By Becky Brewster —
Members of the Culberson County Hospital District (CCHD) met on Wednesday, Oct. 6, to review the initial findings of a 10-year capital improvement plan for healthcare in Culberson County.
“The primary goal of the CCHD Board is to maintain and enhance the delivery of healthcare services to the residents of Culberson County,” said Edwin Easley, chair of the CCHD Board. “This plan will provide us with a roadmap to achieve this goal.”
Based on input from the CCHD Board, Culberson Hospital administration, staff and providers, the plan presented by Judy Blazek, president of Business Strategies, Inc., identifies both facility and equipment needs, including replacement of the clinic, renovation of the ambulance garage, purchase of new ambulances and conversion to an electronic health record (EHR) as required by the federal government.
Members of the CCHD Board engaged in a detailed discussion of the need for and cost of a new clinic. The current building is a prefabricated structure that was intended to last only five to seven years and has reached the end of its useful life. In addition, the building is not sized adequately to accommodate the four providers who see patients in the clinic. An initial floor plan for a new clinic prepared by Jim Gary, an architect working with BSI, encompasses about 6,000 square feet and is organized to improve the function of the space from the perspective of both patients and providers.
Also included in the preliminary plan is a breakdown of potential sources of funding for the projects including items that may be purchased by Preferred Hospital Leasing â€“ Van Horn, Inc., potential grant funding and allocation of reserves set aside by the CCHD for this purpose. If approved, the cost of a new clinic could be easily funded through the reserves established by the CCHD in combination with a small increase in taxes.
Preferred, the company that operates Culberson Hospital, spent over $230,000 this year to implement the initial phase of the EHR including new software and computers. “Full implementation of the EHR over the next few years will cost Preferred an estimated $800,000,” noted Andy Freeman, president of Preferred.
The community will also benefit from the recent award of a Community Block Development Grant that includes $50,000 to be applied towards a new ambulance. “Matching funds provided by the CCHD, along with funds obtained through a grant from the state funded EMS-Trauma Systems Regional Advisory Council and a contribution made by Preferred will allow us to purchase a new $180,000 ambulance in 2014,” said David Massey, vice chair of the CCHD Board.
Blazek and Gary were asked by the CCHD Board to further develop plans for a new clinic and to secure more detailed project cost estimates for review at a future meeting.
BSI worked with the CCHD Board in 2007 to develop a facility plan for the new addition to the hospital, and continued to work with the board and hospital through the renovation project completed last year.
Also discussed during the meeting were the many Medicare Advantage plans currently being offered to Medicare patients in Culberson County. These plans are offered by commercial insurance companies and reimburse the hospital and clinic differently than traditional Medicare.
“Any resulting declines in Medicare reimbursement will mean that there is less money available to help the CCHD repay the bonds issued to construct the new hospital addition and could result in higher taxes,” reported Freeman.
“Culberson Hospital and the providers at the Van Horn Rural Health Clinic may not contract with all of these plans,” said Jared Chanski, hospital administrator.
As a result, patients may not be able to use our services without paying more out-of-pocket which could offset any premium savings promised by the Medicare Advantage Plan,” he continued.
In addition, Medicare Advantage Plans may restrict and limit access to inpatient rehabilitation or “swing bed days” requiring patients to spend hundreds, if not thousands, of dollars that would otherwise have been paid by traditional Medicare.
The name Medicare Advantage is confusing to patients because they often assume it is a Medicare supplemental or secondary plan that also offers prescription drug coverage for little or no premiums. If a patient has a Medicare Advantage Plan, they cannot be sold a supplemental plan and cannot use supplemental coverage provided by their spouse's insurance, so will have to pay 100 percent of any deductibles and co-payments associated with the Medicare Advantage Plan.