An anticipated 2005 budget deficit has led to several joint meetings of the Telluride Hospital District Board and Telluride Medical Center management and staff to determine a course of action. According to THD board president Stephen Wald, the budget deficit is a result of unexpectedly high costs for employment, materials and supplies at the beginning of the year and lower revenues.
“It’s the nightmare of every medical center in the country no matter how big or small,” said Wald, citing billing issues with insurance companies as one of the main revenue issues. “We’re trying to see if there’s a way we can do better.” The medical center has already had improvement on some contracts with various insurance carriers.
The medical center is focusing on the business aspect of the operation, particularly that of front office billing and receiving and insurance reimbursement. In doing so, the THD board has contracted with GroupOne Health Source of Jefferson, Missouri, specialists in comprehensive medical facility analysis. The company will assess TMC’s business practices, including staffing, billing, collections, claims processing, and coding accuracy.
“It’s a question of what they call coding on charges,” said Wald. “Someone comes in with ailments, and depending on the severity, there are coding tables you base charges on. We want to charge what’s equitable to other facilities like ours charging.” The firm will also be reviewing billing procedures to assure the center is billing properly.
“We’re very keen on learning what they are going to say,” said Wald. “We brought them in to get judgment from an organization that sees dozens of organizations like ours. We really want to give them a chance to give us specifics on things we may not see.”
The board and staff have also identified a number of steps that can be implemented immediately to address a portion of the deficit.
“We’ve had a couple of voluntary departures – people changing jobs – and some of those won’t be replaced,” said Wald. “We’ve had some savings there.” Some employees have also taken reduced hours and there is the possibility of a reduction in hours the facility is open on certain days. “We’ll see what the consultants say,” said Wald, stressing “we’re doing this while keeping our standards as high as possible. The medical care and professional medical services of this center are very high, and we should be proud of it.”
Wald called the level of service at the center “equal to some of the best facilities,” naming Peter Hackett, M.D., and Sharon Grundy, M.D., as two examples of the highly qualified medical staff. “We’re really fortunate to have him,” he said of Hackett, a leading expert in high altitude medicine, and, “Sharon could work anywhere in the country, but she wants to be here.”
Wald said the process of balancing the TMS budget was a continual one. “As a Colorado Special District, we are mandated to end each year with expenses equal to revenue. The more quickly we identify and implement changes, the greater the impact these actions will have on this year’s financial results.
“The business changes that we are implementing now address necessary budget corrections,” said Wald. “Following our separation from the Montrose Hospital District two years ago, we have gained an understanding of the actual costs to operate an independent rural medical facility. The business of providing medical care in today’s environment is challenging. Our first priority remains providing quality medical care for the Telluride community.”
