GHS Board of Trustees to consider $2.2 billion budget

Greenville Health System’s proposed 2016 budget will include an approximately $2.2 billion operating revenue budget, an additional 564 jobs – and, for the third straight year, no room rate increases or system-wide price increases.

The budget, which was approved by the GHS Planning and Finance Committee on Tuesday, must also be approved by the GHS Board of Trustees. The budget is expected to be discussed at the board’s meeting on Sept. 29.

“Our goal is to advance the strategic initiatives key to our long-term success as a critical healthcare resource for our patients and community,” said GHS President and CEO Mike Riordan. “Integration and innovation are key to not only surviving but thriving in today’s rapidly changing healthcare environment. Thanks to managers, physicians and staff who continue to work together to balance the future and strategic priorities of our health system with the current needs of the organization, GHS is well positioned to meet the healthcare needs of our community in FY2016.”

Terri Newsom, vice president for financial services and chief financial officer at GHS, credited the system’s financial discipline and tight control over costs for the strong budget. “As impressive as these accomplishments are, we still face challenges ahead and must proceed conservatively and continue to monitor spending.”

GHS now employs approximately 15,000 people. Most of the additional hires will be nurses, physicians and mid-level providers, as well as other clinical and support staff.

“Most of the new positions will be to provide increased access for both primary care and specialty care within Greenville County as well as surrounding counties. They include physicians, nurses, medical assistants and clerical staff,” said Doug Dorman, vice president of human resources at GHS.

Improving patient access to health care – either through additional physicians and providers, expanded physician office hours or innovative community partnerships – continues to be one of the top priorities for GHS.

Working with local partners, GHS has enrolled approximately 1,912 uninsured patients in the Healthy Outcomes Plan (HOP), which focuses on education, care coordination and improved access for uninsured patients with chronic conditions. Through the program, GHS and its partners have improved the patients’ clinical outcomes while also reducing in-patient admissions and lowering emergency department visits.

GHS’ partners include Greenville Free Clinic, New Horizon Family Health Services, Greenville County EMS, Good Shepherd Free Clinic, Taylors Free Medical Clinic, Carolina Health Centers, LLC, Department of Mental Health of Greenville County, AccessHealth Greenville County, Phoenix Center, Clemson Free Clinic, Foothills Community Health Care Center and the Rosa Clark Free Clinic.

The efforts – which have included everything from intensive education and appointment follow-ups to home visits – have led to improved provider collaboration and increased resources and access for patients.

“Access to care may be limited even if you have insurance or the means to afford the care you need,” said Jennifer Snow, director of accountable communities at GHS. “For those patients who are uninsured and may not even understand how to access the health system, finding a doctor can be extremely difficult. The GHS HOP bridges the gap and ensures patients have access to an interdisciplinary care team, which consists of social workers, paramedics and community health workers, who help patients navigate through the healthcare delivery system.”

GHS has seen a decline in the length of stay and related charges for these patients resulting in lower charity charges even as its charity applications continue to increase. GHS is now up to 1,800 charity applications per month.

Healthcare reform has already and will continue to impact GHS and other healthcare providers. Cuts to Medicare reimbursement due to Affordable Care Act (ACA) regulations and sequestration will result in a reduction of $13.1 million for GHS in the new fiscal year. Later years of the reform program may include expansion of Medicaid eligibility, Medicare reimbursement reductions, reductions in inpatient and outpatient rates and further cuts to both Medicare and Medicaid DSH. The impact of not expanding Medicaid in South Carolina is still unknown, as is the full impact of the health insurance exchange.

GHS continues to work aggressively to contain costs. The FY2016 budget includes a total of $6.5 million in expense savings and revenue enhancements that are attributable to cost-containment initiatives through GHS’ employed physician group. Examples include eliminating redundant clinical areas and resources and minimizing supply costs through standardization of products.

Meanwhile, GHS’ capital budget contains previously approved projects, capital pools for projects less than $1 million and individual project requests greater than $1 million. Previously approved projects total $219.7 million for FY2016 and include many long-term projects, such as patient room renovations, infrastructure upgrades for Marshall I. Pickens Hospital and the continued implementation of Epic, the GHS electronic medical record and revenue cycle system. The FY2016 Capital Pools requests total $37.9 million and are designated for routine capital projects and equipment less than $1 million each. New FY2016 requests for projects costing in excess of $1 million total $73.2 million. The cash flow for the new projects spans multiple fiscal years, but board approval is required for the full amount of the requests. One of the largest capital expenditures in FY2016 is Epic at Laurens and Oconee.

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