Bartlett Regional Hospital’s Finance Committee learned on Tuesday night that probably the biggest reason why admissions have declined is because of a national trend where more people are accessing fewer health care resources.
Bill Henning, regional vice president with Quorum Health Resources, said they are seeing a strong shift from inpatient services to outpatient business.
“Even the inpatients that are being admitted are staying for a shorter time,” he said.
That shift also isn’t fully translating to just outpatient services, Henning said. What he’s found is that more people are facing higher deductibles and higher personal costs for health care, so people are utilizing health care services less and less.
Henning said in talks with Medicare representatives that they have seen the lowest increase in beneficiary use in the past 25 years.
“They also see people trying to utilize things less,” he said. “There’s apparently an impact — the wallet impact. With the increase in deductibles, things like that, we’re seeing the same trend elsewhere. That’s even going into the ER (Emergency Room).”
Henning believes this trend will continue for several years, and that numbers of people seeking treatment will never reach what it once was. Henning also thought there would be somewhat of a turnaround as the economy improves.
“If people are being denied coverage, they’re not paying for it themselves,” he said.
Interim Chief Executive Officer John Vowell said Bartlett won’t see a full turnaround, and department directors are expecting to remain flat with the volumes they are seeing this year.
“We’re basing them on, we’re going to stay at the levels we are and even some decreases in some of the services,” Vowell said.
Interim Chief Financial Officer Dennis Stillman reviewed the February financial reports with the committee and the downtrend in admissions remains consistent with the last year-end projections — which put the hospital at breaking even for the year instead of a $4 million to $5 million fund balance.
Stillman said inpatient revenue for February was 8 percent under budget — or 8 percent under where they had projected to be for the month. Outpatient revenue was 9.6 percent under budget. Total expenses were down 6.1 percent.
“We had a positive bottom line for the month,” Stillman said. “We’re still about $4.5 million behind where we planned to be for the budget for the year. If the volumes stay where they are now, we still look to be on track to break even by the end of the year.”
The committee also took a look at draft policies for charity care and self pay collections.
Bartlett is working on fine-tuning some of its policies for how it collects funds — or doesn’t. In the past few years the hospital has seen growing bad debt or charity care amounts.
Stillman said the hospital hasn’t had a policy — more of just a general way of doing business — regarding payment plans for patients. This leads to people paying typically $50 a month on an outstanding bill indefinitely. On accounts that have more than $20,000 in remaining debt owed by the patient, that typically means the patient won’t ever pay it off.
“This policy is for those people who can’t pay off their bills when they first come due,” Stillman said.
The draft policy states that “the general expectation is that self pay balances will be paid in full within 30 days of the initial patient billing statement.”
However, it also recognizes that there are many instances where this is not possible. The proposed policy is to have a more formal procedure with patients about different payment options, but the plan is to have all paying patients pay off their bills within 24 months or less. The time allowed is proposed to be in correlation with the amount due with eight tiers planned. For example, on balances of $100 to $1,250 the patient is expected to pay within three months. The eighth tier will have balances of $8,751 and higher due within 24 months.
The second draft policy, on charity care, expands the system in place for those who need health care services but don’t have the means to pay.
“Last year we had $12 million between charity care and bad debts,” Stillman said.
The financial services department looked at reasons why bad debt accounts failed to meet the requirements for charity care and reflected that in the draft proposal. They said charity care will be available to more people and more services, which will more accurately reflect expenses in accounting.
“In neither case are we going to get paid anything,” Stillman said. “The incentive is to say, this is community service.”
The hospital will use the Census Bureau definition of family income and use federal poverty guidelines for Alaska for determining how much to allocate to charity care.
“We could probably move about 2/3 to ¼ of these accounts in bad debt to charity care,” Stillman said. “We want to make sure that we’re trying to collect everything we’re owed when people have the means to pay. When people don’t have the means to pay we want to make sure and account that as charity care instead of bad debt.”
This only applies to services that are deemed medically necessary.
• Contact reporter Sarah Day at 523-2279 or at sarah.day@juneauempire.com.
Comments (6)
Add commentPlanning for Failure and Blaming Charity
What happens later when their best-guess budget doesn't add-up? Spending at Bartlett is out of control and the best they can do is to hope for a break-even.
Now Bartlett is setting-up their charity cases as their future excuses. Later this year they will need to come to the City begging for a bail-out, again. All the while blaming their increased chairty caseload for their financial woes.
This old story has been played-out by many other city owned hospitals elsewhere. In the end, the mismanaged city owned hospitals get sold to private concerns.
End of the road?
For decades now hospitals, pharmacies, etc. have been living large off health care insurance. Well, health care is now out of reach for many employers and their employees. If you buy it yourself, right, huge deductibles. The gravy train is gone and its time to slim down.
Here's another reason
Here's another reason (perhaps). Did you know that Bartlett no longer do casting on kids? I did not know that till a few months ago.
My youngest broke her arm, and was sent to Bartlett. Bartlett specifically mentioned that they do not place casts on kids. That must be done at Juneau Bone and Joint.
The accident was on Saturday, the cast was on Wednesday.
So ... one of the reasons why less people are going to Bartlett could be due to Bartlett is now providing less services then the in the past.
And another reason
I dont know anyone that has gone there that doesn't have to go to seattle to get what they need.No one there can even read a cat,mri,or an xray without some outside expertise.The only thing keeping them in business is birthing babies,and even that needs outside help.
Business is down at BRH because of BRH, not the national trends
BRH is NOT user friendly and they do NOTHING to cultivate business. They do PSAs but they usually are for some paid service when you get through their phone chain 20 mins later.
Their prices are also ridiculously high but then it takes a ton of cash to fund the Quorum management service...and reward their top staff for extravagant purchases by giving them 3% of whatever they spend. If they spend $1million on a new mri machine, they get a cash bonus of $30,000.
Of course since the last time that was made public no one has been able to get a copy of the new extreme handouts they get.
Duhhhh
Business is down cause we've been priced out of hospital services even when you have insurance. 50% of my paycheck now goes to health insurance and i still have to be careful how many times I access services due to co-pays and non covered expenses. NOT OK.
we deserve basic care without going to the poor house. If services were fairly priced instead of outrageously inflated we wouldn't be having the discussions about medicare and post office closures (which is driven by medical costs) that we are having today. It's another CRIME against the American People just like the Wall Street and Mortage Industry mess.
One more thing....if you can afford it ...fine...you can have all the latest treatments. Why do we have to throw everything but the kitchen sink at a sore throat? A simple look and penicillin was all it took to treat my strep as a child..but now it can cost over 500 bucks to get treated. It's exploitive and unfair.