Regina Doxtader - CFO, Botsford Health Care, Farmington Hills, Michigan
How has the recession and its ongoing effects changed the way you manage finances at Botsford?
In southeastern Michigan, we probably got hit harder by the recession than many other areas of the country. We did see an increase in uncompensated care, but we have mechanisms in place to help the uninsured or underinsured get financial counseling, apply for Medicaid, etc. We have also focused on cost reduction initiatives and improving efficiency. Our hospital is part of a larger health system, which includes an ambulance company and a skilled nursing facility. Diversification in our business portfolio did help us weather the recession.
What aspects of healthcare reform will most impact the way you do business?
Healthcare reform has made us look at how we care for the patient through the continuum of care. What is the cost of taking care of the patient from beginning to end. That includes not just physician services, but home health, skilled nursing, etc. The accountable care initiatives and Medicare shared savings program is forcing institutions to look at efficiencies in caregiving. There is an increased focus on quality and patient outcomes. There will be dollars attached to quality and patient satisfaction. Hospitals will have to do business differently.
Even if the healthcare reform legislation is overturned, hospitals will still focus on a more efficient model of care. Private payers are looking for efficiency as well. They want to pay for quality and outcomes. The reform legislation is just the tip of the iceberg, and it’s not a question of ‘if’ but ‘when.’
Are hospital-physician relationships integral to accountable care and the link between outcomes and reimbursement?
Absolutely. One of our top strategic initiatives is centered on physician alignment. We have 60 to 70 directly-employed physicians, although 600 physicians are on staff. We are looking at partnering with physicians in a variety of arrangements, such as joint ventures and leasing arrangements. The employment model is not the only model. It depends on the institution and the region they serve.
Do you have any large capital projects in the works?
Our facility is over 40 years old. Capital planning is at the top of our list, but capital capacity will drive what we do. We have some short-term projects on the horizon, expanding in areas where we see a lot of business. Our ED is pretty busy, but its footprint is pretty small. We want to expand strategically.
Interviewed Richard Pizzi, Editorial Director.