By Christi Baron
Olympic Peninsula News Group
FORKS — Health care delivery is going to change, according to Tim Cournyer, Forks Community Hospital CEO.
“Health care is changing from volume to quality,” Cournyer told those gathered at a West End Business and Professional Association meeting March 29.
“We have to reduce costs. They are out of control,” he said.
Health care is moving away from in-patient hospital care to more management through clinics that lean toward home care, he said.
Clinics would manage the population with home care and get paid on outcome.
‘Reward on the result’
“The government will pay based on how we succeed — expecting us to tighten our belt, then reward on the result,” said Cournyer, who was hired as the chief financial officer in March 2015 and became the CEO in September of that year.
Health care might move toward payment per resident, he said, adding that rural community folks will balk because “this is not what we’ve always done.”
Cournyer said rural residents don’t want someone in their home telling them what to do.
There are many services the hospital offers, and they need to be utilized to continue, he said.
“The changes that are coming could take up to three years,” Cournyer said.
“In the meantime, our hospital is doing good. … We have a very good staff and we’re doing OK financially.”
In 2016, the hospital lost about $1 million — and has been at a loss for a few years now. That has been covered by reserves, the CEO said.
Nursing home help
The hospital is supplementing the nursing home.
“To help this, we have had to re-class some beds to swing beds, which will help with Medicare payments, and the patient sees no difference,” Cournyer said.
“We also changed in ER reporting, charging for actual percentage of time the doctor sees the patient in ER instead of the whole time the patient is there.”
Cournyer said that in 2016, reserves dropped from $4 million to $3 million due to some major equipment that needed to be replaced because parts were not available any longer. The entire hospital was also re-roofed.
In the very near future, EMS funding ($100,000) will be used to get one to two ambulances and other needed equipment
The payer mix to the hospital for services in the Forks community includes Medicare, Medicaid, commercial insurance and no insurance, with costs picked up by taxpayers.
Medicare came up with a rural payment plan of cost plus 1 percent, but that is changing again and probably going away, Cournyer said.
“If we choose to do things, we need to do them well,” Cournyer said. “We’ve had a revolving door of providers at the clinics, and we are changing that.
“We have a new clinic administrator and we have made the decision to not interview locums [traveling doctors] — we decided not to interview candidates unless they want to stay here.”
New employees
Just recently added to the clinic staff are Dr. Esker Ellis, DO, and Howard Welch, ARNP.
Dr. Sue Keilman, who specializes in obstetrics and gynecology, plans to retire. The hospital is seeking a replacement, Cournyer said.
Cournyer said the Clallam Bay clinic has been updated and now has regular times for providers that rotate through the week with the Bogachiel Clinic.
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Christi Baron is editor of the Forks Forum. The Forum is part of the Olympic Peninsula News Group, which also is composed of Sound Publishing newspapers Peninsula Daily News and Sequim Gazette. Reach her at cbaron@forksforum.com.
