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‘Good health epidemic’ impacts Southern Maine Medical Center

BIDDEFORD – The number of inpatients at Southern Maine Medical Center has dropped in recent months, a development the hospital attributes to a mild winter, effective preventative care, and a lack of insurance.

An “epidemic of good health,” is how SMMC President and CEO Ed McGeachey described the recent trend in the hospital’s monthly newsletter.

While the decrease is good news for health, it also means decreased revenues for SMMC, which is paid based on the number of services it provides.

McGeachey said that from October 2011 to March 2012, SMMC saw the slowest inpatient volume months it has seen in two years.

Sue Hadiaris, the community development director at SMMC, said that the decrease has been seen nationally, and health experts are trying to determine: “Is this a cycle, or is this a trend?”

Hadiaris said that SMMC focuses heavily on preventative action, from flu shots and hand hygiene awareness to childhood obesity prevention and smoking cessation efforts.

In addition, she explained, the hospital has been focused on getting patients to use primary care physicians in the facility to address problems before they become serious and patients find themselves forced to go to the emergency room.

Jeffrey Austin, the vice-president of government relations and communications for the Maine Hospital Association, said that the low volume is a “trend statewide and nationally.”

Caroline Steinberg, the vice president of trends analysis at the American Hospital Association, echoed his comments. She said that her national organization doesn’t have “specific numbers on current volume but we have heard the same thing from our members.”

“Many attribute it to the economy as well which would be consistent with historical volume patterns during past recessions,” she explained.

 Steinberg said that she has also heard others citing the mild winter, which brought less flu, and increased immunizations for flu and pneumonia.

Austin said that there is little hard data to explain the causes for the decreased inpatient volume, but higher rates of unemployment and scaled back health benefits for the employed, as well as flat salaries, have likely contributed to the drop.

A greater emphasis on avoiding hospitalization, both from the point of view of employers and insurers, has had an effect on the decreased patient volume, Austin said, adding that preventative care has “absolutely” made a difference.

SMMC, like other hospitals, is trying to find a way to make up for lost revenue, and see its reimbursement rate more closely match its ability to keep patients healthy.

In his newsletter column, McGeachey said that “keeping people healthy is what we strive to do, and payment systems need to shift to support that goal.”

He noted that SMMC is working with its MaineHealth partners to develop an accountable care organization under which the hospital’s contract with Medicare, and eventually other payers, would shift from the fee per service model to a fee per patient system. McGeachey said the hospital hoped to see the shift take place over the next few years.

Austin said that accountable care organizations “have not made huge inroads in Maine,” but the programs are coming, especially in southern Maine.

Austin said that Eastern Maine Health, which runs the Eastern Maine Medical Center in Bangor, was chosen as a “pioneer” by the federal government to roll out an one such organization for Medicare.

Maine is also in the process of developing similar programs for Medicaid, he added.

Hadiaris said that insurers are beginning to understand that fee per service system “doesn’t make sense,” and are starting to adjust their focus. A shift in the system, however, won’t be simple, Hadiaris added, comparing the process to “changing the engines on an airplane in mid-flight.”

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