County council, board of trustees discuss hospital’s future [The Union Daily Times, S.C.]

July 20--UNION -- The Union Hospital District Board of Trustees and the Union County Council Committee on Public Health and Social Services held a joint meeting Thursday morning to discuss the future of Wallace Thomson Hospital.

The meeting began with Union Hospital District (UHD) CEO Paul Newhouse providing information to those in attendance. Newhouse explained that for FY 2013, the district had a 4.4 percent increase in indigent care, which means $2.3 million in noncollectable charges. If the percentage of indigent care had remained similar to FY 2012, the UHD would have an income of $2.3 million. Newhouse also reviewed the payer mix and continuing reductions from Medicaid/Medicare and commercial insurance.

Newhouse also discussed meetings which had taken place with leaders from Health and Human Services, South Carolina Hospital Association and the Office of Rural Health. He noted that many of these reductions and decline in payer rates are statewide trends and concerns. He said he learned from these meetings that UHD may be eligible for assistance regarding indigent care, as well as a small increase (4 percent) in Medicaid to offset the previous reduction (7 percent).

Newhouse also pointed out that a main focus of concern for the district is recruiting new physicians as well as retaining those currently employed. He said that during a medical staff meeting, longtime physicians explained that new physicians coming out of medical school are not trained to expect the round-the-clock on-call situations like they were in the past. He noted that putting in place a hospitalist who would attend to and admit patients after hours has proven beneficial to primary care physicians.

Partnership

Newhouse stated that another potential option for viability would be for the district to partner with a larger health care system such as Spartanburg Regional or Greenville Memorial. One option is to share physicians who are currently under served in their areas by utilizing them in Union. Another option would be to utilize the larger entities' preferred negotiated rates with managed care companies as well as purchasing groups.

Recovery Plan

Frank Hart -- chair of the county's Committee on Public Health and Social Services -- requested a tangible plan for the successful financial recovery of the UHD. He asked when the county could expect to see a return on the amount borrowed by the UHD from the county.

Hart specified two phases to the UHD's recovery plan. One phase would include immediate and expected remedies which are currently underway to eliminate financial stress on the district.

"Paul Newhouse, his administration, and the Hospital Board have done a good job at looking at cost reductions and process efficiencies to accomplish Phase I," Hart said.

The second phase would include the "partner" program to ensure continued sustainability and financial viability of the district on a long-term basis. This phase could include partnerships and revised business models.

"Considerations as to what is the proper scope of care that we should provide, if we should affiliate with another hospital system or health care entity, what that affiliation should look like -- as it can vary from simply agreeing to purchase items together for economy of scale all the way to allowing another entity to provide for the operation of the hospital as was recently done in Laurens County -- are all part of what should be considered in a Phase II analysis," Hart said.

Newhouse closed by mentioning he would have South Carolina Hospital Association CEO Thornton Kirby provide education for the board with regard to similar situations and strategies of hospitals throughout the state.

"We will start discussions on various options of collaboration with other area hospitals to find ways that will be win-win situations for the hospitals, while providing the necessary level of care for our community," Newhouse said. "The meeting today was a great start to the path of determining what the hospital needs to look like in the coming years. We have been meeting with several organizations from the state level to assist us in looking at what works in rural communities. We will have further presentations from the hospital association to educate the board on what other community hospitals have done over the past few years to be successful."

County Supervisor Tommy Sinclair said an important aspect of the meeting was the engagement of county council -- through the committee -- with UHD board members as well as hospital staff.

"Today's meeting put in context and framework a way ahead for the future of health care in Union," Sinclair said, explaining that while the UHD is important in the way of local economy and as an employer, those aren't its primary functions. "The prize here is sufficient and affordable heath care for our citizens."

UHD Board Chair Rhonda Ingle said she viewed Thursday's meeting as very positive.

"The county has been and continues to be very supportive of the hospital system," she said. "We will continue to have joint meetings and would like to extend an invitation to the county council as well as citizens of the county to attend our monthly board meetings. We welcome all input on how we can best serve the citizens of this county. Our primary responsibility is to the health care of our citizens."

Hart also commented following the meeting.

"I left with the sense that we were all on the same page as to the challenges that we are facing and the need to formalize a long-term plan," he said.

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