Medicaid issues keep MMH from funds
Bureaucratic system issues have been keeping Melissa Memorial Hospital from receiving reimbursement for its Medicaid patients since Feb. 22, according to MMH CEO Trampas Hutches at the Tuesday, Feb. 28, East Phillips County Hospital District board meeting.
In the midst of new screening levels for Medicaid providers set by the Affordable Care Act and Colorado’s Medicaid management information system transition to the Colorado interChange claim system, provider revalidation quickly became pretty complicated.
Some hospitals began experiencing problems in mid-September 2015, nearly immediately after the transition took place. Implementation deadlines for the new system were put off until October 2016, and then again until March 1, 2017.
Now, with the mandatory system implemented and still no fix for the issues, hospitals like MMH are out of luck. “Medicaid is now denying all claims,” said Hutches.
Billing for Medicaid patients, who represent 7-8 percent of MMH’s patient base, will be delayed until the issue is resolved.
The lack of Medicaid funding in combination with Colorado’s proposed budget with cuts to the hospital provider fee would have an immediate impact of a $230,000 loss for MMH, according to Hutches.
The CEO planned to attend “Protect Rural Hospitals” day Wednesday, March 8, at the Capitol in Denver to join other affected Colorado hospitals in requesting a solution from legislators.
Wesley White hired as new CFO
Hutches also announced the hiring of new Chief Financial Officer Wesley White at the Tuesday meeting. Current CFO Jason McCormick has been slowly transitioning out of the role for months.
White was one of three applicants from a pool of about 50 that earned an on-site interview at MMH. He will begin at MMH by the next board meeting, Tuesday, March 28, bringing with him a wealth of experience as a CFO and interim CFO at facilities from New Mexico to Idaho.
Hailing originally from the Grand Junction area, White was described as very knowledgeable and a team player by Hutches at Tuesday’s meeting.
During his interview process, he met with staff, management, the leadership team and the finance team, ensuring that staff had a voice in choosing the new CFO.
January 2017 scorecard shows progress in several areas
In other news at the Tuesday meeting, Hutches also reported the largely positive results for MMH’s January 2017 scorecard.
Satisfaction rankings in all departments of the facility were in the 59th-99th percentiles compared to other hospitals. Actual satisfaction percentage responses were between 60-94 percent positive.
Emergency department satisfaction responses were the lowest of the respective categories at 60 percent, just below the benchmark goal of 61.2 percent, but ranked the highest compared to other hospitals in the 99th percentile.
Outpatient procedures were both responded to and ranked highly at 94 and 98 percent respectively. Inpatient satisfaction responses were 75 percent positive and ranked in the 59th percentile.
The clinic, while ranking well in the 89th percentile, has the farthest to go to reach MMH’s set benchmark. It received a 67.8 percent satisfaction response, while the goal is 78.4 percent. Still, the clinic has seen significant progress, as average wait time has been going down even as patient volume has been going up in recent months.
The new Athena medical health record system, when implemented in late summer, should help prompt doctors to bring up the need for cancer screenings and other preventative health measures, which are important for government reimbursement reasons as well as community health.
In addition, MMH controller Kurt Schueler and operations director Heather Cloward were very excited to announce that accounts receivables continue to improve, reported at 74 days at the end of January and, on the day of the board meeting, was as low as 60.92 days on the hospital side.
Pharmacy performing well
Another successful area within MMH is the MMH Hometown Pharmacy, which has been keeping pace with prescription projections so far, filling 650 prescriptions in January and about 1,000 in February.
The amount of money made per prescription, however, has not been as high as anticipated. Pharmacist Amy Kleve explained that insurance companies reimburse more as pharmacies become more established and maintain good ratings. Some companies do not reimburse at all until the pharmacy has been open for a designated amount of time.
In April, however, a program will kick in that will allow the pharmacy to purchase qualified drugs for 40-75 percent less than what they currently cost.
Hospital medication control and dispensing system to be purchased
The retail pharmacy is separate from the management of hospital medications, which must be controlled in how they are dispensed for hospital use. Technology designed for this purpose allows the use of only consultant or very part-time pharmacists.
With the implementation of Athena and the age of MMH’s current system, the board approved the purchasing of a new top-of-the-line system, Omnicell, for a cost not to exceed $210,000.
This is actually a price reduction of over $347,000, coming with a commitment by MMH to use only Omnicell systems. The system should last at least 10 years.
MMH works toward optometry and chemotherapy services
Working toward other long-term goals, the board also approved the lease of $43,000 worth of optometry equipment for the new optometry service.
Chemotherapy was discussed as well at the Tuesday meeting, and it was explained to the board that it will take $30,000-$40,000 to get the room for mixing the chemical products up to the current safety code.
MMHF Legacy Event a success
Diana Baeza gave the MMH Foundation report at the Feb. 28 meeting, informing the board that the recent MMHF Legacy Event, “Titanic Grandeur,” had about 235 guests in attendance and raised a total of $82,675.
The auctioning of pediatric packs to be donated to the EMS department went extremely well, and two packs were purchased as anticipated.
The next event being researched by MMHF is Building New Bridges, planned to take place in June or July.
Other business
In other business at the Feb. 28 meeting, the board:
—approved one new appointment, Ray Bogitch, M.D., in teleneurology; two resignations, including Adam Asarch, M.D., in dermatology and Judy Weimer, F.N.P., in family practice; and eight reappointments, including Ira Chang, M.D., and Adam Graham, M.D., in teleneurology, Lyle Barksdale, M.D., in pathology, Eric Hoyer, M.D., and David Kellam, M.D., in radiology, and John Drury, M.D., Michael Kim, M.D., and Arnold Pfahnl, M.D., in cardiology.
—held a 10-minute executive session for the purpose of contract negotiation. Resuming open session, the board authorized chairman Steve Young to sign Hutches to a three-year contract extension.