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Schneider Regional Medical Center Faces $24 Million in Unsettled Bills, Calls for Prompt Aid

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Schneider Regional Medical Center (SRMC), a beacon of health services in the Virgin Islands, is wrestling with financial strain amid burgeoning unpaid patient bills. As conveyed by Tina Commissiong, the CEO, during her Senate Committee appearance, these challenges threaten the very financial backbone of the establishment.

The figures presented by Ms. Commissiong were daunting. For the 2024 fiscal year, SRMC plans for a budget of $105.7 million. Of this, they anticipate net patient revenues will constitute $72.3 million. Notably, the institution manages to self-fund almost 70% of its operating costs. She also called for a $31 million allocation from the territorial general fund, which will serve primarily to offset uncompensated care expenses and match local Medicaid needs.

However, the fiscal scenario becomes bleak when looking at the figures for uncompensated care. Senators were taken aback to learn that these expenses might soar past $24 million this fiscal year. To provide perspective, in FY 2023, SRMC has billed an excess of $14.7 million for self-paying patients, managing to retrieve a mere 4% of this amount.

One of SRMC’s more formidable challenges is the steep gap between Medicare and Medicaid reimbursement rates and the actual costs incurred. Ms. Commissiong threw light on a striking fact: SRMC provides roughly 80% of its care either entirely free or at significantly reduced prices. This places immense financial stress on the center’s resources.

Reacting to Committee Chair Senator Donna Frett-Gregory’s concerns on the poor settlement rate of bills by self-paying patients post-care, Ms. Commissiong enumerated potential solutions. These included revamping Medicare and Medicaid reimbursement structures, broadening the local insurance net, and advocating for uncapped federal Medicaid resources.

On the operational side, SRMC has been relentless in its drive to augment revenue, optimize collections, and curtail overheads. The CEO shared an encouraging metric: a 17% spike in cash collections, topping at a commendable $5.7 million in May 2023. They’ve also launched innovative payment methods, introducing online payment options and SMS bill alerts.

In terms of expanding their medical expertise, SRMC eyes fields such as psychiatry, cardiology, dermatology, and gastroenterology. Parallelly, to keep expenditures in check, they’re moving away from pricier contractual workers to more permanent staffing solutions. They’re also rerouting some long-term care funds to address prior uncompensated care.

An additional point of concern brought to the fore by Ms. Commissiong is the lack of capital for deferred maintenance of their aging facility. The recommended yearly investment stands at $3.9 million, a figure corroborated by Darryl Smalls of the Territorial Hospital Redevelopment Team. The team is veering towards a more comprehensive revamp rather than piecemeal renovations.

A priority for SRMC is to instill confidence in local residents. The center aims to harness a portion of the $30 million insurance fund that typically exits the territory. However, apprehensions were voiced, with Senator Marvin Blyden sharing less-than-ideal personal experiences at SRMC, prompting Senator Frett-Gregory to push for stringent quality checks.

On an optimistic note, Ms. Commissiong spotlighted SRMC’s accomplishments, from maintaining a flawless two-year accreditation after rigorous Joint Commission audits to garnering high praise from the Centers for Medicare and Medicaid Services, especially for their hemodialysis wing.

Moving forward technologically, SRMC is on the cusp of rolling out a patient portal and a virtual nursing platform. This new system, currently 82% ready, forecasts a yearly collection boost of about $2.5 million. Nonetheless, they still need an additional $3.5 million to see it through, along with auxiliary data backup measures.

Ms. Commissiong concluded with a clarion call for swift fiscal support from the Virgin Islands government. Emphasizing the center’s dedication to quality healthcare for an aging, underinsured populace, she remarked, “The hospital’s financial backing is not just a need; it’s imperative to uphold the health and well-being of our community.”

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Governor Bryan Pushes for Urgent Legislation to Address Medicaid Fund Shortfall

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Governor Albert Bryan announced on Monday that the territory has exhausted its funds for the local Medicaid match, prompting Government House to submit draft legislation to the Senate seeking an additional $3 million for this purpose.

Despite the fiscal shortfall, Governor Bryan views the situation as a sign of increased healthcare access. “We’re having so many people access care,” he stated, highlighting that during the pandemic, nearly 40,000 individuals utilized Medicaid for services including braces, dental care, and various medical appointments. Furthermore, eased referral requirements have facilitated access to specialty care. “Before, you had to go to East End or Frederiksted Health Center for a referral; now, a regular doctor can refer you,” Bryan explained.

These expanded services and simplified processes have rapidly depleted the Medicaid matching funds. However, Governor Bryan does not foresee this as a recurring issue, predicting stabilization next year. He noted that the V.I. Department of Human Services has already reduced some services, which has led to a decrease in Medicaid enrollment.

The proposed $3 million allocation remains critical for Virgin Islanders. Governor Bryan emphasized its importance, pointing to the recent U.S. Department of Defense Innovative Readiness Training (IRT) Program health fair, where medics served over 2,500 people seeking no-cost healthcare services. Although 6,000 people applied, many were turned away due to limited resources. The governor stressed that healthcare costs for uninsured residents ultimately fall on the territory, whether through Medicaid or hospital services.

The effort to secure adequate Medicaid funding is ongoing. In 2019, Congresswoman Stacey Plaskett successfully obtained an additional $252 million for the territory in a fiscal year 2020 spending bill, raising the federal match from 55% to 83%. This increased match rate, initially set to expire in 2021, has been made permanent, ensuring the territory receives the highest possible Medicaid match in the U.S.

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Measles Outbreaks Prompt Vaccination Drive in U.S. Virgin Islands

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As measles outbreaks rise across the United States and the Caribbean, U.S. Virgin Islands Health Commissioner Justa Encarnacion is urging parents to prioritize their children’s vaccination schedules.

Commissioner Encarnacion voiced her concerns this week about the alarmingly low vaccination rates among children in the territory, emphasizing the imminent threat of measles. “We are very concerned about the low childhood vaccine rate in the Territory, especially with measles threatening the US,” she said. Currently, only 60 percent of USVI children are vaccinated, a situation worsened by an increasing number of parents seeking vaccination exemptions.

The urgency is underscored by the latest data from the Centers for Disease Control, which reports weekly on measles outbreaks. As of June 6, 2024, there have been 151 measles cases across 22 jurisdictions, including Arizona, California, Florida, and New York, with over half resulting in hospitalizations.

The infectiousness of measles is a significant concern for the V.I. Department of Health. “While 151 may seem like a low number, it is alarming because one person can infect nine to ten others,” Encarnacion explained. She also highlighted the risk of the disease spreading to the USVI and neighboring regions, noting that the Turks and Caicos Islands reported their first measles cases since 1991 this past May.

In response, the Department of Health launched the “Be Wise, Immunize” campaign earlier this year. This initiative aims to educate parents about the vital importance of vaccinations, stressing that immunization is the best defense against diseases like measles both in childhood and later in life.

The primary defense against measles is the measles, mumps, and rubella (MMR) vaccine, which provides long-lasting protection against all strains of the virus. Measles can lead to severe health complications, particularly in children under five, including pneumonia and encephalitis.

Measles is highly contagious, spreading through the air via coughs or sneezes from infected individuals. It remains active in the air or on surfaces for up to two hours. Symptoms typically appear seven to 14 days after exposure and include high fever, cough, runny nose, red watery eyes, and a characteristic rash.

Although declared eliminated in the United States in 2000, measles continues to persist globally and is often brought into the U.S. by unvaccinated travelers.

The VI Department of Health is urging parents to ensure their children are vaccinated and provides resources for scheduling immunization appointments at www.doh.vi.gov/immunization.

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Douglas Koch to Lead Kearney Regional Medical Center in Nebraska

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Just a day after announcing his resignation from the Juan F. Luis Hospital (JFL) on St. Croix, CEO Douglas Koch has been named the new CEO of Kearney Regional Medical Center in Nebraska. He will assume his new role on August 5, according to a report from KSNB Local 4.

In his resignation letter, Mr. Koch cited a desire to return to the Midwest to be closer to his family. His departure has been a significant loss for local health officials, with JFL Board Chair Chris Finch expressing disappointment. Mr. Finch, who also chairs the Territorial Hospital Board of Directors, highlighted Mr. Koch’s exemplary service, noting that he had recently received an excellent personnel evaluation from board members.

Koch’s new role in Nebraska is eagerly anticipated by his future colleagues. John Woodrich, Executive Vice President and Chief Operating Officer of Bryan Health, which owns Kearney Regional, praised Koch’s midwestern roots, education, and extensive operational experience as ideal for the position. “Doug’s commitment to community health and his leadership skills will be a tremendous asset to Kearney Regional Medical Center,” said Woodrich.

Before his tenure in the U.S. Virgin Islands, Koch held leadership positions in South Dakota, Wisconsin, and Illinois. At Kearney Regional, he will oversee the expansion of inpatient facilities and the construction of a cancer center, similar to his work with JFL’s transition to a temporary modular structure. Woodrich emphasized Koch’s ability to help communities thrive, stating, “He will be an outstanding leader for Kearney Regional Medical Center.”

As Mr. Koch prepares to embark on his new journey, JFL officials now face the task of finding a new CEO to lead the hospital forward.

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