SC Hospital Executive Update, August 29, 2011

SCHA DHEC TELECONFERENCE

SCHA and DHEC will be hosting a teleconference this Wednesday, August 31st at 10 a.m. to address the upcoming influenza season. This teleconference will address topics such as the preparation for this flu season, vaccination policies for healthcare workers, critical care triage, and lessons learned by a facility that instituted mandatory vaccination of health care workers. Please call (888) 289-4573 and enter participant Code 1952452. If you have any questions, contact Bernie Chapman, bchapman@scha.org, or 803-744-3526. 

CALL FOR 2011 TAP STORYBOARDS

Share your hospital’s story with a featured storyboard at the 2011 TAP Conference, held on September 15-17, 2011, at the Hilton Head Marriott Resort & Spa. In the past, South Carolina hospitals have highlighted their quality and patient safety initiatives with storyboards at the TAP Conference. Storyboards have proven to be a fantastic opportunity to highlight the hard work our hospitals have done to improve health care across South Carolina. We are eager to learn about your innovations in practice that tie in with our SCHA Reengineering efforts, showcasing creative ideas with measurable outcomes. Please note that your storyboards do not have to be quality or patient safety driven. Share your stories relating to collaborative teamwork and/or areas where you have made measurable improvements in population health, enhancing the patient experience and/or reducing the cost of care. Please have your storyboards displayed in a sports theme or playbook to coincide with the overall 2011 TAP Conference activities. This year we are not linking the storyboards with the IHI National Conference, however, our submission guidelines follow the same criteria found in the 2011 IHI Storyboard Handbook. This handbook contains information on storyboard layout, content suggestions and other details to guide you through the submission process. Storyboards will need to be on display at the Hilton Head Marriott by noon, September 15. Displays will be recognized during breakfast on September 16. 

Please complete the Storyboard Registration Form and TAP Registration Form to secure your storyboard spot at the 2011 TAP Conference. For more information, see the Storyboard Details & Timeline and Storyboard Schedule of Events or contact Mary Stargel  or (803) 744-3511. All storyboard applications along with the TAP registration, should be returned to Mary Stargel, mstargel@scha.org, by August 30, 2011. Please help us make this year’s 2011 TAP conference a success by submitting your hospital’s innovation success stories. We look forward to sharing your stories!  

SAFE SURGERY 2015: SOUTH CAROLINA COACHES RECEPTION

Please join us during SCHA’s 2011 TAP Conference at the Hilton Head Marriott Resort & Spa for a special reception to meet with members of Atul Gawande’s Safe Surgery 2015 Team, Bill Berry, MD and Lizzie Edmondson. The reception will take place from 4:30 to 6 p.m. on Friday, September 16 at the Hilton Head Marriott Resort in Ballroom B.

RECENT NEWS COVERAGE OF RURAL HOSPITALS

Yesterday morning The State newspaper published an article portraying the current plight of SC’s rural hospitals. The article accurately highlights the challenges faced by many rural hospitals in our state, and I think that’s a good thing. Policymakers and the general public need to be aware of the problems that arise when state and federal funding is cut to essential components of the health care delivery system. But the article could be misconstrued by people who aren’t aware of the many conversations and efforts taking place behind the scenes to help our rural hospitals.

In recent months I’ve been part of a number of conversations with Tony Keck and Graham Adams (CEO of the SC Office of Rural Health) about ways we can help our state’s rural hospitals. All three of us are very concerned about the long-term viability of rural hospitals, and we believe the CMS-driven reimbursement system inappropriately causes them to pursue high-revenue services (surgery and imaging) when their communities have a much greater need for first-rate emergency and primary care services. Since emergency and primary care services are not well compensated under our current system, rural hospital leaders are forced to pursue surgery and imaging in order to survive. This dynamic, coupled with the scarcity of commercially insured patients in our poorest communities, is a recipe for chronic financial instability. Many of our rural hospitals see no good way to replace their aging physical plants, and they are understandably anxious about what role they will play in the changing health care system. Some have explored affiliations with larger hospital systems, while others have decided to sell their hospitals to larger systems. Tony, Graham, and I believe we need to work collectively to help our state’s rural hospitals explore more creative options if they want help. We’ve already been asked by a few rural hospitals to help them explore new ideas, and we will continue to do so.

At this point I want to share some important data you may not have seen. When Tony Keck spoke at our recent CFO conference, he addressed head-on the reason he excluded certain small and rural hospitals from the July 1st rate cuts. Simply stated, the largest hospitals in the state receive the lion’s share of all Medicaid payments to hospitals and the smallest receive only a small fraction. When Tony broke the state’s 60 acute care hospitals into quintiles, he reported that the top two quintiles (24 hospitals) receive 84% of all Medicaid payments while the bottom three quintiles (36 hospitals) receive 16%. For the rural hospital conversation that made the news yesterday, it’s especially important to note the bottom quintile (12 smallest hospitals) represents only 2% of all Medicaid payments in SC. Tony, Graham, and I believe there’s room to re-think the business and payment model for our smallest rural hospitals without causing any tangible financial impact on the state’s larger hospitals. This conversation is just emerging—it’s a few weeks old—and we will not advance any fundamental changes without allowing all hospitals to participate in the conversation. After all, larger systems may have their own creative ideas for stabilizing rural hospitals in our state.

Stay tuned for more on this topic. In the meantime, please be assured we are all acutely aware that rural hospitals are vital to their communities and our state as a whole. That’s precisely why SCHA, the Office of Rural Health, and DHHS have rolled up our sleeves to find new solutions to the new problems that are emerging in our health care system. If you have ideas or would like to be involved in this conversation, please let me know. We welcome your thoughts.