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Our focus is your focus

February 2013

I hope you’re aware of TVHC’s hospitalfocus 2015 project. This project is focused on planning for the future of our hospital to ensure that our services are relevant and well-supported by our community in the coming years. It’s not possible to plan for the future without hearing from you, and one method of communication has been through community forums that we have held.

During our series of forums last fall, you told us you were interested in several primary areas: affiliations, billing accuracy and pricing structure. We’ll talk about affiliations and billing now, and discuss pricing in the next article.

Let’s talk about affiliations first. The overall goal for affiliations at TVHC is to sustain the long term viability of TVHC as a local hospital. Whatever the outcomes may be for small rural hospitals through mandated healthcare reform, we can trust that cost reimbursement rates will drop. This means that we have to increase our utilization – adding services that utilize existing staff and facilities so revenue goes up faster than expenses; and become more efficient in our spending. As we discussed in our meetings, regulatory changes, combined with advances in technology, have to be integrated with community needs and desires for healthcare. This will require collectively broadening our view about the delivery of healthcare.

Core services, such as the ability to perform X-rays and staffing a round-the-clock Emergency department, must remain at the hospital. Some core services, such as general surgery and pain management, can only be supported on a part time basis given our community size. Certain services can be performed remotely, such as reading X-rays (currently outsourced to Medical Imaging Associates) and coding our bills (outsourced to a firm in Wyoming and to Madison Memorial Hospital). Certain functions are best performed if we are part of a larger group, such as being part of a purchasing organization (we currently belong to Amerinet) or sharing clinical resources.

We need to function effectively. We can read X-rays 24 hours a day because we contract (like many hospitals in the region) with a group of radiologists. We do not have enough volume to hire a radiologist to cover 24/7 on-call; our current affiliation lowers our cost per X-ray read. We are also exploring telemedicine alliances with specialty facilities, and sharing back-office duties. As a small hospital serving a small community, we do not have depth in key roles. Establishing management agreements to improve our capacity is key to our long-term survival.

Next up is billing accuracy. Nationwide, the number one complaint about hospitals is related to cost for services. Hospital billing runs a close second. TVHC has had significant problems in the past with billing and billing accuracy. This has had significant impact on both our financial performance and on the community. Moving forward, we continue to improve billing timeliness and accuracy. We know we have to enhance readability and the level of detail in our bills. What does all of this add up to? Better accountability for you.

In November and December 2012, we served 2,978 clinic patients and 1,487 hospital patients for a total of 4,465 people. Complaints received for the same time period equaled 21 with 18 directly referencing billing. Most of the billing complaints were resolved through an explanation of services rather than finding errors on the bill. While the percentage of actual errors was very low, several complaints led to finding an error in our process that caused a small percentage of bills to be stated in error. We have corrected the process and we’re grateful for the patients who posed the questions. Fortunately, although the printed bills had errors in amounts owed, our internal systems maintained accurate balances. We’ll continue to share our patient complaint status report with you every two months, and as always, we encourage you to share your concerns with us.

We’re making progress on the subjects that you consider to be most important. Our next article will focus on hospital pricing structure with tips for you about price comparisons.

Our next hospitalfocus 2015 forum, is scheduled for Thursday, February 28 from 6 – 7 p.m. at the Senior Center in Driggs. I hope to see you there. If you have suggestions for us but can’t attend the forum, please feel free to share your thoughts via Facebook or