Hemingford and Alliance Rural Health Clinic advisory boards meeting review
The annual Hemingford and Alliance Rural Health Clinic (RHC) Advisory Board meetings for Greater Nebraska Medical and Surgical Services (GNMSS) were held October 5 and October 18 respectively. The RHC meetings in Hemingford and Alliance included topics on physician recruitment; Accountable Care Organization; Chronic Care Management progress; a review of volumes and statistics; financial performance; and discussion about the new location and building construction timeline for the Hemingford Clinic.
Individuals in attendance at the Hemingford Clinic meeting were: Box Butte General Hospital (BBGH) Marketing representative Shae Brennan, BBGH CEO Lori Mazanec, Administrative Assistant Brittany Stull, GNMSS Registration Clerk Melissa Stricker, Physician Assistant Brittney Bauer, Advisory Board representatives Lynda Novotny and Blanche Randolph, BBGH COO Jim Bargen, and Clinic Manager Joni Sautter. Mazanec, Stull, Bargen, and Sautter attended the Alliance meeting, with Dr. Jessica Ott, Nurse Practitioner Kristin Ferguson, Marketing representative Brian Kuhn, and advisory board representative Linda Schneider also attending.
Last year’s meeting minutes for both boards were reviewed and approved.
Ms. Mazanec started the meetings with an update on physician recruitment efforts. “We are partnering with Goldfish Medical Staffing to search for two Family Practice Physicians with Obstetrics,” she said. She added that she has been in contact with a third year resident interested in practicing with GNMSS, as well as two first year residents. Ms. Mazanec commented it is often difficult to recruit people to live and work in rural areas if they aren’t from that kind of environment. One strategy the hospital is focusing on to overcome that obstacle is the recruitment of an in-house Hospitalist at BBGH to augment the already successful remote eHospitalist program that began in December 2017 with Bryan Telemedicine. “I’m happy to report that we are in the contractual stage with a physician to become our in-house Hospitalist at BBGH,” Ms. Mazanec said. Ms. Sautter added at the Hemingford meeting, “Times are changing. Medical practice used to be an expected interruption to a provider’s life… but now doctors know they can have lives outside work, and don’t want to go to a facility where that is taken away by being on call.” Ms. Bauer added, “eHospitalist is great. Providers not getting a call from the PCU in the middle of the night, every night, for something like a Tylenol order is a huge benefit.”
Ms. Sautter explained how the Accountable Care Organization (ACO) the hospital joined in January (Caravan Health) is helping the organization improve quality scores from patients. The ACO assures Medicare beneficiaries get the correct tests, screenings, and medications, driven primarily on the importance of annual wellness visits. To gain more savings, the hospital will be moving to a bigger collaboration this coming January. “The intent is to reduce cost to Medicare, and a portion of the shared savings come back to the individual organizations; based on where they’re ranked on shared savings in their own organization compared to other organizations in the group,” Ms. Mazanec added.
Ms. Sautter discussed progress of Chronic Care Management at GNMSS, designed to partner the clinics with the hospital’s Emergency Department (ED) and Patient Care Unit (PCU) for follow up when patients are discharged from the ED or the PCU. The goal is to reduce readmissions. She also gave her report on Chart Review results for the past quarter for the two clinics.
Ms. Mazanec gave a summary on volumes/statistics during the year. The Hemingford Clinic had a 24 percent increase in volume, with 259 additional visits over last year. Ms. Bauer said there have been a lot fewer complaints about the availability to get an appointment scheduled. Alliance experienced a 22.7 percent volume increase with 1,723 additional visits compared to last year. Ms. Sautter saying additional providers coming on board was a factor in that improvement as well.
Financially, Ms. Mazanec said the Hemingford clinic is 10.7 percent ahead of revenue projections, and operating expenses are over by about 20 percent, which can be attributed to the addition of more staff for more days as well as addition of services. The Alliance clinic is eight percent ahead of revenue projections for the year, with operating expenses over budget by nearly nine percent, primarily due to additional surgeries and the addition of one family practice physician not included in the preliminary budget.
Good news from Mr. Bargen about the new location/building to be constructed this spring on the main highway going through Hemingford ended both meetings. “Design and development meetings are being held, and we should have schematics starting soon,” he said. “Construction will start in early spring of 2019.” Ms. Novotny commented, “The city is really excited. Anything we can do to make this town flourish is awesome. The new building is going to show people that you care.”
Box Butte General Hospital is an equal opportunity provider and employer.