County Hears Annual State-Of-The-Hospital Report

SNOW HILL — Atlantic General Hospital (AGH) met with the Worcester County Commissioners this week to deliver an annual report on hospital operations.

The report outlined ways in which AGH plans to use emerging technology to provide better care, the financial challenges that are ahead as well as the biggest health issues in the community.

AGH will look to combat most of the same major health challenges in 2014 as they have in years past. The main difference is that as the community continues to age, chronic illnesses will become more prevalent and require new strategies.

According to statistics provided by the hospital, there are 10,000 baby boomers turning 65 each day with about half developing some type of long-term health condition. National Medicare costs are expected to hit $1 trillion annually by 2022, nearly double the current cost of $560 billion. This has a real and measurable local impact since the county has a higher average age per resident than many of its neighbors.

“These are the key issues in our community, obesity, and then a lot of this gets to older age when we talk about heart disease, cancer, high blood pressure, those types of things,” said Michael Franklin, CEO/President of AGH.

The other chronic issues that Franklin mentioned will receive a focus next year include diabetes, dental health, cardiovascular, access to care and mental health. The growing need means that AGH will continue to expand services, said Franklin, but will have to do so carefully to avoid ballooning costs.

“How do we continue to create systems where we continue to grow to meet the needs of the community, but not have to grow the number of people who are there to meet the needs of the community? So we’re working on the efficiency side of things, we’re working on the supply side of things,” Franklin said.

Already AGH has more than 600 year-round positions, including a medical staff of 220 with a total payroll of more than $38 million annually. New service lines are constantly being added, including three new practitioners in areas like urology, dermatology and bariatric care. The hospital will be actively recruiting primary care physicians and nurse practitioners for Selbyville, Ocean City and West Fenwick in 2014.

AGH is exploring new kinds of partnerships such as the joint effort with the Kennedy Krieger Institute to offer doctor’s appointments online via telemedicine for youth with developmental disabilities. The hospital is also working in tandem with Worcester County schools to instill health literacy skills among students at a young age with the hope that the children will develop life-long good habits and become healthier adults.

After hearing Franklin’s report on the biggest red flags that AGH will be focusing on in 2014, Commissioner Judy Boggs brought up a more topical issue: the potential legalization of marijuana in Maryland some years down the road. Boggs asked Franklin if AGH will look to get ahead of the curve on the issue, which she believes could become a major health concern someday.

“With the rush nationally to legalize marijuana, I learned many years ago that smoking marijuana was as harmful if not more harmful than smoking tobacco,” said Boggs.

However, research is inconclusive on that, responded Franklin.

“There hasn’t been a whole lot of research done on the harmful side-effects other than obviously the buzzed side-effects and what it can cause from an impairment standpoint,” he told Boggs.

As more states legalize, Franklin suspects that the information available will increase dramatically but the issue isn’t a focus of the hospital at this time.

Some other highlights from the annual report include a number of strategic initiatives planned for 2014. AGH will attempt to “improve patient compliance with medication orders” by adding an ancillary pharmacy so that medicine can be delivered to patients before they leave.

“As research has shown only about 60- or 75-percent of people stop and get their discharge medications on the way home, we get a number of those people that are ending back up in the hospital,” he said.

As far as finances go, AGH saw an increase in the amount billed and received in FY13 compared to FY12. Last year, $119,611,769 was billed compared to $111,639,530 the year previous, with $95,207,833 and $86,680,899 collected those same years, respectively. The hospital also saw an increase to its total margin in FY13 at $2,726,012 compared to a margin of $1,456,119 in FY12, mainly due to a boost in the operating margin as well as additional community support.

However, finances will still be a challenge in FY14 as a proposed new waiver system could mean a switch from fee-for-service to a global payment system. State assessments are also poised to change.

“The bottom line in all of this is that we’ve got to figure out how to do this. So this is going to be quite a challenge particularly on that revenue line when, yes we do more business but we get the same or less money,” said Franklin.