THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Friday, January 27, 1995 TAG: 9501250140
SECTION: PORTSMOUTH CURRENTS PAGE: 10 EDITION: FINAL
SOURCE: BY PHYLLIS SPEIDELL, STAFF WRITER
LENGTH: Medium: 85 lines
Virginia's first report card on the efficiency and productivity of its acute care hospitals and nursing homes gave Maryview Medical Center and Portsmouth General Hospital the opportunity to see how they measure up against other hospitals in Hampton Roads.
Among 20 acute care hospitals in the eastern region, Maryview ranked ninth and Portsmouth General ranked 15th.
Sentara Leigh in Norfolk is the most efficient health care provider in the region, said the report, which was released in December.
In 1992 the Virginia General Assembly directed the Virginia Health Services Cost Review Council to develop a method of recognizing and ranking the efficiency of Virginia's health-care providers. Working with data from fiscal year 1993, VHSCRC compiled a report aimed at helping insurers, employers and other health-care purchasers to compare providers.
The report is limited, however, in that it looks primarily at financial indicators and does not evaluate quality of care or patient satisfaction. Those are facets that the VHSCRC plans to include in future years as the report's methodology is refined and expanded.
``The value of some type of proficiency rating is that employers and insurers, including the government with the Medicare and Medicaid programs, are entitled to some sense of how proficient a provider is,'' said Carl F. Medley Jr., Portsmouth General administrator. ``It is not good enough anymore to just hold yourself up and say, `We're wonderful, so come here and spend your dollars.' ''
However, neither Medley nor Gary J. Herbek, executive vice president/CEO of Maryview Medical Center, is willing to accept this report as a completely valid criterion. ``I don't think that the report told a story that really captured the essence of Maryview,'' Herbek said.
Maryview ranked favorably on staffing and bed utilization factors as well as in the community support category, the amount of care a hospital provides to patients who are unable to pay their bills.
The hospital's rating was in the bottom quarter on several financial indicators such as return on assets and cash debt coverage. During 1993 the hospital incurred a one-time loss of nearly $2.8 million when it refinanced long-term debt.
``It was a wise decision for long-term financial stability, but because the refinancing expenses show up in the fiscal year of 1993, in the report we appear to be doing poorly, and that is really not the case,'' Herbek said.
Herbek added that Maryview's affiliation with the Bon Secours Health System, headquartered in Baltimore, further strengthens its financial position. ``But the financial strength of the Bon Secours system was not reflected in the report and that makes it look like we have no local resources,'' he said.
Both Maryview and Portsmouth General ranked low in relation to the average length of time a patient stays in the hospital. Portsmouth General averaged 6.26 days and Maryview averaged 5.82 days.
Herbek believes that too little weight was given to the fact that patients at the hospital psychiatric center average a stay of about 1.5 days longer than medical patients and account for 20 percent of the total patient days.
Similarly, Portsmouth General's 25 bed rehabilitation unit, where patients average a stay of 19 days - or four times longer than most medical patients - represents a quarter of its average patient census, Medley said. Including the rehab unit with the general hospital also inflated the report's cost factors for Portsmouth General.
Medley attributed Portsmouth General's favorable scores on several financial indicators, including capital costs, to the hospital's conservative financial philosophy and basically debt-free position.
Did the report have any significant impact on the hospitals? Not from the general public, said both Herbek and Medley.
``I think informing the buyers of health care more fully of the value of their purchase is valid and what we will see more of in the future,'' Herbek added. ``But I am not sure that this particular report reflects all the things that would be useful.''
``I think you will see more competitive bidding from providers for blocks of patients who will be looking for value, high quality, and low price,'' Medley said. ``I think this report is an interesting first approach to comparing efficiencies.'' ILLUSTRATION: Staff photo by MARK MITCHELL
Carl Medley, left, of Portsmouth General and Gary Herbek of Maryview
discuss the rankings of their hospitals.
KEYWORDS: HOSPITAL COSTS MEDICAL COSTS by CNB