GHS moves forward on cost-saving measures

Greenville Health System on Tuesday said it had initiated a range of action plans to address a year-to-date $16 million loss while continuing to move ahead on its transition from a fee-for-service model to a value-based care environment.

The action plans include a reprioritization of capital spending that will reduce the budget by $39 million, officials said at a Tuesday meeting of the GHS Board of Trustees’ planning and finance committee. Additional steps will be taken throughout the year.

GHS leaders pledged to minimize the impact of the current financial situation on employees but said positions could be eliminated under the current plans.

“The initial action plans call for eliminating roughly 410 positions, but more than half of these positions will be the result of normal attrition, not filling open vacancies and the possible implementation of a voluntary exit incentive program,” said GHS Chief Operating Officer Greg Rusnak.

Rusnak stressed that estimates reflect positions and not necessarily individuals, and that the number of positions could increase or decrease based on a shift in financial performance as well as ongoing cost-reduction efforts.

Even with the anticipated change, GHS remains one of the county’s largest employers, currently with 15,000 employees, and on track to employ more people than it did in the prior year.

“For GHS to stay on our course, we must remain flexible and committed to our mission and vision. We must continue making transformative investments that advance our strategic priorities,” said Rusnak. “We are committed to finding a way to balance the present and future healthcare environments while, as always, delivering high-quality care.”

“Being a value-based care organization is the right thing to do for our community,” said Rusnak. “It will improve quality and access to care and will bend the cost curve for consumers over time.”

In fact, the average amount of time patients are staying in the hospital is down 3.4 percent in part because of the value-based initiatives GHS has already launched, such as its community paramedic program, mobile-health clinic and system-wide changes such as giving antibiotics to some patients while en route to emergency rooms or immediately upon arrival. These steps can significantly improve patient care, resulting in fewer days in the hospital and potentially fewer visits to a physician practice – which also reduce reimbursement to the provider.

“We are proud to transform how care is delivered in the communities we serve,” said Rusnak.

Under value-based care, which is expected to become the national model, payments will be based on the value of care that organizations provide for patients and their ability to keep people well and out of the hospital — instead of providers being paid for the number of visits and tests they order which was part of the traditional “fee-for-service” model.

As a result, GHS is making significant investments to prepare for the future which include implementing a new electronic medical record system, developing a clinically integrated network and innovating care delivery through telemedicine. Additionally, GHS is continuing to expand access to care through significant investments in its provider network.

These necessary investments, coupled with lower than anticipated patient volumes, contribute to the current financial performance GHS is now experiencing, Rusnak told committee members.

“But this is not new to us; we have been focused on continuous process improvement for years, and this is part of that effort,” he said. “We are focused on positioning GHS for success both now and in the future. Ensuring our patients can access the right care at the right time and in the right place is the driving force behind everything we do.”

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