V.I.'s hospitals have differing reviews of contractor's aid in boosting revenue


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Officials from the territory's financially struggling hospitals on Wednesday presented dramatically different viewpoints on how projects to beef up revenues at their facilities seem to be doing.

Schneider Regional Medical Center officials said they are not yet seeing their goals met - and in fact, cash collections are down - while Luis Hospital officials said they expect to see more patient revenue making its way into their coffers as soon as this month.

Months ago, when Luis Hospital officials were trying to get the territorial hospital board to approve a proposed contract with The Advisory Board Company for a revenue cycle optimization project - aimed at capturing more revenue through better billing and collection practices and other means - officials from both hospitals were talking about their hopes that the contracts with the company would provide the way for the struggling hospitals to grow their revenue streams.

At the time in April, Schneider Regional Medical Center had a contract worth about $300,000 that had been in place with The Advisory Board Company for several months.

Luis Hospital in April brought a proposed $1.2 million contract with the same company to the territorial hospital board for approval, but the board raised concerns about it and sent hospital officials back to the table.

The contracts had different scopes of work.

Eventually, Luis Hospital interim Chief Executive Officer Dr. Kendall Griffith executed a $100,000 contract with The Advisory Board Company - an amount that did not require board approval - so they could get to work right away.

Then Luis officials returned to the board with a scaled-back version of the original proposal for $460,618, which the board approved on June 23.

Schneider's perspective

At the territorial hospital board meeting on Wednesday, Schneider Regional Chief Financial Officer Fred Vitello reported that there had been some "interesting trends" with cash collections at Schneider.

Goals that are set out in the contract, Schneider officials said, are not yet being met.

"As far as cash collections, we ended up with some pretty bad months," Vitello said.

Cash collections at Schneider were up significantly in April, he said, in part because of a settlement with Medicare and a payment from an insurance company. Outside of those payments, though, collections improved about 25 percent in April, Vitello said.

However, he said, May and June were bad months, with collections down significantly. June was the worst month for collections in a couple of years, he said, noting that there had been some improvement in July.

Vitello pointed out that year-to-date financials show Schneider Regional operating at a loss of more than $10 million, "which could result in close to a $16 million loss by the end of the year," he said.

He and Schneider Chief Executive Officer Bernard Wheatley said they have been working to focus the efforts of The Advisory Board Company to meet the hospital's needs.

Vitello said they solicited a specific person from the company to "breathe life and accelerate" the process of educating employees about the importance of capturing all patient charges. That person, Vitello said, has been reaching out to employees and doing training.

Although the company is not reaching the goals that are set out in its contract for cash collections and other measures, Vitello said he feels "positive about it, that a lot of the right things have been put in place."

"These initiatives take a lot of time," he said.

Lesson to learn

Board member Angel Dawson Jr. asked whether the situation had "retrogressed" at Schneider - and raised the question of how that bodes for Luis Hospital.

"Should we be concerned that Schneider is a few months ahead of Juan Luis Hospital and these are the results that we are seeing?" Dawson asked.

Board chairwoman Lynn Millin-Maduro said it is important for Luis Hospital officials to hear that the improvements to revenue are not likely to happen overnight.

"While we were hoping to achieve something with The Advisory Group, it's not going to be an immediate solution, we're not going to see immediate results," she said.

Luis' perspective

During his report, Luis Hospital acting Chief Financial Officer Michael Younger said that initially there were some information technology challenges getting The Advisory Board Company and its partners connected with the hospital after the contract was signed in June.

"We really saw the program kick in the second week of July," he said. "So we are seeing great progress as far as identifying cash coming in. We should be able to see that in August, and I'm excited."

The hospital, with guidance from the company, has created committees focusing on different areas of collections and revenue, according to Younger.

The committees, he said, are working to identify deficiencies and correct them.

Younger said the whole process is moving forward, and Luis officials expect increased cash to show in the hospital's August financials.

"We're seeing progress," Younger said. "We should start seeing cash - which is what we wanted to see out of this whole process - in August."

In addition to hearing reports, the territorial hospital board on Wednesday approved credentials for physicians at Luis Hospital and approved 16 policies for Luis. The territorial hospital board is acting as the district board for Luis Hospital, because the Luis Hospital board does not have a quorum to conduct business.

The territorial board also went into executive session to discuss legal matters, and eventually lost a quorum and recessed until its next meeting.

- Contact Joy Blackburn at 714-9145 or email jblackburn@dailynews.vi.

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