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January 30, 2014

Weidner: ‘Apprehensively bullish’ on CRMC’s positioning for health care reform

CULLMAN — After posting the best financial year since separating from Baptist Health System, Cullman Regional Medical Center feels “apprehensively bullish” about its standing with national health care reform, CEO Jim Weidner said in his annual State of the Hospital address Wednesday.

 With uncertainty about the Affordable Care Act’s impact lingering, Weidner laid out challenges facing the community-owned hospital — namely cuts to Medicare payments and a large number of uninsured patients — but also its advantages — pre-emptive adoption of technology, a new approach to payments, low cost structure and an overall healthy population.

“We feel sure that our pluses will outweigh the minuses,” Weidner told those in attendance at the Cullman Area Chamber of Commerce’s business leaders luncheon. “Our goal is to be the best community-owned hospital in the country.”

CRMC ended fiscal 2013 with a $1.6 million net profit, representing a $4 million swing after ending 2012 and 2011 with deficits of $2.6 million and $2.4 million respectively. Weidner attributed the financial turnaround to a drastically improved billing and collection system, a fortuitous bump in Medicare payments with Hartselle Medical Center’s closure  — and consequently favorable insurance contracts — and $2.7 million in cost reductions.

It also has healthy cash reserves. And while many hospitals have hit financially hard times, CRMC saw its credit rating improve from negative to stable, Weidner said.

“We’ve managed to go against the tide,” he said.

A continuing point of concern is the ballooning cost of indigent care, which went from $4.3 million in 2007 to $8.2 million in 2013. The hospital writes off that bad debt. Weidner said about a third of its patients don’t have insurance. Its coverage area includes 175,000 people.

“We’re hoping the $8 million loss we saw last year is the bottom,” Weidner said.

The sweeping health care legislation aimed at getting uninsured patients covered has experienced underwhelming enrollment in insurance exchanges. Hospitals agreed to take a cut in Medicare payments with the expectation that more patients would get insured, he said.

“Not nearly the amount of those promised have signed up so hospitals cut their own throats a bit,” Weidner said. “Only time will tell how many people will get covered.”

Gov. Robert Bentley’s refusal to accept $1.5 billion to insure 300,000 more Alabamians has also hurt hospitals, he said. Weidner is hopeful the money will be available again in 2015 and hospitals can convince Bentley, if reelected this year, to accept the money.

Weidner said a significant positive ACA change is medical providers going from volume -based payments to value-based ones. Previously, hospitals would charge per service, racking up tests and procedures, but under ACA, patient satisfaction and good outcomes are the metric for payment.

Over the past year, CRMC made the following hospital upgrades: $200,000 for new signage, $500,000 for new digital patient monitors, $500,000 for new laboratory system, $750,000 for the forthcoming renovated Cullman Emergency Medical Services ambulance building, recruitment of three new physicians and renovated rooms in 3 West and 3 East.

Weidner also laid out the CRMC board’s goals for the next three years: providing excellent patient experience, highly reliable organization for quality, united and aligned medical staff and hospital, renovated hospital interior through the CRMC foundation’s $5 million Refresh-A-Room campaign as well as grow to meet needs of its service population and have its bond rating upgraded to ‘investment grade.’

Weidner also touted CRMC’s six national awards for its innovative programs: eSurgery tracking board (allows families to follow patient’s surgical progress from the waiting room), Good-to-Go (patient access to digital recording of discharge instructions), Proventix (tracks hospital staff’s hand washing in between patients), MedSnap (identifies and analyzes patients’ medications and alerts to negative drug interactions) and DoseWatch GE (monitors radiation exposure for scans).

The chamber also awarded Dr. Jeremy Stidham, CRMC’s medical department chairman, with the Healthcare Professional of the Year. Stidham is an internist at Cullman Internal Medicine and served as chief of internal medicine in 2013. He is also medical director for North Alabama Community Care which seeks to improve primary care to patients covered by Medicaid. Stidham was named 2013 Alabama Hospital Association Physician Hospital Hero for his efforts to help Medicaid patients through his clinic. He also serves on the Good Samaritan Clinic’s board of directors and the CRMC Foundation board.

* Tiffeny Owens can be reached by email at towens@cullmantimes.com or by phone at 256-734-2131, ext. 135.

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