Incumbent Grays Harbor Hospital District 2 commissioner Pete Scroggs is being challenged by Melanie Sturgeon for the Position 2 seat on the hospital district commission. They are running to fill the two-year unexpired portion of a term. Below, the candidates respond to four questions posed by The Daily World.
PersonaL
Pete Scroggs
54 years old, Grays Harbor native. Education: B.A. in Business Administration from University of Washington. Professional: 10-plus years’ experience as a Grays Harbor Community Hospital board member. Former small business owner. Currently Advancement Director, St. Mary School, Aberdeen.
Melanie Sturgeon
My name is Melanie Sturgeon I am running for Grays Harbor Hospital District 2 Position 2 against incumbent Pete Scroggs. I’ve been working in the medical field for over 20 years as a medical assistant, phlebotomist and insurance coordinator.
1. Minutes from the district’s last meeting indicate the hospital’s net income for the year at minus $858,303. What are some of the things the district can do to reverse the losses?
Scroggs: Our hospital suffers from a financial condition I would call “In-between-itis.” We are too big to receive the cost-based reimbursement that the government gives to smaller hospitals like Summit Pacific and Willapa. However, because we are in a rural, economically-challenged area, the hospital does not have the large number of patients with private insurance that hospitals in Olympia or Seattle do. There is no one solution to this challenge, but some of the initiatives the hospital is working on include: reducing the in-patient bed count to qualify for cost-based reimbursement for primary care, competitive bidding for Medicaid insurers, restructuring debt, and reducing overhead. All of these solutions have trade-offs, but I believe they are necessary to keep our hospital viable.
Sturgeon: While attending a previous hospital board meeting I was shocked to learn that the hospital was millions of dollars behind in submitting medical claims for payment reimbursement. The reason given was because there was such a significant lack of medical coders available to do the job. For a hospital, I believe this is completely unacceptable. Due to contractual agreements, a medical facility has only so long to submit claims to an insurance company. If those claims are submitted after the deadline expires, the medical facility won’t be reimbursed for their hard work. Getting the claims out on time and getting paid on time is certainly one area that I believe the hospital can improve upon.
Unfortunately, if there is a delay in cash flow, ALL departments within the hospital will feel the impact. This impact will trickle down and not only affect the morale of the employees, but the patients themselves.
2. Do you have confidence in the current management team at the hospital? If not, what direction would you offer?
We did a calculation several years ago of the amount of additional revenue that our management team had gained for the hospital by finding special funding sources, writing legislation, and thinking outside the box. The figure was somewhere between $5 million and $8 million per year. I’m sure that the figure is now higher. Healthcare is unlike any other business, and the skill set it takes to operate a health system with over 700 employees is quite complex. I have complete confidence in our leadership, and wish that everyone could see the amount of effort and creativity they put into keeping our hospital performing at its best.
Sturgeon: I definitely feel that there is room for improvement when it comes to the hospital’s current administration. As previously stated, billing is a significant issue. In addition, Grays Harbor County has a primary care physician crisis. I know it is hard to attract primary care physicians to the Harbor and get them to stay, but I don’t see the hospital taking a truly active role in reaching out to medical facilities like University of Washington. What is the hospital doing to recruit new primary care physicians to the area? Maybe the hospital could reach out to Capital Medical Center where they have successfully paired up with University of Washington to open a new general practitioner facility. We don’t have to reinvent the wheel, but we can sure look at successful programs like what Capital is doing and improve upon it.
3. Difficulty recruiting medical personnel, a high percentage of patients without insurance and uncertainty regarding government-funded insurance make things very difficult for rural hospitals. How does the district meet those challenges?
Scroggs: These are among the constants that aren’t likely to change for our hospital anytime soon, so we have to adapt to them as best we can. With regard to recruiting, the hospital has done a better job recently of attracting physicians who see the benefits of living in a place like Grays Harbor, rather than trying to recruit just anyone and hope they will learn to like it here. The hospital is also in the process of starting a residency program that will host doctors completing their training, and hopefully convince some to stay in the area. The nursing program at Grays Harbor College is a huge advantage for attracting nurses. With regard to government insurance, there is no easy answer. Both state and national government programs are moving to try and improve health outcomes and to save money by linking payments to results. This is a good idea, but the transition from our current system could be painful for rural hospitals with less healthy populations like Grays Harbor. Our best bet is to continue to use approaches described in the first answer above, along with educating our lawmakers about the risks we face.
Sturgeon: I believe the hospital is a steward of the patients’ AND the state’s money. The hospital must run like a well-oiled machine in order to survive. We can’t worry about what the “other Washington” is doing. If we did that, our hospital wouldn’t even exist.
A. I believe that ALL insurance companies should be contracted with the hospital. It really concerns me that a taxpayer based hospital could not find common ground this year with an insurance carrier such as Molina Health Care of Washington. And until around August, Community Health Plan of Washington was not covering the folks in Grays Harbor either. The hospital should work for ALL, not just the payers who reimburse more than what the state does.
B. Urgent Care: Grays Harbor needs one badly. Significant health issues such as heart attacks and strokes should be reserved for the emergency room. Medical conditions such as pink eye or a sinus infection should be seen by a primary care physician or at the urgent care. An ER doctor should not be a patient’s primary care physician. By being a visible and transparent leader in the community, the hospital could educate folks about the importance of catching medical conditions early, hence they are actually cheaper AND easier to treat. The hospital can be more proactive, not reactive.
C. Member Based Health Care Plan: Grays Harbor could maybe look at the possibility of creating a member based health care plan similar to what is offered in Kitsap County. KPS (Kitsap Physician Service) Health Care Plan has been around for 60 years and provides very affordable health care coverage to its members. They are also associated with carriers such as First Choice Health, Providence and MultiPlan Network.
D. Research: There is a lot of funding for medical facilities willing to do research, development and clinical trials. Maybe Grays Harbor Community Hospital could reach out to entities such as Seattle Cancer Care Alliance and/or Fred Hutchinson Research Center.
E. Global Budgeting: There is a lot to be said for a medical facility that is so well run that it can create a budget for its entire year. Right now the hospital is not doing that.
F. Opioid/Drugs: Public Education and outreach programs are a must. The hospital should be one of the leaders in trying to fight this horrible epidemic. The more this is controlled, the cheaper it is for everyone. Again, just like with research, there are substantial monies available to those medical facilities who want to step up and fight. Maybe the hospital can pair up with the Health Department. There is a lot of money just sitting there waiting to be used for the greater good of ALL in the community.
4. Given those challenges, should the hospital consider partnering with a larger health care provider.
Scroggs: “Partnering” can take a lot of different forms. The hospital already has a loose affiliation with Multicare Health System that provides physician education, access to specialists, and help with patient transfers. If we were to pursue a stronger partnership with someone, the trade-off would likely be more financial stability in exchange for less control over what services we provide locally, and where our patients go when they need a higher level of care. We may come to the point where that type of partnership is in our best interest, but I prefer to keep as much control locally as we can for the time being.
Sturgeon: Absolutely. As previously stated, I believe that it would be wise to pair up with a larger health care provider like University of Washington and Fred Hutchinson Research Center. In difficult times, Grays Harbor Hospital needs to get creative and proactive. The people of Grays Harbor County deserve nothing less the hospital’s best.
