be a new oversight bill coming from the State’s Republicans. He also explained that the state of Connecticut, which had used Medicaid Managed Care, decided to move away from that model and go back to State-run care. Myers hopes that Iowa State legislators will look at the situation that happened in Connecticut and try to see what the issues were and what led to that decision. He further pointed out that the previous Medicaid system in Iowa has been dismantled and there is no one to monitor the managed care situation other than the MCOs.
In May, Myers will be attending the American Hospital Association annual meeting in Washington D.C., along with physicians and a board member from VMH. “That’s where the healthcare decisions are made and we need to continue to make our voices heard to them,” Myers said.
VMH is looking into upgrading its radiology equipment. Myers said one of the pieces of equipment still runs on Windows 7, which is no longer supported. Myers visited with the CEO of Gundersen and they discussed the vision of healthcare from both entities, as well as the future of healthcare for each of the entities, in addition to both local and national levels of care.
In the area of Medical Staff, the hospital has had time to evaluate if its model of using full-time providers from Emergency Practice Associates is working and if there is a need to make any changes. “We have been very pleased with the work that these individuals have done and our partnership with EPA (Emergency Practice Associates),” Myers said.
Also discussed at Tuesday's board meeting was Press Ganey and patient satisfaction. As payment is moving more towards value-based, VMH will be looking at possibly re-formatting those Press Ganey surveys to include elements from the HCAHPS surveys used by Medicare and report results to Medicare.
Patient safety will also be looked into, and VMH is looking into how patient safety issues are monitored, reported and addressed, such as falls, medicine errors or outcomes, in relation to preventing or minimizing these issues. Myers used the example of re-admission and working to design a system and process of care to monitor patients more intensely and make sure they are getting the follow-up appointments, prescriptions filled and understand what to look for as far as problems with their injury or condition. Myers said there will be internal meetings to look at this, with the ultimate goal to enhance the care provided to patients by VMH.
The hospital will also be looking at how payment models are shifting and how to address the changes. He gave the example of a bundled payment for joint replacement, which means there will be one payment disbursed to all involved. VMH will be looking at how this will impact its processes as a facility and the healthcare industry as a whole.

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