St. Francis Hospital in Poughkeepsie has been serving its community for nearly a century. The fifth largest employer in Dutchess County is doing its best, said Robert Savage, hospital president and CEO, to provide quality health care even as Medicaid and Medicare reimbursements continue on a downward spiral.
Savage has been watching payments dwindle for the past decade, despite the national call for the quality of care to improve.
“It is difficult to reduce the deficit without telling people to either pay more or for hospitals to give less. … we are duty bound to provide everyone who walks through our door or comes in through the emergency room with the same high level of care, regardless of their ability to pay.”
Savage said the state and nation will be facing the additional financial pain of the baby boom generation aging into the Medicare system. “This is a very knowledgeable group; at the same time, they are also a very demanding group and are already seeking more services than they need ”“ but want them because they are there.”
With everyone looking to contain costs, Savage said St. Francis has been careful in both its scheduling and staffing. It is also encouraging 1,500 full and part-time employees to stay fit. Partnering with other community hospitals to buy in bulk is another way for it to leverage some savings from suppliers.
According to Savage, a June 2010 report from the Center for Medicare and Medicaid Services rated St. Francis as one of the top four hospitals nationally for its value-based buying. “In order to be in the winner”™s circle, we had to achieve 70 percent on clinical outcomes and 30 percent on patient satisfaction.”
That gave the hospital some extra federal and state funding, he said. “At the same time, all participating hospitals began by having their reimbursements cut. The ”˜losers”™ lost money ”“ the ”˜winners”™ gained money … but we all took an initial cut.”
Savage said the prospect of losing more reimbursement under new state guidelines and some of the provisions of Congress”™ new health care legislation are mind-boggling, particularly when it comes to the federal government”™s proposal not to reimburse a hospital if the same patient is readmitted within 30 days of a prior admission.
“The best way to prevent a readmission for the same illness is to have follow-up care outside the hospital, even if just a phone call to make sure the patient is following the doctor”™s orders. Having home health care aides checking in on patients is another way. We have had a home-health care agency under our wing for several years,” said Savage, “and the goal is good after-care. It is and needs to be part of the health care spectrum. Care doesn”™t just end once a patient is discharged.”
Over the past decade, St. Francis has invested between $80 million and $100 million in upgrades and infrastructure improvements. It plans to spend $1.9 million for a new MRI in 2012, as well as a 128-slice CT scanner at a cost of more than $1 million. Tying all its services together will be a new electronic health record system it will be putting in place as well.
Savage, a member of Northern Metropolitan Hospital Association”™s board of directors, is not envious of Gov. Andrew Cuomo”™s position.
“With so much of the state”™s budget going into Medicaid, we are hoping the cuts are not too deep to put people out of business.”
