Prowers Medical Center, like similar hospitals across the country, may experience some financial changes next year in light of federal funding changes and potential program alterations from the new administration in Washington, DC.
Chief Executive Officer, Craig Loveless, told the Prowers County Commissioners, the hospital is exploring those lines of service that can generate the most revenue in direct pay to the hospital. “The provider fees are expected to be reduced and some government programs are on the wane,” he explained, adding that the provider fee is expected to be reduced by 13% which translates to a $600,000 revenue loss to the hospital.
Anticipating future payment system alterations, Loveless said that in 2019 a system based on quality performance measurements will be put into play and will impact how the hospitals are reimbursed for service. “We’ve focused on this for some time at Prowers Medical Center,” he said, stating that behavioral health is one of those categories. “This focuses on how well we deliver those services to the community. The hospital has left that service line in the past to Southeast Health and High Plains and we’ll continue to do that, but we intend to strengthen the collaborative efforts of the local medical community to score in that area as well.”
Loveless said because PMC serves an area with a less prosperous population than other parts of the state, the hospital can’t afford to provide in-house cardiology services. “We don’t have a service line cardiologist on staff which is why we’re concentrating on attracting orthopedics which is one way we can provide a much needed service at Prowers Medical Center and serve our community.” Loveless said there are visiting cardiologists that offer their services, but they are not under contract to the hospital, so that translates into a dollar loss as those revenues go to other hospitals.
He explained that over the past three years, PMC has had to out-source at least 350 surgeries, not counting the University Hospital in Colorado Springs which had also reduced revenue potential. “Now that we have renovated our surgical suites, we can provide those types of operations locally.” He explained there are still several hurdles to overcome because the hospital has a 38% Medicaid population and orthopedic surgeries and reimbursement are considered elective, unless you just can’t walk. These regulations hinder the scope of surgeries and reimbursement.
Loveless questioned the longevity of some new health programs from Washington, DC which are federally subsidized. “Medicaid,” he explained, “is state run, but disperses funding from the federal government.” He added that PMC will continue to adjust to provide affordable service to the community in light on new regulations and the hospital will continue to be profitable in light of declining government funding.
Taking a broader range of hospital activities, Loveless stated that Doctor Foley will join the medical team on December 28th to add to the ob-gyn department and an interview with a potential internal medicine doctor will be held next month. He was optimistic about the relatively new Big Timbers health alliance with pulls together medical and community resources to improve health and lifestyles for the local population. He’d like to see some of the smaller schools in the district become involved, beyond Lamar Community College, which is already taking a role in the program. “Our economic development groups, coupled with education in general will play a role in the scope of the collaboration,” he suggested.
By Russ Baldwin
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