SWEETWATER COUNTY — The Memorial Hospital of Sweetwater County presented their annual report at today’s regular meeting of the Sweetwater County Commissioners.

The presentation included a current financial breakdown through April 2017 and a budget for Fiscal Year 2018, to many positive comments from the Sweetwater County Commissioners.

MHSC Chief Financial Officer and Interim CEO Irene Richardson presented a summary of what what the hospital has done over the last year, as required by Wyoming statute.

Updates included a listing of current services offered, a listing of providers by specialty, a financial breakdown for this year and next, and the administration’s 2018 goals.

“We’re going to be expecting a $2,343,000 gain next year with a projected loss of $6.7 million loss this year,” said Richardson, who outlined that many changes have been made to achieve those numbers.

Commissioners were happy to see the change projected for 2018.

“I wouldn’t have changed anything, not with the outcome that we have. Management wasn’t going in the right direction,” said Commissioner John Kolb.

See below many of the slides and commentary from Richardson and the county commissioners.

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Medical Services at MHSC

The Shriner’s Telehealth is a new service.

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Medical Providers

A list of the providers by specialty. MHSC is at two locations now. A Family Practice and Occupation Health Clinic opened in April.

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Statistics

MHSC has increased significantly in clinic visits. Outpatient surgeries have grown slightly.

“We’ve seen a huge increase in our outpatient visits, which is basically the trend in healthcare. Healthcare has been moving more and more to the outpatient setting. We get penalized for patients who come in within 30 days of discharge. Our goal is to treat patients on an outpatient basis,” said Richardson.
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Financial Performance

Richardson said there is lots of talk about a lot about Gross Patient Charges. That is what the patient is billed. That’s not exactly the same as what the hospital collects from the insurance companies. What gets collected is called Net Patient Revenue

With Medicare and Medicaid, the reimbursement can be significantly less than what the patient is billed. Medicare rates can be 50% less. Medicaid can be much less, even in the teens. This is why the hospital must leave lots of room in the operating budget.

“We’ve had a slight shift in payer mix from commercial insurance to Medicare and Medicaid. Memorial Hospital has also seen an increase in length of stay. We are trying to do a better job of discharge planning and getting the patients out in a timely manner,” said Richardson.

As an example of how this creates a budget problem, if you have a Medicare patient in the hospital with pneumonia, the hospital needs to get the patient home in the amount of time set by Medicare. The hospital won’t get reimbursed past the set length of stay for that illness. This can compound the deficits already associated with Medicare and Medicaid.

According to Richardson, the 2017  budget was supposed to be a break-even budget, but things have happened throughout the year which have “brought us to this point of a negative $5 million bottom line through April. We’ve had to make some changes so we can turn that bottom line around. We’re hoping that we can show you we’ve tried to improve our financial picture based on some changes we’ve made,” said Richardson.
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Fiscal Year 2018 Budget

The Fiscal Year 2018 Budget is to be discussed at the regular MHSC Board of Trustees meeting tomorrow at 2 pm.

Richardson said they were conservative with projections for the 2018 revenue because the economy is slightly down.

They’ve created a Utilization Management Committee to make sure they are getting patients out in a timely manner.

“We’ve had some decreases in our expenses by exiting some agreements. We’ve tried to reduce our agency staffing because it’s 2-3 time more than what we pay for our own employee. We’re going to be expecting a $2,343,000 gain next year with a projected loss of $6.7 million loss this year,” said Richardson.

“So that’s almost a $9 million dollar swing,” said Commissioner Reid West, to which Richardson agreed.

Richardson also said they needed to increase charges by 5% to keep up with inflation.

“We’ll need to make sure we look at this budget every single month and make adjustments accordingly,” said Richardson.

Sweetwater County Commissioners were pleased with the new budget.

“It’s outstanding. Huge,” said Commissioner Wally Johnson.