This post is reprinted with permission of the Taxpayers Channel (Greenwood).
At today's special meeting, the Board of Supervisors heard statements from GLH CEO Gary Marchand, Mr. Sam Odle (the consultant hired by the board), Congressman Bennie Thompson, State Senator David Jordan, and State Legislator Solomon Osborne.
The meeting was called to discuss the dire financial crisis that threatens to close GLH, which has almost completely run out of cash to pay its employees and bills.
Near the end of the meeting, the board went into executive session for further discussion.
After returning to open session, on motion made by District 1 Supervisor Sam Abraham, the board voted to appropriate $2.25 million to GLH. There was no mention made of where this money would come from.
However, earlier in the meeting, Sam Abraham asked whether the legislature can change the law to allow Leflore County to levy up to 10 mills of additional property tax to help fund the hospital.
Mr. Marchand sketched the effects of COVID on the hospital's financial situation. Even though GLH received more than $35 million in grant funds, it had to burn through essentially all of its $20 million cash reserves in order to pay premium prices to contract nurses at over double the cost of local nurses. Marchand advocated expanding Medicaid, changing the reimbursement formula for small rural hospitals, and trying to get GLH designated as either a Rural Emergency or Critical Access hospital, which would improve Medicare reimbursement rates. Marchand stated that 75% of the patients at GLH were covered by Medicare, Medicaid, or no payment, and that both Medicare and Medicaid paid the hospital less than the cost of providing the services to those patients.
Mr. Odle echoed much of Mr. Marchand's statement. Odle also suggested that GLH would have to find ways to rent some of its unused space to other medical providers to generate more revenue.
Congressman Thompson spoke about the possibility of getting a waiver to allow GLH to become a Critical Access hospital, even though it does not presently qualify under the federal rules. He reminded the board that there were other hospitals in the state in similar desperate financial trouble. He recommended that public pressure be put on the state legislature and on the governor to make changes, including expanding Medicaid. He warned that the workforce would be decimated if the hospital closes. Thompson suggested that the state legislature should require Medicaid to pay the same as Blue Cross pays.
City Council member Ronnie Stevenson asked whether the hospital and the city and county could file a lawsuit against the state.
Senator Jordan described the hearing today in Jackson where GLH's woes were discussed by Senator Hob Bryan's state senate committee. The fear is that somewhere around 24 hospitals might have to close within the next year or two. Jordan blamed GLH's financial crisis on Governor Tate Reeves for refusing to expand Medicaid.
Sam Abraham asked whether the state could recoup the Medicaid money that has been lost over the years due to the state opting out of expansion. Congressman Thompson stated that only future expanded Medicaid money can be received. Thompson repeatedly suggested that the public needs to get an initiative to place Medicaid expansion on the ballot. But the initiative system has been tossed out as unconstitutional by our state supreme court.
Mayor Carolyn McAdams exhorted everyone to call Governor Reeves and demand that he approve expansion of Medicaid.
Sam Abraham asked whether the legislature can change the law to allow Leflore County to levy up to 10 mills of additional property tax to help fund the hospital.
Supervisor Reginald Moore joined Stevenson in advocating that Leflore County sue the state for money to keep GLH open. He said that such a lawsuit is "critical" to save healthcare in Mississippi.
State Legislator Solomon Osborne decried the fact that his bills to expand Medicaid never even get out of committee. Osborne said that it would be a surprise to him if the legislature is ready to take any action. He repeatedly claimed that the Republicans are blocking progress that would help poor people in Mississippi. He decried the fact that the legislature approved $250 million in economic incentives, but won't help us keep our hospital. He pointed out that the initiative process is not an option at this time. He said that the legislature is the worst place he's ever been in terms of trying to get some progress.
Mr. Odle stated that the hospital administration has been very cooperative with his research efforts.
Mr. Marchand told Supervisor Robert Collins that it would take $3.5 to $6 million in gifts from the city and county in order for the hospital to stay open through March 2023.
Mr. Marchand stated that the attempt to get UMMC to lease the hospital is over and completely done.
City Council member Johnny Jennings asked what one issue torpedoed the UMMC possibility. Marchand answered that he really doesn't know why UMMC withdrew from the negotiations.
Video of this afternoon's meeting may be seen here: Leflore County Board of Supervisors Meeting, November 21, 2022
To review our reporting on GLH and its financial woes, please see here: Index of Greenwood Leflore Hospital news articles
57 comments:
The head racist, Bennie Thompson, has no problem being seen helping the black community, while the farmers drown from the lack of pumps.
"Nah."
What a playbook. Lawsuits and higher taxes. And in this case, much higher taxes. Ten mills is an outrage.
Can somebody tell me in simple terms how expanding Medicaid will save this hospital and others like it? We have 772,000 people enrolled in Medicaid as of 2021 out of a population of about 3 million. The state unemployment rate is only 3.8%. So if so many people are working full time, are that many really uninsured?
I'm really asking, I'm not trying to be a butt. The county population has gone from 53,000 mid-1900s to 28,000 today. Maybe they are not big enough for a stand-alone hospital. I don't see that trend changing.
Hospitals run by county supervisors. What could go wrong?
Will medicaid expansion even save it at this point? My guess is no. Even Tim Moore said yesterday in the Senate hearing that expansion alone wouldnt solve all the problems facing rural hospitals.
[AND] not one peep out of any of the Officios and Majordomos present asking the hard questions as to why Leflore County has lost -25.3% (that is 1/4th for you Barksdaler and LaddCo readers) in the last 20 years.
How is it that almost everywhere in Bennie Thompson's congressional district economic conditions have gotten during his time in office?
I don't know the particulars of the GLH hospital financials or situation generally, but I have been in the healthcare industry for almost 20 years and have some observations:
The reason why for-profit companies like HCA, CHI, Lifepoint and Tenet (as well as large not-for-profits like Ascension and Holy Spirit) have been buying up hospitals for the last few decades is because these companies/organizations run hospitals like a business. You can argue whether healthcare should be treated purely as a business - and there have been some adverse outcomes to reducing medicine to a business - but one advantage is that in most cases it keeps hospitals operating.
Community hospitals like GLH are often run more for the benefit of the employees and not the patients. These community hospitals were/are often one of the largest employers in the area, so the boards/politicians use them to create and maintain employment. This results in bloated administrative staff and perhaps even over-staffing at the lower levels for the sake of saving jobs.
I don't know that GLH suffers from the above, but I believe it is a possibility. It is probably too late for GLH to benefit from a for-profit buyer. It probably would have already been acquired by now if it had potential for improvement and profitability. Too bad, because a sophisticated operator may have been able to keep it in the black and keep the doors open.
death by freeloaders-
@9:27
I always hear this from Republicans. "It won't solve everything", so nothing is the better option?
We could bring you the Golden Goose and you'd complain it wasn't a Swan.
Step into someone else's shoes once in a while. This is terrible and the fact that we STILL don't have a initiative process to fix it should scare the hell out of y'all. Fools.
If it wont solve the problem, sometimes, yes, nothing is the better option.
Medicaid expansion is the only thing that could save rural hospitals.
It pains the guys in charge who know this fact because to accept federal funds for their operations is like defeat all over again….they have to agree with Nancy and that hurts.
HMA (now a part of CHS) owned several hospitals in MS and sold them all only to watch them flail and perish. Clarksdale being one in particular.
Medicaid expansion would provide more funding for people near the rural hospitals and provide funding for businesses who service the hospital.
The end result though is politics - Tate and company say no to billions in federal aid to the poorest of the poor.
Only thing left to do is steal welfare money….oh wait.
PS - look at Louisiana which is now on their 7th year of expanding Medicaid and there is no talk of hospital closures.
Stupid is as stupid does
"Marchand stated that 75% of the patients at GLH were covered by Medicare, Medicaid, or no payment, and that both Medicare and Medicaid paid the hospital less than the cost of providing the services to those patients."
I presume that expanding Medicaid will potentially provide some revenue to pay for the patients that don't qualify for Medicaid but cannot/donot pay the Hospital for services that the Hospital must provide (Emergency care).
If Medicaid and Medicare pay less than the cost of the care provided the demographics of the area make running the hospital at anything other than a loss a fiscal impossibility. Either we admit that providing care is a function of government and producing taxpayers eat the cost or the area doesn't need a hospital because the area cannot support one.
Actually applaud the LefloreCo Sups willingness to increase the ad valorem. If the community wants that hospital to remain open despite the economic headwinds then the community should be ready to throw their own good money after bad.
LefloreCo Sups are showing more courage than Lumumba can muster.
If Medicaid doesn't cover costs how does expanding Medicaid do anything other than cover more people with reimbursement that doesn't cover the cost of care? If every Medicaid patient produces negative revenue adding more Medicaid patients doesn't solve anything. They need paying customers with real insurance or cash and the only way to do that is to attract new people with money.
Bringing in high paying private sector jobs is the only avenue I see but I don't see how they attract them to the area given that there is pragmatically very little to offer and substantial political opposition to changing that.
Take me to Ruleville!
Yes, GLH has been mismanaged for the last 2 decades.
The city council and board of supervisors appoint people to the hospital board of trustees who do not understand medical economics.
Last fiscal year, the hospital lost $18 million with a $100 million annual budget. It lost $18 million in spite of the $9.5 million in grants it received.
10 mills in Leflore County will raise somewhere around $2 million.
Folks who live in Greenwood are already paying a grand total of 172 mills in combined city, county, and school property taxes. Property taxes went up 5% this year.
The only hope for us having a successful hospital is to have one that the city and county have no input or control over.
But with the prospect of raising property taxes, the city and county may be able to maintain their grasp over the management of the hospital.
Which means we are doomed.
John Pittman Hey
The city council and board of supervisors appoint people to the hospital board of trustees who do not understand medical economics.
Same modus JPH as the Jackson Municipal Airport Authority. Sycophants, butt kissers and stooges before competency every day of the week.
Sure, expanding Medicaid is probably not the panacea and rural healthcare delivery is changing quickly. Greenwood ain't the economic engine it was 100 years ago. Yet, expanding Medicaid is perhaps not the evil some make it out to be. Most folks on Medicaid are barely scraping by - working multiple low-wage, no-benefit jobs. Medical debt will crush them financially.
So, if a rural hospital can get paid something (even less than cost) when it would otherwise receive nothing, that's probably a win/win as it reduces the overall loss and hopefully helps the low-wage worker avoid medical debt.
John Pittman Hay - thank you for chiming in here and telling the story that nobody else in the state has had the balls (or political interest) to say. GLH is failing due to mismanagement more than any of the other claims that are constantly thrown out (non-expansion of Medicaid being the primary claim).
Rural hospitals in many areas of the state are in financial trouble - but primarily because they are no longer operating as hospitals; rather, they are Emergency Rooms triaging patients for transport to a nearby major hospital where they are treated. A quick look at the Dept of Health's annual report provides evidence that many are unwilling to acknowledge, the daily room occupancy rate of many of these rural "hospitals" - a rate that is in the low single digits for a dozen or more of these facilities.
GLH suffers from that same disease, but unlike the smaller community hospitals, GLH has squandered more dollars than those other facilities see in a year. Trying to save GLH by an infusion of dollars, regardless of where the dollars come from, won't work until the management is taken away from the city/county influence.
I don’t get the point of spending money to keep this hospital afloat. What’s next? Grocery stores and gas stations? If you choose to live in the middle of nowhere then you need to accept that you won’t have everything you want
@11:45 AM, how does the rural hospital stay in business providing services at less than cost?
GLH teetered on the brink of insolvency long before the covid crisis due to years of poor management and oversight. Its mix of Medicare, Medicaid and uninsured patients is not unlike many other MS hospitals which aren’t threatening lawsuits and exorbitant tax hikes to stay afloat.
Well, it's not just failing due to mismanagement. The existence of that hospital is an antiquated and failed business model. Greenwood doesn't need a hospital. It needs triage and a clinic. Pouring more money into that model and that hospital, be it local taxes, welfare funds, or whatever is akin to subsidizing buggy makers during the advent of the automobile. There's a comment above: Stupid is as stupid does. Stupid is adding good money to bad. They should have sold the hospital a few years ago when they had the chance. But, as many have pointed out, they like the jobs program. So, how's that jobs program going now?
@9:21
Look at the Labor Force Participation Rate [LFPR] instead of the misleading, doctored unemployment rate. LFPR is the percentage of working-age, not-imprisoned, not-institutionalized who are actually working. https://fred.stlouisfed.org/series/LBSSA28 Mississippi's LFPR is only 55%. That is the reason, in large part, there are so many uninsured.
Why stop at 10 mills? Hit Greenwood up for 20-25 mills and “Build Back Better”! Higher taxes always equates to better gubmint services!
Covid is the only thing that kept them open this long. MULTI millions poured in from Uncle Joe Biden!!!!!!!!
Two words - Brain Drain! Communities need population growth to sustain the local economy, and nobody is moving to Greenwood/Leflore County while most of those who can afford to move are.
Somebody tell Uncle Bennie that 'the state' doesn't have the authority to require increases in medicaid payments to hospitals.
The congressman never shows up in the district unless a bomb has fallen. Then he arrives (late) in a fire truck carrying no water or pump. We'll be better off if he simply restricts himself to flyovers and crucifying an ex-president.
"@11:45 AM, how does the rural hospital stay in business providing services at less than cost?"
Isn't that the whole point being discussed here and in Greenwood?
Republicans are idiots. Democrats are crazy. And we’re all stuck in the middle. (Raise taxes-really?)
Unless there is some hedge fund or private equity firm waiting to buy up these hospitals, I fail to see the angle in refusing Medicaid expansion for the state of MS.
Let the rural hospitals close and see how fast these politicians change their tune about it. Hospitals/E.D.’s in the Jackson Metro are already overwhelmed by patients from rural areas. It can and will get much worse. Mess around and find out, right?
I think the point is, expanding Medicaid does not increase reimbursement rates. It only increases eligibility. The statements in the presser are contradictory.
"If Medicaid doesn't cover costs how does expanding Medicaid do anything other than cover more people with reimbursement that doesn't cover the cost of care?"
This is the question all Medicaid expanders must answer.
The mismanagement is magnified for all to see when it was pointed out that millions were spent on traveling nurses.
If a boat is loaded with people paying a quarter to board, will it help to give 40 more people a quarter and allow them to board the boat? The sumbitch was going to sink anyway since quarters won't pay for the boat's operation.
To play devils advocate:
Assuming the hospital performs a service that costs 100.
If the patient is uninsured, the hospital likely collects nothing, loses 100, and hounds the patient for the debt.
If that patient is covered by Medicaid, the hospital may collect 90 and the patient is not in debt.
The loss of 10 in the later scenario is much easier to overcome with profitable services elsewhere then the former.
11:45 - evidently you don't understand what "expanding Medicaid" means.
you talk about the folks on Medicaid that "are just barely scrappig by". Probably true, except for those that are scamming the system which is not a significant number. But, those that would be covered if Medicaid was "expanded" would include by definition and statutory language those that are making up to 130% of the poverty line.
Basic Medicaid currently covers families who's income does not exceed 100% of federal poverty level. But there are a dozen or more 'exceptions' for those who's family income exceeds that number, plus Medicaid for the working disabled, or disabled children within a household with much higher income (check former House Medicaid Chairman's grandchild from NE Mississippi for example) and of course the CHIPS program that covers many children who's household income greatly exceed this level.
To state that those eligible for Medicaid are 'just scrapping by' ignores the various categories of covered, but more importantly misses the concept of what "expanding Medicaid" means.
1:03 - in measuring the LFPP rate, one needs to ask why the number is at the levels in certain areas of the state, such as in Leflore County on the edge of the Mississippi delta. Employers across the entire stretch of flatlands have problems hiring AND KEEPING employees that will 1) come to work - every day and/or 2) show up for work fit to work.
There are many who choose to claim disability or inability to work at the jobs that have been available, leading to many employers that attempted to locate in the area to pack up and move. A 'cheap' labor force proved to be less than a blessing when the labor force does not recognize the concept of a 'job'.
Same with healthcare - there are plenty of programs that provide basic healthcare to the impoverished, making it hard to keep professionals in the area that practice medicine with the concept of making a living from the patient's payments rather than the grant funding for the organization.
What is ignored, purposfully I'm sure, by all those crying over the hospitals that are failing and near closure (recent AP report claiming 54% of hospitals in the state were near closure - although the report failed to say that it was 54% of the RURAL hospitals - a big ass difference but evidently not to AP 'reporters) - is that many of these rural hospitals are no longer functioning as a hospital. Most particularly in these numbers are the rural hospitals that are County Owned facilities.
Currently there are 84 accredited hospitals in the state, representing some 11,000 plus beds.
There are thirty - 30 - that the average daily census of hospital patients is less than 10%. More descriptive - these 30 hospitals have an average daily hospital bed census of 1.7. Yes, average daily hospital bed census of less than 2 beds.
Of the 30 hospitals, ten of them have an average daily hospital bed census of less than 1 bed per day being occupied.
These 30 hospitals with an ADC of less than 10% represent 876 licensed beds. Greene County has seven licensed beds; Alliance Hospital has 78 licensed beds. The average size of these 30 hospitals is 29.2 beds.
And what do they seem to have in common? Twenty six appear to be county owned facilities, and all in rural counties.
Would 'expanding Medicaid' solve the financial problems of any of these 'hospitals' or would a re-establishment as these facilities to Emergency and primary care facilities with the beds converted to nursing beds be a better way to address the medical and health care needs of the state.
I have found that working for a living and paying for my own health insurance is highly overrated and very expensive. Keeps the gubmint checks and Medicaid coming you dumbass capitalist.
Who killed the UMMC deal? The best option for this rural hospital. They would have closed all unprofitable units and kept it alive. I have been in the medical field for many years. A physician has to see 7 Medicaid patients to equal the reimbursement of one BCBS patient. Simple math that happens in every state. Sad but true. Ask any doctor in Greenwood about it. Also ask them how many patients they have to see in a day compared to a city with a majority of commercial pay patients. It’s a numbers game. You come to a point in rural areas where there is not enough hours in a day just to break even. If GLH stays open, to be profitable it will look nothing as it did years ago. Cuts have already occurred to help keep it afloat and be attractive to a buyer. Use Batesville as your guide. How many times has it changed hands since the county gave up trying to operate it. There will be someone or group hanging around to pick it up for pennies on a dollar right before it looks to close . Usually a group of local doctors. Not sure if this will happen in Greenwood.
868 -- all true. Or, one could also look at the 'deal that was to be' up north when Representative Trey Lamar put $3 million into the appropriation bill so that his family could cash in on the county's sale of their already closed hospital.
Other than cutting costs and reducing to make it possible to sale, pull some political stunts and hide a few dollars when you are in a position to do the hiding. Just hope you don't have someone like Tater that actually does his homework and reads through the bills (yes, staff - I know) and is willing to pull out his veto pen.
So barring having a Committee Chairman and a Board Attorney in your back pocket - gotta go your route.
To John Pittman Hey - where did you acquire your "knowledge" of medical economics? Asking for a friend.
I am asking the same question as 8:58 pm. Who did kill the deal between UMMC and the Greenwood hospital? From all published reports, it was only a matter of time before the deal was finalized. Sounds like some back door political shenanigans going on. Where is MS Today and their staff of ace investigative reporters? This is as big a story as the medicaid expansion.
"Who killed the UMMC deal? " I think it was UMMC when GLH refused to one 1) fork up $9mm in repairs and 2) retire some outstanding debt. As far as Medicaid expansion, I've been against that sine 2010 with ObamaCare. I figured they would pay the 90% until they couldn't and the state would get stuck with it as you can never roll back and entitlement program. But someone asked how it would help. Well, by expanding Medicaid, yes it may be less than actual costs but by adding people to the Medicaid roll, it would at least help cover fixed costs as they are likely seeing nothing from the self pay. So, the answer to the problem is changing patient mix. The only way to do that is to improve patient care and make GLH a desirable option to the insured. UMMC might could have done that by providing services that were otherwise not available. That fell through. So, maybe it's time to make it an emergency room with some holding areas and rent out the remaining space for grant based clinics. You really can't overcome bad management in today's environment. You can't overcome razor thin margins anymore in healthcare.
UMMC/Oxford/IHL was looking to take advantage of a pennies-on-the-dollar deal but didn't get it because the powers that be smelled out their greed and lack of interest in actual services to be provided to Delta families.
Nov 22, 2022 @ 8:09 PM
Facts and hard data are unimportant to the Democratic (and RINO Hosemann) narratives.
"UMMC/Oxford/IHL was looking to take advantage of a pennies-on-the-dollar deal but didn't get it because the powers that be smelled out their greed and lack of interest in actual services to be provided to Delta families."
I wonder where Lexington and Grenada would be without UMMC's presence. Probably no hospital?
@5:49 am - you've got to do better than this. You obviously have o idea of what you are talking about regarding your comments 1) and 2). Please share with us the source of your inside knowledge of the negotiations. Waiting for your reply.
5:28, the comments you objected to by 5:49 are actually matters of public record. UMMC wanted the city and county owners of GLH to pony up $9.1 million to cover deferred maintenance and the Medicare Advanced Payment loan repayment.
The agreement was that the city and county would purchase Irrevocable Letters of Credit (ILCs) in favor of UMMC for the $9.1 million.
The city readily complied, but the Board of Supervisors refused to authorize the purchase of an ILC in favor of UMMC.
BoS members made public comments that they were going to hold on to the money until UMMC agreed to guarantee certain services that UMMC didn't intend to continue.
Then, it turned out that the ILCs couldn't possibly be provided to UMMC until at least 90 days had elapsed to float bond issues to pay for them.
Three days later, UMMC terminated the lease discussions.
I reported extensively on these facts in several news articles, with videos of the meetings, which you can find in reverse chronological order at the last link in the article above.
John Pittman Hey
@10:08, you ask where did I acquire my "knowledge" of medical economics.
I'm sure that Kingfish doesn't want us to redirect his blog post to a personal discussion of my knowledge of these matter.
The short answer is, I acquired my knowledge of these matters in the course of 30 years of professional work in the healthcare financial field.
Using that knowledge, I have published 103 news articles about GLH's financial demise starting in 2008. The article above was written by me.
If you need further details, I'll be glad to share them with you. Shoot me an email at the contact address at the bottom of the page found at the last link in the above article.
My comment was about people without medical economics knowledge being appointed to the GLH board of trustees.
If you have basic knowledge about medical economics, this specific example should suffice to demonstrate my point:
A prominent and highly successful local business leader was appointed to the hospital board of trustees.
After he spent a month or two poring over the hospital's financial records, he attended a meeting at which the medical staff was also in attendance. He announced that he had discovered why GLH was losing money, and that he knew how to easily fix it.
He then announced that Medicare and Medicaid were paying the hospital less than the hospital's cost to provide its services.
The solution, he opined, was that the hospital just needed to increase its prices, so that it would receive higher reimbursements from Medicare and Medicaid.
Some in the audience laughed at him. The rest were aghast that he would say such a stupid thing.
John Pittman Hey
Thanks 6:13. I knew the numbers were at least close but really didn't want to dig through prior thread re: GLH and find the actual numbers.
You said: "
The solution, he opined, was that the hospital just needed to increase its prices, so that it would receive higher reimbursements from Medicare and Medicaid."
It's been a long time since I have had anything to do with this but from my recollection, the only way to effect Medicaid per diem or Maidicare DRG payments to through cost reports or getting reclassified as to the level of care patient mix in you facility. Other than that, how did he propose to "receive" higher reimbursements. Again, it's been year since I had anything to do with this and even then, these rules were changed seemingly weekly. These questions are for inpatient but the same is true for procedures and outpatient visits. Just curious. TIA
@4:28
That's my point. He was a successful business man, on the hospital board of trustees, and he didn't know that 3rd party payers (Mcare, Mcaid, BCBS, other insurance) don't pay based on what you charge!
IOW, he didn't have a grasp of basic medical economics.
Changing your price doesn't have any impact on your 3rd party reimbursement rates at all.
All it does is impact the DISALLOWED amount that the insurance payors subtract from your "price" to meet their fee schedule.
Their fee schedules are pretty much handed to the medical providers at the end of a sword. You have to be really strong, like UMMC, to have any influence on the payment fee schedule of private insurance companies like BCBS. And look how that has turned out so far!
That's just a tiny part of the mismanagement that has destroyed GLH.
John Pittman Hey
@2:59 This is quite interesting. While a lack of medical economics should not prevent anyone from serving on a hospital’s board, a lack of general business knowledge should. In the business world, it is not unusual at all for members of a board to have no knowledge of the economics of the business, however these boards hire executives who have the experience and knowledge to successfully operate said business. From your comments it appears that you expect the hospital’s trustees to operate the hospital instead of qualified executives, and if this is the case, the hospital is doomed. Your comments on other management mistakes would be welcome. This has the making of an excellent case study at any reputable business school.
No hospitals, means no businesses!
@5:26 - I agree that the trustees ought to have general business knowledge, but most of them do not have even that.
It would surely help if they also had a basic grasp of medical economics.
After all, they pick the executives. They hire/fire the management positions, and the physicians. They approve all contracts for services, contract providers, etc.
And all of that is kept secret from the public, so there can be no accountability and review by outsiders.
The Board of Trustees is the actual governing body of the public hospital. Remember that it's a GOVERNMENT ENTITY, like the Board of Supervisors or the board of alderman. The executives are completely subordinate to the trustees.
In the past, on many occasions, the trustees have overruled the executives they hired to "run the hospital." Three CEOs have actually been fired by the BoT with no public explanations ever given.
The reason they need to have basic medical economic knowledge is that the medical financial world departs from regular old business economic principles in several ways. So if you have business practice knowledge, but not medical financial knowledge, you are going to make certain bad decisions, because you need to understand in what ways medical economics modifies the normal expectations of business economics.
Not knowing that you cannot set basic pricing means that you won't understand that the regular world of supply and demand curves are grossly distorted in healthcare.
Also, not understanding that the patient and the physician don't have the final say in what services are rendered, but rather the 3rd party payers, is another cold splash of water in the face.
John Pittman Hey
Post a Comment