Baystate Franklin president reflects on new wing, effects of new U.S. presidency

  • Baystate Franklin Medical Center President Cindy Russo. Recorder Staff/Paul Franz

Recorder Staff
Published: 2/1/2017 11:01:20 PM

Baystate Franklin Medical Center President Cindy Russo, now a little more than half a year into her job, has unveiled the hospital’s $26 million surgical center, is overseeing conversion of its former operating rooms and is seeing an increase in in-patient care.

And all this has come as Baystate Franklin struggles with flat or decreasing federal Medicare and Medicaid reimbursements, increased due to inflation, and the threat of what could be staggering cuts in health care funding because of proposed policies in Washington.

The $26 million surgical wing, which opened this past fall, has begun to translate into an increased demand for the advanced surgical procedures that it allows, said Russo, and the “phase two” renovation of the former operating rooms to allow for endoscopy and bronoscopy suites to examine for the gastrointestinal, lung airways and other internal systems.

“I walked in right before the surgical wing was opening, and I almost felt guilty because all the work was done, and I got to take all of the glory that the numbers are increasing, the patients are happy and the physicians are happy. Now it’s about how do we continue to grow the services that are needed in the community.”

Baystate Franklin suffered a $2 million reduction in its federal Medicare reimbursements and a $2 million loss in Medicaid reimbursements. At the same time, the Greenfield hospital — which depends of these government payments for two-thirds of its revenue, like its counterparts everywhere — is seeing expenses rising by 2 to 4 percent.

“There’s a disconnect,” said Dennis Chalke, Baystate Health’s chief financial officer.

“It was devastating in a way,” added Russo, because it just compounded all those other pieces, with government payments not covering its program costs.

And yet, the good news is that Baystate Franklin has been seeing an uptick in its admissions — 18 percent in emergency department cases that required follow-up hospital stays, 2014 to 2016, part of a 38 percent overall spike in medical and surgical hospital stays. Also add to this a 38 percent increase in surgeries in those years as a result of the hospital’s ability recruit more surgeons and specialists as a benefit of its new state-of-the-art surgery center.

In fact, Baystate Franklin had to re-open one of three patient pods in 2015 that had been previously dormant, and it’s being used pretty consistently, instead of simply two or three times a year, according to Andrea Nathanson, the hospital’s financial director.

Russo said she believes the hospital’s renovated emergency room is gaining a reputation for quality of care and the overall “patient experience,” and that instead of a more typical 13 to 16 percent of those rural hospital ER patients needing to be admitted, Baystate Franklin has been seeing 18 to 20 percent with conditions serious enough to require inpatient care.

“I’ve also heard, and we’ve gotten testimonials, also from patients coming for (obstetrical) services,” Russo said of the hospital’s Birthing Center. “Patients are coming from outside our service area because of the service they know we deliver. I think that’s why he volume has increased.”

With a new urologist, orthopedic surgeon and sports medicine specialist, the hospital has also had 30 new medical staff members join this year, in part because of its new surgical wing, resulting in what Russo said is an increase in its share of the regional “market” for inpatient care.

“We’ve been able to draw a bigger part of that pie,” she said, although she acknowledges that the gain is a “double-edged sword,” since the lion’s share of those patients are on Medicare or MassHealth, with underfunded reimbursements resulting in more uncovered costs.

Still, Baystate Franklin’s 2 percent “margin” — essentially a profit that gets plowed back into the nonprofit facility — isn’t enough to keep up with a 7 to 10 percent rise in medication cost and 3 percent overall increase in expenses, with commercial insurers increasing their payments by 1 to 2 percent.

“The fact is, we need to be able to invest back into the organization to be able to care for our patients,” Russo said.

As a result of the Medicare reductions — something that Chalke said “should correct itself next year hopefully” — Baystate Health looked at ways to streamline its operation and called for a total of 323 job cuts last fall, including the loss of 12½ positions in Greenfield. Of those, two were layoffs and employees in six-and-a-half positions were offered incentive packages to retire. Five-and-a-half vacant positions weren’t filled and one position was moved within the system.

“That was difficult for us,” Russo said of the reductions, which included “administrative staff and a couple management positions,” with “no direct-service” jobs affecting patients. “But I think it was the right decision to stay in good financial shape for this community.”

Meanwhile, with a hard-won nursing contract that expired in December, Baystate Franklin is in active negotiations with its Massachusetts Nurses Association bargaining unit, with what Russo called “common goals to assure caring for this community in a safe, effective manner.”

With the new Trump administration in Washington trying to dismantle the Affordable Care Act, potentially disrupting a $53 billion, five-year Medicaid waiver agreement with the state of Massachusetts and leaving $470,000 a year at stake for the Greenfield Hospital, Russo said, “Regardless of what happens with the new administration, with reimbursements, that’s concerning as we see reimbursements declining, and concerning to think what the new administration might do regarding what we currently have. “Our direction is in keeping care local, attending to the needs of people in the communities we serve with safe, high-quality care in an appropriate setting. … No matter what happens, that’s where we’re headed.”

To help guide that effort, a new community advisory council is being formed as a liaison between the community and Baystate Health trustees.

“One of things that was shared with me before I came here was around community involvement here and the closeness of this community,” said Russo. “I heard that and understood it from the perspective of where I was coming from,” in Connecticut. “I could not even imagine the strength of this community and the pillar that this organization is in the community.”

You can reach Richie Davis at rdavis@recorder.com

or 413-772-0261, ext. 269




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