New Year’s Thoughts

The turn of a year is traditionally a time for individuals and institutions to look both back and foreword. For your District, 2017 was a year with good news and not-so-good news.

The renovation work, requiring blocks of the facility to be closed off for extended periods, significantly reduced patient-traffic flow for almost the whole first quarter. Then, the burden of the Care Center continued. And we lost, through his retirement from the Board, a great asset in Jerry Snyder.

On the good side, though, despite all the sandbags the District had to carry, we will apparently end the year with a quite decent net positive income; the amount cannot be certain as I write, but through November the net was over $70,000.

In good part, that is owing to the skilled management of our CEO/CFO, Gary Bostrom; and another item of good news is that we have persuaded Gary to stay another year, so he will be with us through the middle of 2019, lending both stability and acumen in that position. And, as Jerry leaves us, we welcome in John Kragt, whose dedication, energy, and intelligence will be a continuing asset.

Looking forward to 2018 and beyond, the most obvious challenge we, and all healthcare facilities in the country, now face is a dramatic restructuring of how health care gets paid for.

The new dictum is “value-based payment”, as opposed to the current “fee-for-services” model.

The idea is to pay for demonstrable good patient outcomes rather than for this or that particular visit or procedure. But the details of how such a system is to actually be implemented are going to be a very tricky business.

As I heard one participant at a seminar say, “The healthcare field has gotten pretty stable now: I don’t think there’s been a major shift since mid-morning.”

Fortunately, your District was a charter member of the Washington Rural Healthcare Access Preservation (WRHAP) initiative, a state-sponsored program intended to assist the most at risk rural Public Hospital Districts (PHDs) with transitioning from the current system to the new system as that new system evolves.

Working with support from the Washington State Hospital Association (WSHA), the WRHAP Group got HB1520 enacted, a state bill that provides multi-year earmarked funds to get the WRHAP member Districts over the hump.

It’s still going to take a lot of focused hard work to get it all together, but your District is one of the state leaders in the process.

Another big positive, started in 2017 but just coming into flower in 2018, is the Grand Columbia Health Alliance. That is a newly formed “interlocal” group where currently a half dozen contiguous rural PHDs associate so that they can act as a single entity in ways that benefit all: “Stronger together”. The interlocal has negotiating power six times that of any one of its members.

For instance, when purchasing supplies, placing a large joint order should give better bargaining power. Or the interlocal could hire needed administrative or medical personnel who would split time among the member

Districts, whereas no single District could readily hire one-fifth or one-sixth of such a person.

All in all, 2018 will be a challenging but exciting year for your District.