Good Shepherd Medical Center is hemorrhaging.
It's not a fatal wound, according to Edward D. Banos, chief executive officer for Good Shepherd Health Systems. But it is costly and something that needs to be addressed.
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Emergency room visits: Banos wants a strategy on how to handle visits to the emergency room that turn out not to be emergencies.
Grant funding: He expects Good Shepherd to start applying for grant money to help fund the cost of providing services.
Provider choice: Longview hospitals' exclusive contracts with health insurance providers and self-insured businesses and entities is another issue on Banos' plate.
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"This hospital is going to have to make some changes," he told the editorial board of the Longview News-Journal on Wednesday. Good Shepherd is annually losing about 40 percent of its $400 million in revenues because of patients who do not pay for services, he said.
"We're providing about $160 million a year in uncompensated health care," Banos said. That figure is substantially higher than industry standards and other hospitals where he has worked.
"There are a lot of good things going on in health care in Longview," he said. "But there is a problem with the system and the amount of uncompensated care provided."
Much of the hospital's problem stems from activity in Good Shepherd's emergency room, Banos said.
"It's amazing that in a city of 75,000 people, we have 90,000 emergency room visits a year," he said. "You have to wonder how many of those are real emergencies."
Banos started work at the helm of Good Shepherd in June after coming from Pittsburgh, Pa. He said addressing the issue of emergency room visits and how to best handle those visits that might not be real emergencies will be a priority in coming months.
He estimated the hospital is not paid for as many as 40,000 of those 90,000 emergency room visits a year. That activity accounts for a large portion of Good Shepherd's $160 million in uncompensated care annually, Banos said.
"We want to be a community resource, but we're going to have to make some changes," he said. Banos said he expects the hospital might be forced to refer those patients showing up at the emergency room without real health care emergencies to clinics.
Overall, he said about 20 percent of the hospital's patients do not have insurance.
Banos also said he expects Good Shepherd to start applying for grant money to help fund the cost of providing services like nonprofit local clinics do. While those clinics are doing a good job of serving people needing medical services, Banos said one of the drawbacks of other clinics is that they are not open nights and weekends.
Another issue he plans to look at is that of each Longview hospital, Good Shepherd and Longview Regional Medical Center, having exclusive contracts with health insurance providers and self-insured businesses and entities.
"I'd like to see both hospitals compete on quality of care and service," he said. It is too early to say whether some kind of agreement can be reached to remove the exclusive element of those agreements that require all patients under a specific plan to go to one hospital or the other — unless the patient wants to pay substantially higher fees out of pocket.
Banos said he has met with Jim Kendrick, CEO at Longview Regional, and plans additional communication with him.
"We're looking at reevaluating things," Banos said of Good Shepherd's stance on the issue.
In his few weeks on the job, Banos has been pleased with the quality of medical care provided in Longview by hospitals and local health care providers.
"Between both hospitals we have the latest equipment and a medical community that provides a high standard of care," he said. "There's no reason for people to have to go to Dallas or Shreveport for medical care."
Banos arrived at Good Shepherd after serving as chief operating officer at Allegheny General Hospital in Pittsburgh. He succeeded Jerry Adair, who died in late 2007 after serving as president and chief executive officer of the nonprofit health system for 21 years.
Comments
By Linda
Aug 16, 2008 4:46 AM | Link to this
I would be much more forgiving of GS's situation if they were using locals for all the construction I see going on. We have very good local companies that can do more than keep big-city contractors honest. I would like to see stats on the locals that have used. Keep your money here; buying, building, whatever.
By Linda
Aug 16, 2008 4:46 AM | Link to this
I would be much more forgiving of GS's situation if they were using locals for all the construction I see going on. We have very good local companies that can do more than keep big-city contractors honest. I would like to see stats on the locals that have used. Keep your money here; buying, building, whatever.
By Bob
Aug 11, 2008 11:48 AM | Link to this
Scott,
Your comments are well said... Everyone should take preventative measures by exercising rather than hitting the all you can eat buffets around town.
By Scott
Aug 10, 2008 11:26 PM | Link to this
The statement about charging uninsured patients higher rates than those accepted under private insurance contracts is very important. The hospitals get to claim all this "charitable" work being done but ultimately include it as part of their costs when negotiating insured pricing.
Many Doctors seem ready to "fleece" those with insurance to improve their own profits as seems to have happened to me twice. Once I went along with the Dr.'s recommendation which wound up costing my insurance plan about $30,000 in medication for my children to avoid a possible RSV infection when they were under 1-year-old. A week in the hospital would have probably been 1/6th that amount IF it had happened. This was not a smart choice.
A second time it was recommended that I take a different child to the hospital for 3-4 days to receive breathing treatments even though blood oxygenation was in an acceptable range and the total cost of medication and a machine to deliver the medication was less than $500. I chose the home treatment and save my insurance plan and myself $$$$. After a few days, the treatments cleared the breathing and everyone was fine for less than $500.
Not all Dr.s are this way. Dr. Yu helped a friend of mine, who did not have insurance, with sleep apnea. Dr. Yu was very cost conscious and saved my friend's health without driving up unnecessary costs.
The financial problems do not stop with the Doctors however. Patients need to learn how to watch their expenses also. Too often people think that money should not be a factor in health care. Money will always be an issue but people should watch the expenses before they get to the Dr. Lose weight, stop smoking, eat well and try to get some physical activity. If each of us do not try to take care of our health, how can we expect the Dr. to save our life for free?
By Zen Fellow
Aug 9, 2008 8:50 AM | Link to this
Having roots in Longview, I've read with interest this story and the blog. It sounds as though Mr. Banos is quite a change from Mr. Adair. It also sounds as though Good Shepherd is really no different from many other not-for-profit, community hospitals. These hospitals bear the burden of healthcare for the masses in their communities, are not financially supported by county funds, and have very slim profit margins. In fact, a recent study cited in the Wall Street Journal stated that more than 50% of all not-for-profit community hospitals operate in the red.
For those who keep up with such things, hospitals in the United States are closing at an alarming rate. In the state of New Jersey, with which I am now intimately familiar, State financial shenanigans that have gone unaddressed for years are causing hospitals (similar to Good Shepherd) to close their doors because the State lacks money to support the NJ Medicaid program. If left to operate with only the Medicare and private insurance reimbursement, hospitals cannot make it. The proportion of self-pay or no-pay patients as a result of the Medicaid crisis makes it impossible for hospitals to operate very long without financial losses and, in some cases, ultimate closure.
Imagine life in Longview, or any other community, if the largest provider of healthcare there was forced to close. Do you believe access to care would improve? Do you believe that for-profit facilities would lower their prices or accept a larger proportion of uninsured patients out of the goodness of their hearts? Do you believe this would be good for retaining expert healthcare providers such as physicians, nurses, physical therapists, etc. whose lifeblood is a hospital? From my experience, the answers are no, no, and no.
As I witness the carnage that is healthcare in my State, I encourage all of you back home to find ways to improve the situation there. There are many ideas with potential to begin changing healthcare delivery in Longview. Expansion of low-cost clinics, philanthropic giving to establish free-medical clinics for those who are uninsured but need access to non-emergent care or primary care management of diseases such as diabetes, and personal accountability to pay your own medical care bills are just a few ways to positively impact your hospitals' ability to continue to provide care. There are certainly a multitude of others.
I challenge you all to tackle these issues head on. Don't just reserve your comments for a blog on your local paper's website. Get up and get out. Find out where the presidential candidates stand on healthcare, encourage your friends and family to use your ER's only for emergent injuries and illnesses, establish yourself with a family practice clinic to manage your routine healthcare needs, and join your local health club to lose weight and be heart healthier. The easy path is to sit back and gripe (or blog). What you need, as so many other communities do, is for people to get up, get out, and get involved. Longview is too good a place for anything but that to happen.
By Michelle
Aug 8, 2008 11:26 PM | Link to this
In replying to RN too's comment, I must say 140 million is a lot in uncompensated care.
However, what your not telling these fine folks on this Discussion Board is the amount your figuring is BILLED charges, which is over inflated to begin with; therefore, it's not a realistic number.
Perhaps,take all the bills not paid, then instead of totaling that as a whole, add the loss from the hospitals potential contracted rate; meaning the amount they would have accepted if the patient was insured.
Then you will probally have a more acurate loss number. Which, my guess may only be pennies on the dollar.
That's another thing an insured walks in and is charged 10,000; however the contract rate (amount accepted is 1,750)..if the patients deductable is paid, the hospitals writes off the remaining $8,250.00.
Now, an uninsured walks in--and is charged 10,000-they still owe 10,000.
What's wrong with this picture?
By RN too
Aug 8, 2008 7:11 PM | Link to this
That is a very common misconception, Good SHEPHERD is NOT a county hospital and therefore is not finicialy supported by the taxpaying the citizens of Gregg County. Yet, Good SHEPHERD provides 140 Million in uncompensated care to the citizens of the East Texas Area. That says a lot about the vision and mission of
Good SHEPHERD and their dedication to the people of East Texas.
By Jb
Aug 8, 2008 3:16 PM | Link to this
This man needs to get in touch with the local hard working people without insurance. If you do not have ins you will get in and be told to go see a doctor tomorrow. The main reason people come to the emergency room is because they cannot afford the "new patient" fees that ALL doctors require before they will even look at you, and so far, Good Shepard is a county hospital that does receive help for those that cannot pay their HIGH UNFAIR fees. Healthcare in East Texas is nothing more than a money game, people do not become physicians to help others, they do it to get rich. Without ins, they do not care what is wrong with you or if you get well or not.
By Brandi
Aug 8, 2008 12:23 PM | Link to this
I am a hard working mother of two me and my husband both work.But cant not afford helth care with the cost of daycare, gas, and the other costs of living these days. My children recive medicaid but there is no medical help for the parents. I also recive a very small amount of food stamps a month. but you people who say you are tired of people living for free you are wrong. The state has it backwards, they will help those who arent willing to help themselfes befor they will help families like mine. Who are trying to better them selves and just need a little help along the way. And no we are not ridding around town in a new car.
By Lynn
Aug 8, 2008 9:15 AM | Link to this
Wow! I hope Mr. Banos reads these comments and pays attention. Healthcare IS a hot button in our society today, especially with a increasingly elder population.
I agree with most all comments - yes, I think that our ER should start turning away non-emergencies, as there are many in the waiting rooms with the "flu", while it's probably just the sniffles. And yes, we do need more low-cost clinics.
However, I can say, that as a daughter of a nurse, I can vouch for the LONG hours referred to by "RN". My Mom, now retired, has the worn out knees and chronic back pain from lifting, supporting and taking care of patients hours on end. She has been spit on, cursed at and yes, threatened by patients and she still had to smile, turn the other cheek and give them the best care possible - so please don't judge until you've been a nurse. And the pay...well, they damn sure work for it! We weren't wealthy, but it paid the bills. I'm with you RN!
Although I do still stand by my original comment that the cost of healthcare is grossly overpriced, I can say that our healthcare here in East Texas (Tyler & Longview) is some of the best around. My father suffered a stroke himself over a year ago and received the BEST care at GSMC with wonderful doctors and nurses. No, everything wasn't roses everyday, but in the month he spent in the hospital and on the rehab floor, they did the very best they could do for him. And, regardless of the bill (which was the price of a small home AFTER insurance), my father is alive and here with us. That, in my mind, is PRICELESS.
Yes, the price of healthcare is outrageous and needs fixing, so I hope Mr. Banos comes up with a solution that's workable the entire community, insured and uninsured.
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