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Many challenges facing health care

By Matt Gross • Jan 23, 2018 at 11:00 AM

As we begin the New Year at Fisher-Titus, we expect that the speed of change in the world of health care will occur at an increasingly faster pace.

While much of this comes from outside sources beyond our control, we will continue to position ourselves to proactively respond to new challenges.

How we respond is guided by our commitment to continue our 61-year tradition of providing health care to our patients and remaining a viable independent community hospital that is governed locally.

The universal issues of health care reform, lower reimbursements from government payers, shifting payment models and burdensome regulations are impacting the financial health of all hospitals across the US with community hospitals particularly challenged. According the American Hospital Association’s 2017 annual report, there are 159 fewer community hospitals in the U.S. than in 2012. Forty-four percent of those hospitals operated at a negative margin in 2016.

The margins of hospitals and health systems are being squeezed by a combination of public-sector rate cuts and market-driven pricing pressure.

More than 60 percent of the patients we serve at Fisher-Titus are beneficiaries of Medicare and Medicaid — government programs whose reimbursements do not cover what it costs us to provide services. About 35 percent of our patients have private commercial insurance that traditionally pays us enough to balance the underpayments we receive from the government programs. But shrinking rates from private insurance companies, further reductions in reimbursement from Medicare and Medicaid, and the increase in patients using government programs are trends we are closely monitoring.

Another financial challenge is a major shift that is occurring in how hospitals bill for services. The traditional model of billing for the volume of patients or services rendered is moving to a quality-based payment system in which providers are paid for keeping patients well and managing their care across the full health care continuum. To begin preparing for this, we implemented a concept called “population health” several years ago at Fisher-Titus and we have seen many positive outcomes.

The uncertainty around health care reform from our government leaders greatly impacts us. We are in an environment where some of the old rules of the Affordable Care Act still apply, others like the individual mandate have been repealed and other key programs are in limbo. Regulatory and administrative burdens introduced by reporting programs have strained health systems. Currently, we undergo 26 different surveys or licensing inspections. While we are proud of the quality of care this represents, the investment of both human and financial resources to maintain these accreditations is substantial.

As we plan for the future, our work is extremely challenging, but our goals are well worth it.

You may have heard that Affinity Medical Center in Massillon announced recently that it is closing its doors after serving the community since 1904. Such news means the loss of tax money and jobs, less convenient health services, lack of local emergency services, and a negative impact on quality-of-life aspects that make a community an attractive place to live and work.

I think we all can agree that one of the cornerstones of a strong community is a strong hospital and health care system.

At Fisher-Titus, with a focused strategy and steady leadership, we are being proactive in meeting the health-care needs of our community and remaining financially stable. The support from community members — our “shareholders” — is critical to our future success as we address the challenges before us. We thank you for choosing Fisher-Titus for your health-care.

Matt Gross is CEO, Fisher-Titus Health.

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