ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, January 7, 1996 TAG: 9601110130
SECTION: BUSINESS PAGE: D8 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
More than 12,000 people worked in health care in the Roanoke area in 1995, and the numbers aren't likely to be much different in 1996, even though hospitals continue to scale back employment.
Changes facing workers are more shifting than cutting, meaning nurses who once worked inside the hospital now go on home health calls. But more of all health care employees are working part-time and doing split shifts and in some cases, making lower wages.
And hospitals are making less money.
Based on sheer numbers, there are just as many people using hospitals as ever, but many more of them are not staying overnight for care. Outpatient services bring in less money to hospitals, which is why patients are directed to them by insurance companies.
There is a lot of stress in the entire health care delivery system, confesses Thomas Robertson, chief executive officer and president of the largest area-based health care company, Carilion Health System of Roanoke.
Carilion spent 1995 remaking itself from a company structured according to its facilities to one designed by function. In the process, it eliminated some layers of management and will end up trimming some jobs in general this year as the new structure settles into place.
The revolution of the system has kept staff in an uproar. Lab workers throughout the 13-hospital system had to reapply for jobs when the labs were consolidated under a new subsidiary. About 50 restaurant workers opted for severance packages rather than take jobs with a private contractor that took over the public food service at Roanoke Memorial Hospital. Some managers ended the new year with applications for positions under review.
Robertson said, however, that he hopes the changes can be made without layoffs.
"We're constantly trying to match resources with demands and I don't anticipate forced reductions, but I do anticipate we will have new needs," Robertson said.
A major reason for such changes is that between 5 percent and 20 percent of the region's residents - the portion varies among sources - are members of a managed care plan. As that number grows, hospitals and other health care facilities have to change.
Robertson said he jokingly told his board of trustees recently that every year he has said managed care is coming, but "this year it's going to happen."
There are no guarantees about anything in health care employment, he added. William Downey, chief executive officer and president of Lewis-Gale Hospital in Salem said ditto to that.
"If we continue to keep an eye on volume and services, we won't have to have layoffs," he said.
No hospital can predict its future, though, until the federal government - Congress and President Clinton - decides what it will do about Medicare and Medicaid, Downey said. These programs for the elderly and the poor provide the bulk of income for some hospitals and a good chunk of income for others. as well as contribute money for medical education.
Downey came last summer from Tidewater to run Lewis-Gale, which is part of Columbia/HCA Healthcare, the nation's largest chain of hospitals.
Since his arrival, the Lewis-Gale Psychiatric Center has been folded into the hospital to create Lewis-Gale Medical Center. The name became official Jan. 1. Downey said Lewis-Gale will also look for ways to cement its relationship with other Columbia properties in the region, including Montgomery Regional, Pulaski County and Alleghany Regional hospitals.
The plan for Lewis-Gale, the larger of the facilities, is to fill the gaps for specialty services the outlying hospitals might not find feasible to offer. For example, marketing functions for the hospitals will be combined in the first quarter so that activities and images can be coordinated, Downey said.
Currently, Alleghany, Montgomery and Lewis-Gale have marketing directors. Downey said each hospital will continue to have someone in a public relations role. The selection of the centralized marketing director is expected to be completed by the end of February.
LENGTH: Medium: 76 linesby CNB