At the Becker's Hospital Review Annual Meeting in Chicago on May 10, community hospital executives and healthcare consultants discussed the promise that exists for community hospitals, as well as the challenges they face in the changing market.
1. Revenue and service lines. "We're facing the same issues [as larger health systems]," said Ron Mornelli, COO of Olean (N.Y.) General Hospital. "Volume is dropping, reimbursement rates are dropping, there's lots of pressure on the top line. The difference is [community hospitals] don't have many ways to grow the top line." Hospitals can only cut so much from their expenses, he said, so community hospitals are forced to focus on eliminating duplicative services in their markets.
2. Physician recruitment and alignment. Many rural hospitals bemoan the difficulty in recruiting physicians, but Mr. Mornelli said there are physicians who prefer to work at his facility, especially given its proximity to a premier ski resort and other outdoor attractions. There are interested physicians, he said. The hospital just has to find the right ones to recruit.
Smaller, standalone hospitals often have strong relationships with their physicians, said Brian Fritz, administrative director of operations at Olean. That's true of Olean, but the majority of their physicians — 60 percent to 70 percent of them — are over age 60. The hospital is working actively to recruit younger physicians, but that's more challenging in New York, which has a corporate practice of medicine doctrine, because most younger physicians prefer employed relationships.
3. Partnership and expansion strategies. Olean had a problem with its surgery department. The operating room was frequently running until 2 a.m. because patient loads were so high, said Mr. Fritz. They built a surgery center to be more efficient with their surgery loads, outsourcing the management to physicians. That helped prevent losing surgery business to local competitors.
It's also helped to recruit more surgeons to their market. Mr. Fritz said one ophthalmologist who used to do two cataract surgeries per hour can now perform 16 before noon, thanks to the scale and efficiency the surgery center provides. Speed and throughput is important for hospitals, said Tom Faith, vice president of healthcare operations for The C/N Group, but the surgery center helps assure physicians the focus is on quality turnover, not rushing patients through at the expense of their health.
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1. Revenue and service lines. "We're facing the same issues [as larger health systems]," said Ron Mornelli, COO of Olean (N.Y.) General Hospital. "Volume is dropping, reimbursement rates are dropping, there's lots of pressure on the top line. The difference is [community hospitals] don't have many ways to grow the top line." Hospitals can only cut so much from their expenses, he said, so community hospitals are forced to focus on eliminating duplicative services in their markets.
2. Physician recruitment and alignment. Many rural hospitals bemoan the difficulty in recruiting physicians, but Mr. Mornelli said there are physicians who prefer to work at his facility, especially given its proximity to a premier ski resort and other outdoor attractions. There are interested physicians, he said. The hospital just has to find the right ones to recruit.
Smaller, standalone hospitals often have strong relationships with their physicians, said Brian Fritz, administrative director of operations at Olean. That's true of Olean, but the majority of their physicians — 60 percent to 70 percent of them — are over age 60. The hospital is working actively to recruit younger physicians, but that's more challenging in New York, which has a corporate practice of medicine doctrine, because most younger physicians prefer employed relationships.
3. Partnership and expansion strategies. Olean had a problem with its surgery department. The operating room was frequently running until 2 a.m. because patient loads were so high, said Mr. Fritz. They built a surgery center to be more efficient with their surgery loads, outsourcing the management to physicians. That helped prevent losing surgery business to local competitors.
It's also helped to recruit more surgeons to their market. Mr. Fritz said one ophthalmologist who used to do two cataract surgeries per hour can now perform 16 before noon, thanks to the scale and efficiency the surgery center provides. Speed and throughput is important for hospitals, said Tom Faith, vice president of healthcare operations for The C/N Group, but the surgery center helps assure physicians the focus is on quality turnover, not rushing patients through at the expense of their health.
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