Business Journal NORTHEAST
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October 2019 VOL. 34 NO. 10
Health care update: Endangered revenue streams systemic problem because, if tooth-related problems an incentive to curb unnecessary use. “Wayne joined to help our system stay competi- are ignored, they can compound and cause severe Like meandering rivers flowing into the ocean, a tive and sustainable,” said Dunsinger. medical issues. series of endangered revenue streams are delivering According to Hollander, his system’s $6.5 milShe added that providers across the landscape precious dollars into the nation’s overflowing health may still have to “jump through hoops” to receive lion annual budget must be balanced, and he will care system. never vote for a deficit balance, even with financial promised payments from private insurers who all Patty Dunsinger, director of finance and CFO with operate with different rules. In severe cases, authoreserves. Wayne Memorial Hospital, manages the “Yes, I do feel some insecurity with rization to receive payments, finances of a genuinely rural facility that the sustainability of our mission,” said coupled with suffocating serves patients from birth to hospice. Hollander. “Business costs keep going government regulations, According to Dunsinger, for the fiscal up, and we’ve done our best to control increases operating costs year that ended on June 30, the hospital our operating expenses whenever poswhile delaying the arrival of received about 47% of its operating revsible.” critical revenues. enues from Medicare, 9% from Geisinger With finite revenues a harsh ecoCosts for uncompensated insurance products excluding Medicaid, nomic reality, the existence of financial care is creating bad debts 15% from Blue Cross Highmark and competition for all caregivers inflicts anxifor services provided to the Dunsinger Hollander 17% from all Medicaid products. ety upon Hollander. This market-based uninsured or under-insured. In a big move designed to provide demand for talent allows little if no opAt Wayne, this totals in the future sustainability, the system has joined the pilot portunity to cut wages and benefits, and with federal millions of dollars annually. program known as the Pennsylvania Rural Health deficits exploding, the futures of both Medicare and “Some private insurance doesn’t even use uniModel. Within the effort, The Centers for Medicare versal billing codes, or they have a different series of Medicaid and their revenues are, at best, unsettled. and Medicaid Services and other participants pay “How will people get the care they need if codes than what Medicare dictates,” said Dunsinger. participating rural hospitals on a global budget with “These types of situations require a lot of administra- Medicare and Medicaid are cut back?” questioned a fixed amount that is set in advance to cover all tive time on our part. If we had one set of processes Hollander. “If people have no insurance, they often inpatient and hospital-based outpatient items and use a hospital ER room for the treatment they need, with all the insurers it would greatly reduce our services. and we all eventually pay for that also.” administrative burdens and operating costs.” “The Rural Health Model includes a focus on In addition, Hollander referred to the system that Rising demand preventative care,” said Dunsinger. “The traditional Joseph Hollander serves as executive director of awards government funding grants as competitive fee-for-service model of operation for providers is the Scranton Primary Health Care Center, where the and tough, and said it may unfold on a tilted playing definitely declining.” staff is coping with an 85% increase in patient count field. This contrasts with grants from private foundaWayne is also included in a new Global Budget tions, which are largely regional in nature and utilize over five years. During 2018, the facility served a Program initiative. Through this system, payments fair processes. total of 11,400 clients through 41,000 individual for inpatient and outpatient services are based on “The one thing we can be sure of is that the need patient visits. historical expenditures and are set across payers in Providing treatment for behavioral issues is vital for health care is not going away with the patients the state, giving hospitals fixed annual budgets and within this effort. In addition, dental care presents a by Dave Gardner
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TS_CNG/NPBJ/PAGES [B01] | 09/25/19
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