Hospital Community Advisory Council learns of past successes, future challenges at annual meeting
Waldo County General Hospital held its annual Community Advisory Council meeting Monday, Nov. 19, at the University of Maine Hutchinson Center in Belfast.
Steven Michaud, president of the Maine Hospital Association (MHA), told attendees that over the 26 years he has been with the MHA in different capacities, about one-third of the state’s 39 hospitals face operating losses each year. It’s not the same hospitals every year but still it has averaged out to 12 or 13 who finish the year in the red.
This year, that figure climbed to 24 hospitals and the operating losses were much higher.
But one hospital he has not seen on the “red-ink” list is Waldo County General Hospital. “Your hospital is something special within the State and within the healthcare system,” he said, adding that Mark Biscone, Executive Director of the Hospital, and his administrative team are one of the reasons for the Hospital’s success.
“The Hospital has had a positive bottom line (including non-operating income) for the last 35 years,” added Lee Woodward, president of the Hospital board of directors.
That may be much harder to continue, according to Michaud. He said Maine hospitals are facing “a plethora of changes and a rapidly deteriorating environment.” These include a poor rural economy in the state, an aging population (the oldest in the country), and state and federal budgets that are in bad shape.
Currently, 64 percent of the patients at Waldo County General Hospital are on Medicare or Medicaid and the state and federal governments keep cutting the reimbursements for services provided for those patients.
But the biggest problem, according to Michaud, is the decline in patient volume over the last couple of years. He cited the economy and affordability as reasons for the downturn in volume.
He said hospitals “need to live in a new reality,” including working to keep people healthy and doing better at working with those patients with chronic diseases. According to Michaud, the top 5 percent of hospital users in Maine’s Medicaid program cost an average of almost $70,000 per year while the average cost for the lowest 80 percent is $937 per year.
“We need to concentrate our efforts on the top 5 percent,” he said. “We need to manage their care, make sure they are taking their medications and keep them out of the hospital as much as possible.”
And if hospitals do that, there needs to be changes in the payment system with a reward for hospitals that keep patients out of the hospitals and in their homes; otherwise, the hospital volume will drop and they will be punished for “doing the right thing,” he said.
To deal with the issues he listed, along with the uncertainty of Obamacare, Michaud said hospitals need to protect what they have and reform “like crazy,” do better with less, and create value in a transparent world. But, he added, government needs to stop cutting the hospitals reimbursements while they are changing. Biscone added that Maine hospitals will lose $80 million per year for 10 years to pay for the subsidies promised by Obamacare.
Michaud said the trade-off was supposed to be that the bad debts and charitable care performed by hospitals would lessen as more people got covered by insurance. “The cuts are for sure and the offset is less sure,” he said.
In other action at the annual Community Advisory Council meeting: two new board members, Syrena Gatewood and J.B. Turner, were elected; Rev. James Barclay was honored for his years of service as the Hospital’s Chaplain; members heard from Woodward that one of the biggest challenges the Hospital has faced is the implementation of electronic medical records; and they celebrated the attendance of 150 people at the meeting, which Michaud said is an unusually high number based on his attendance at other Community Advisory Council meetings around the State.