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RVHS chief: Hospital faces challenges

River Valley Health System wants the community to understand just how much the Balanced Budget Act has hurt its local hospital, but other issues exist in the wake of budget woes brought on by the federal act’s Medicare cuts, RVHS chief executive officer Terry Vanderhoof said.

Tuesday, August 22, 2000

River Valley Health System wants the community to understand just how much the Balanced Budget Act has hurt its local hospital, but other issues exist in the wake of budget woes brought on by the federal act’s Medicare cuts, RVHS chief executive officer Terry Vanderhoof said.

Recruitment of physicians, keeping the doctors here and giving patients an alternative to stay local top that short-term list. At the same time, River Valley continues to look at long-term issues, such as growing healthcare business with additional services and possible affiliations.

"I don’t see any major changes to the hospital coming up in the future," Vanderhoof said. "No matter what we do, we will be an acute care medical-surgical hospital."

Still, the business has for a long time believed in affiliations, he said.

RVHS has been a member of the Ohio State Health Network since the early 1990s, which brought favorable liability insurance rates, group purchasing, mobile mammography, assistance with physician recruitment and other benefits, Vanderhoof said.

But River Valley has remained River Valley, he said.

"I think we are looking at whether other affiliations could benefit this hospital similarly."

Hospital leadership has reached no conclusions, although they are actively considering the idea with an unnamed affiliate, Vanderhoof said.

RVHS is not interested in affiliations that change ownership or those that people perceive as a "takeover" or "selling," he said.

But affiliations can provide ways to grow, enhance patient services and create even more jobs, Vanderhoof said.

"We would look at that as we have in the past," he said.

Rumors about hospital closure or drastic changes and dialogue about the hospital’s financial situation has put affiliation on the public discussion table but "I look at affiliation as a more long-term issue, rather than short-term like the others," Vanderhoof said.

"For us, it is a separate issue," he said.

The short-term issues – physician recruitment and Medicare reimbursements – need even more public discussion, he said.

"We’re committed to providing excellent primary care, that’s our mission," Vanderhoof said.

But it is a competitive market and there have been times when RVHS hasn’t had enough primary care physicians admitting patients, he said.

River Valley tries to recruit physicians to meet community needs, and has at least three lined up now, Vanderhoof said.

A major challenge for all hospitals, however, is keep the doctors from relocating, he added.

Doctors move away from King’s Daughters and Bellefonte, too, but the loss of two or three doctors impacts RVHS, a smaller and more rural facility, more dramatically than at the larger Ashland, Ky., or Huntington, W.Va., facilities, Vanderhoof said.

Community issues, such as the area’s tougher economy and Ironton’s lack of housing, affect physicians’ decisions, too, he said.

But RVHS is trying to overcome that by recruiting with messages of its mission as a high-tech, primary care, family-focused healthcare facility, Vanderhoof said.

The three newly recruited doctors join the hospital system, which, with its Portsmouth facilities, is licensed for 230 beds.

RVHS operates about 80 beds in Ironton and about 30 in Portsmouth now, but that’s misleading because doctors’ goal is to reduce the length of hospital stays and there is more outpatient services today, Vanderhoof said.

"The only way to put patients in those beds is to have physicians put patients in those beds and have those patients want to come here," he said.

All hospitals adjust staffing and handle more outpatient care to compensate for dwindling use of bed space, so it’s not because of competition in Ashland, Ky., or people not wanting to come to River Valley, he added.

"I think it’s a question of not knowing what we do have here," Vanderhoof said, admitting the hospital has not done enough to let people know.

The hospital performs the same technical lab work, does the same laparascopy procedures, handles dozens of types of complicated surgery and is fully accredited by the same organizations as other hospitals, he said.

There may be thoughts that bigger is better, but that’s not true in River Valley’s case, he added.

"We’re here because there is a need for us to be here," Vanderhoof said. "While we’re high-tech, our primary focus is primary care, family-focused."

River Valley will take that message plus news of what it offers to the public and doctors in increased awareness campaigns, he said.

Hopefully, the community will receive the message and know to come to RVHS for things they or their doctors might seek elsewhere, Vanderhoof said.

That also should further answer rumors, he said.

"Will we ever give up being an acute care medical-surgical hospital? We absolutely do not have any plans whatsoever to do that."

It won’t come quickly but hospitals also need a fix to the Medicare reimbursement problem, although service changes and layoffs are working for RVHS in the short term, Vanderhoof said.

"We do expect relief for the Medicare problem beginning in October," he said. "Congress is serious about putting money back."

Hospital administrators have discussed the problem in meetings with employees, many of whom have sent letters of support to lawmakers, he said.