2012 a year of growth for DCHS

IRON MOUNTAIN – Dickinson County Healthcare System added new physicians and new services in 2012, John Schon, administrator/chief executive, reported in a year-end overview.

Schon’s report detailed the growth for Dickinson County Healthcare System as it welcomed new physicians, grew services and achieved goals that enhanced the standard of quality care for its patients.

Physicians welcomed in 2012 were Clayton Shaker, MD, a specialist in cardiology, and Kevin Scott., MD, a specialist in urology.

Dr. Shaker joined Dr. Ramon Ray G. Rayel in the medical management of patients with heart disease and also brought some new more invasive cardiac diagnostic procedures to the area through a special arrangement with Marquette General Hospital. The urology practice of Dr. Kevin Scott became part of Dickinson Physician Services; the name of the urology practice is now Dickinson Urology Clinic.

New or enhanced programs and services were developed in several areas of DCH System as outlined below:

-Dickinson Radiology/Imaging Services added new CT scanner technology. Radiation Oncology completed a technology upgrade that brought Rapid Arc to Iron Mountain.

– Information Systems developed and implemented a surgical tracking system for Operating Room Services, which has enabled family members to track their loved one’s progress through their surgical process.

– Dickinson Pediatric Clinic added a concussion management program and services in pediatric neurology and pediatric nephrology through unique collaborations and telehealth.

– Dickinson Cardiology Services added coronary angiography via Dr. Shaker’s

arrangements with Marquette General Hospital and relocated to Suite 215 in the Dickinson Medical Building.

– U.P. Sleep Center medical practice relocated to Suite 205 in the Dickinson Medical Building and remains a nationally accredited Sleep Medicine Program

– Dickinson Home Health hired a new manager, Tina Zarcone, RN, and contracted with Charlene Greene, DO, as medical director. Patient satisfaction with the service has improved. Central operations will move to River Avenue in Iron Mountain in 2013.

– Laboratory and x-ray services available at the Bellin Clinic on Woodward Avenue are provided by Dickinson Memorial Hospital.

– Dickinson services expanded into Delta County. Adina Anderson, DPM, and Dickinson Podiatry Services as well as Igor Siniakov, MD, and Dickinson Dermatology Clinic see patients regularly at the Cedar Hill-Bayside Clinic in Gladstone.

– The Dietary Department became Food and Nutrition Services and launched the new Room Service Program; patient satisfaction scores climbed from the 30th percentile to the 98th percentile with temperature and quality of the food ranked in the 99th.

– New construction was completed. A clinic in the southwest corner of the hospital campus was completed to house the relocated Dickinson Occupational Clinic and the expanded wound care program – The Center for Wound Healing & Hyperbaric Medicine.

Dickinson Pediatric Clinic remained in Suite 210 of the Dickinson Medical Building but expanded to twice its former size adding additional exam rooms, a telehealth room and an ImPACT testing room.

– DCH System attained an “A” rating for Patient Safety from the Leapfrog Group. The Leapfrog Group, an independent national nonprofit organization, awarded Dickinson Memorial Hospital a grade of A, which represented the hospital’s overall capacity to keep patients safe from infections, injuries, and medical and medication errors. The Leapfrog Group calculates a single safety score, based upon 26 measures of publicly available hospital safety data provided voluntarily by hospital staff.

– Several clinics attained designation as a Provider Based Clinic, which changed their administrative status to outpatient departments of Dickinson Memorial Hospital. As a result, Medicare required a change in the billing process that was communicated to Medicare patients.

– Hospital staff implemented new Medical Record technology throughout Dickinson Memorial Hospital and various medical clinics. This is an effort to meet the meaningful use guidelines imposed by health care reform. Electronic medication administration and computerized physician order entry were successfully implemented throughout the patient care units in Dickinson Memorial Hospital. Electronic Medical Record implementation is now fully implemented in most of the Dickinson medical clinics.

– A new 340B Pharmacy Program was implemented as a cost saving initiative that allowed DCH System to purchase outpatient pharmaceuticals at government / pre-negotiated rates. Additionally, DCH System entered into a retail pharmacy agreement locally that contributed to the positive financial impact of the 340B program.

– New Community Support Initiatives were successfully undertaken as members of the community came forward in new and exciting ways to support the Radiation Oncology Department at Dickinson Memorial Hospital; funds raised were donated toward the technology upgrade that was accomplished in November. The Race For A Cure event at Norway Speedway in August raised over $10,000 through the selling of laps, T-shirts, and 50/50 tickets. The Bras For A Cause event raised over $5,000 through the selling of T-shirts and custom decorated bras.

An in-depth Strategic Planning initiative assessed the following operational highlights of DCH System:

– DCH System is a very efficient, low-cost, high quality hospital/healthcare system.

The majority of DCH System’s commercial insurance reimbursements are between 8 percent and 20 percent below the reimbursement levels of other Upper Peninsula (UP) hospitals.

– DCH System’s Medicare inpatient reimbursement levels are on average $525 per Medicare discharge or $1 million annually less than the other U.P. and Wisconsin hospitals in the region. If DCH System were reimbursed at the average Medicare Inpatient DRG payment rate of $8,682 per Medicare discharge, DCHS would realize a reimbursement increase of $3.9 million annually in Medicare inpatient reimbursements.

– Patients with Medicare and other commercial insurances represent approximately 75 percent of DCH System’s overall hospital utilization. If DCHS’ reimbursement levels for these two patient classifications were paid at the average of the other hospitals in the region, reimbursements would increase $2 to $5 million annually.

– DCH System is a very efficient hospital. In 2012, DCH System’s combined inpatient & outpatient “cost per discharge”/patient treated was $5,444, which was $2,053 or 27.4 percent less costly (per patient treated) than the east-north central state average for hospitals under 100 beds and $3,195 or 58.7 percent less costly than hospitals with total net revenues of $60 million to $99.9 million annually. DCH System had net revenues before expenses of $84.3 million in 2012.

– DCH System has a positive contribution margin on all of its inpatient and outpatient “patient care” service lines and, therefore, does not have the ability to discontinue any of these service lines to improve its financial performance.

– DCH System scores better than the national average and its regional competitors in almost of every quality measure that was compared.

– DCH System has lower reimbursements and higher quality levels than the national average and its regional competitors.

– DCH System’s 2012 bottom-line after capital contributions and a contribution from the Dickinson County Hospital Foundation of $185,000 was $21,700, which was a $1,660,934 improvement over its 2011 bottom-line.

“All across the country, hospitals are struggling with the formulas and methodologies that determine reimbursement for their services,” Schon told the Dickinson County Healthcare System Board of Trustees. “As we move through 2013, we will investigate and pursue every possible avenue available to us to try to improve some of the reimbursement inequities found through our strategic planning process. We were very aggressive and creative throughout 2012 as we sought ways to curb expenses and enhance revenue streams, and the improvement to our bottom line was the result of that collective energy. I am confident we will be successful in the coming year as well.”

In other business:

– A review of the November 2012 financial report showed the health care system had $7,094,788 in total operating revenue, while expenses totaled $7,229,144, resulting in an operating loss of $134,356. After the addition of interest expense and other net non-operating items, the bottom line loss for the month totaled $148,605. Year-to-date through Nov. 30, DCH System experienced operating income of $959,580 and a total bottom line income of $123,072. This compares to a loss of $2,077,511 at the end of November 2011.

– A review of the December 2012 financial report showed the health care system had $6,635,200 in total operating revenue and expenses totaling $6,737,186 that resulted in a total operating loss of $101,986. After the addition of interest expense and other net non-operating items, the bottom line loss for the month totaled $286,913. Year-to-date through Dec. 31, DCH System experienced operating income of $857,594 and received a $185,000 contribution from the Dickinson County Hospital Foundation for a total bottom line $21,700. This compares to a loss of $1,639,234 at the end of December in 2011.

– Board education included a re-cap of DCH System’s annual contributions to the Medical Care Access Coalition (MCAC). The combined clinic and hospital services totaled 308 patient visits, which equaled a financial contribution of $74,922.