Another Negative Trend
Most people in the healthcare field know that hospitals make their largest profit in the outpatient arena. Negative trends in outpatient exams will certainly have serious financial implications on hospitals.
Outpatient exams are impacted by the relationships outlying physicians maintain with the hospital. It should come as no surprise that we are seeing a negative trend in the amount of outpatients that Floyd Memorial is seeing.
From January through April of 2006, Floyd Memorial is performing fewer outpatient x-ray procedures than it did in 2005. With a $65 million expansion, this should be raising some red flags with the Board. Inpatient x-ray procedures are actually up, but because of DRG’s, most of these procedures are bundled with the hospitalization and cannot be billed for separately.
Here are the numbers:
2005 Inpatient exams totaled 11001
2006 Inpatient exams totaled 12352
Increase of 1351
2005 Outpatient exams totaled 31451
2006 Outpatient exams totaled 30318
Decrease of 1133
Many outpatient tests are done as a result of emergency room visits which are also up. Logically, if the ER is busier and many of the outpatient x-ray exams originate from there, you could conclude that even fewer outside physicians are referring patients to Floyd for outpatient x-ray exams.
I wonder why this trend is occurring.
Will anyone else notice and begin asking some tough questions?
We’ll get responses that the new outpatient radiology center is the reason, but that would only partly explain the decline in the overall numbers. With the population increasing along with utilization, we should be seeing much higher numbers.
This is just one more negative trend that was predicted.
Who’s listening???
Outpatient exams are impacted by the relationships outlying physicians maintain with the hospital. It should come as no surprise that we are seeing a negative trend in the amount of outpatients that Floyd Memorial is seeing.
From January through April of 2006, Floyd Memorial is performing fewer outpatient x-ray procedures than it did in 2005. With a $65 million expansion, this should be raising some red flags with the Board. Inpatient x-ray procedures are actually up, but because of DRG’s, most of these procedures are bundled with the hospitalization and cannot be billed for separately.
Here are the numbers:
2005 Inpatient exams totaled 11001
2006 Inpatient exams totaled 12352
Increase of 1351
2005 Outpatient exams totaled 31451
2006 Outpatient exams totaled 30318
Decrease of 1133
Many outpatient tests are done as a result of emergency room visits which are also up. Logically, if the ER is busier and many of the outpatient x-ray exams originate from there, you could conclude that even fewer outside physicians are referring patients to Floyd for outpatient x-ray exams.
I wonder why this trend is occurring.
Will anyone else notice and begin asking some tough questions?
We’ll get responses that the new outpatient radiology center is the reason, but that would only partly explain the decline in the overall numbers. With the population increasing along with utilization, we should be seeing much higher numbers.
This is just one more negative trend that was predicted.
Who’s listening???
posted by Anonymous at 5:57 AM
21 Comments:
What a brilliant person it takes to predict that ANY hospital is going to see a decrease in outpatient procedures given the rapid increase in doctor-owned, and private company outpatient facilities. This is a NATIONAL trend which anyone with a computer and access to the Google search engine can determine in about 90 seconds.
Why do you keep blaming Floyd Memorial for every factor that impacts virtually every hospital in the United States? You really need to get over yourself. You let your personal animosity toward the hospital CEO color every observation you make and every word you write about the hospital.
If that is so, why is it that this administration gave the Board projections that procedures would be higher, not lower for 2006.
Have they not recognized these National trends or do they choose to just ignore them?
You are correct in that compentent individuals would recognize these trends and try to manage them appropriately
You are a riot!
First you imply that it is the hospital's fault that outpatient procedures fell. When that position was challenged as nothing more than part of a national trend, you then switched gears to suggest that hospital administration was incompetent because they didn't accurately predict the number of patients who would walk through the door in a given period. Your logic operates like a bumper car at a carnival midway.
Let's stick with the issues.
The administration has been informed by many people that more and more procedures are leaving Floyd. Yet, they still base their calculations for the budget on increasing procedures.
Needless to say, they are not meeting their stated financial goals. The numbers prove this.
Physicians are increasingly unhappy and when their comes more competition, Floyd will continue to see declining numbers.
They are not adequately addressing the problems with their key referral sources.
Funny how most readers I talk with understand these concepts very well. As you can see from the daily counter, many people are reading and learning.
I think they are learning a lot about your character: Your pettiness, your meanness and your inability to see beyond your preconceived conclusions.
You can pick and choose all the isolated, out-of-context pieces of information you can find. The simple fact remains that overall Floyd has done a better job than its peers in managing through and around the challenges facing healthcare. organizations. Ignoring their record of success and continually predicting disaster down the road, makes about as much sense as saying that you are a terrible doctor because all of your patients are eventually going to die.
Why don't you inform the readers of your identity and let them decide on character.
I think they would truly be enlightened and then fully understand these issues.
I thought we were sticking to the issues? You never seem to be able to stay on consistent logic path.
Can't help but agree with the doc on this one, diogenestrainee. You need to be upfront with your identity so the rest of us can truly evaluate your comments. Anonymous comments have little if any value.
Facts are facts not opinions that might be biased by the identity of the poster.
On several occasions on this blog, Healthblogger has stated that Floyd is a better hospital than others in the region. It has had the same CEO for many years now, so, I repeat:
The simple fact remains that overall Floyd has done a better job than its peers in managing through and around the challenges facing healthcare. organizations. Ignoring their record of success and continually predicting disaster down the road, makes about as much sense as saying that you are a terrible doctor because all of your patients are eventually going to die.
When physicians talk about hospitals being good or bad, we are referring to the care given to our patients.
I would rate our nurses, aides, lab, x-ray, and all other ancillary services as excellent and better than other hospitals despite them having to work short-staffed.
My goal is to see that the medical care and the employees are taken care of and that the satisfaction numbers increase.
It can only continue if the financial side remains in the black.
Decisions and long-term planning about how to implement this is where I believe the "hospital" is below average. I am looking out 5-10 years with these assessments like all Board Members should be doing. Decisions need to be made now to ensure success down the road. Again, this is where we are failing and the financial numbers and other statistics support that.
Lack of vision and recognition of worrisome patterns is my complaint with the current leadership.
The care of the patient has never been questioned except for managements lack of adequate personnel and support it gives the employees.
The employees continue to overcome the shortcomings of the administration, but it will only last for so long.
But my dear and anonymous diogenestrainee, when you write things like, "I think they are learning a lot about your character: Your pettiness, your meanness and your inability to see beyond your preconceived conclusions," it's no longer about pure, isolated facts, and has become about your attacks on someone's character.
THEN, the importance of knowing who you are becomes heightened.
Why not just act out of simple integrity and honor? Isn't that easier in the end?
Character attacks have been the hallmark of the owner of this blog. His victims of ad hominem attacks include the senior managers of the hospital, hospital board members and county commissioners. He has not been satisfied to disagree with their views but has questioned their integrity, intelligence, competence and political motives.
If you want to get back to a pure discussion of issues, I will point out, once again, that I have great trouble understanding the logic of throwing out an administration which for nearly 15 has outpaced its peer group in coping with the changes and challenges in the healthcare environment just because something might go wrong 10 years in the future.
You keep harping on the past. Times have changed and what succeeded in the past will not succeed in this new healthcare environment.
That is the issue. Your repeated comments on past performance is exactly what we hear from administration and that is why there is such concern.
Track records mean something. Speculation about the future by someone NOT trained or experienced in running a hospital (with more responsibility than simply making doctors happy) means a lot less.
Sorry, but you have no track record in hospital management and your "vision" about what may or may not be most useful in the future was not persuasive enough to carry the day at board meetings or with the county commissioners who declined to reappoint you.
You have a right to your opinions and a right to make your case. But just because they are YOUR opinions, doesn't make them correct.
The same is true of yours. At least Dr. E. is willing to stand by his in name. Yours would be much more credible if they had an owner.
There is a big difference. I never said I knew how to run a hospital.
Let the record show that DiogenesTrainee did not attempt to answer my question, except to infer that when it comes to his or her opinion, rules of civilized behavior no longer matter.
Please, DT, address the question: Why not act out of simple integrity?
NA: My identity is not an important factor in this discussion. I am not proposing an agenda or supporting a specific approach to running the hospital. My only purpose in responding is that my family and I have used Floyd many times over the years along with some other hospitals in the region. I feel very strongly that we are most fortunate to have such a well managed, first class facility in our relatively small community and I am offended by HB's tarring of the hospital just because he can't get along with the CEO.
Dr. Dan had his chance to make the case for his proposals. Hospital administration, the board and the county commissioners decided to go another direction. At some point, one has to recognize when it is time to move on.
There are maybe a half a dozen or so things in Floyd County that we can truly be proud of and the hospital is one of them.
It is disappointing to see a professional in a particular field try to pass themselves off as an expert in another. Healthblogger, you should stick to the practice of medicine or spend the appropriate amount of effort to understand hospital management.
You have taken this trend in utilization and made an assumption that it is the result of physician referral behavior in this market.
What you fail to realize is that almost all the hospitals in the southern Indiana market had a slow down in utilization in the first quarter of 2006. Blame it on mild wheather, health patterns, etc. In your "professional" judgement, you jumped to the conclusion that this must be a systemic pattern of behavior affecting only Floyd. Please do your homework before you stir such a controversy! Better yet, try leaving management to the professionals that make it their full time profession
Weather or whatever -- there's some scientific management
I ran across this article on msn home page and find this quote from Don Hodges in the article regarding CEO's to be true where Floyd Hospital is concerned.
"What are they, kings? It's crazy," says Don Hodges, president of the Hodges Fund (HDPMX, news, msgs), a money manager who looks closely at CEO pay when assessing potential investments. "I just don't understand how these guys can even rationalize themselves. How can they look their employees in the eye?"
Hodges says the problem of excessive CEO pay usually comes about because boards of directors are too weak to stand up to pay demands from top executives. "Any board that would let this kind of thing happen is made up of wimps."
That hospital could cut the budget by slicing some salaries from the Administration and have enough dollars to hire several associates who "really" work instead of attending meetings and having their pictures taken for community events. Nurse Quillman is not a genuine person and should consider retirement, PT Truman doesn't know what he is doing or how to communicate effectively with physicians or associates other than his previous handful of employees he directed before adding him to Adm. CEO has made improvements at that hospital in the past but not in the recent past and most likely is biding his time before retirement. CFO and Marketing VP appear to be the core of the Administration there from what I have heard in the public and read. Just a thought.
To read the article in its entirity -
http://articles.moneycentral.msn.com/Investing/CompanyFocus/WhataHugeCEOSalaryWouldBuyYou.aspx?GT1=8199
Brenda (anonymous only due to lack of time)
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