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Healthcare and the Economy: How Area Hospitals are Faring

In this segment of KSMU's Sense of Community Series, Michele Skalicky looks at the impact of the recession on hospitals in Southwest Missouri.

The recession has affected many different areas of our community, and healthcare is no exception. Area hospitals have postponed construction projects and are holding off on filling vacant positions that don’t relate directly to patient care while closely monitoring their budgets.According to the US Department of Labor’s Bureau of Labor Statistics, 107 hospitals had laid off 50 or more employees since November 30, 2008. That’s the highest number since the Bureau began collecting the data.Compared to hospitals in other parts of the nation, Southwest Missouri’s healthcare systems are faring well. But the recession has had an impact here.According to Donn Sorenson, executive vice president of St. John’s Health System, generally, healthcare nationwide and here in the Ozarks has been immune to economic downturns. But not this time…

"We are seeing on the physician side or the clinic side about a six percent decrease in patient volumes, which has led to considerable pressure on our operations."

The health system is seeing similar trends on the hospital side. Overall the hospital volume is down 5 and a half to 6 percent from a year ago.Jon Swope is president of St. John’s Hospital Division…

"Our community experienced the effects of the economic downturn, and it is certainly weighing on our patients' minds as they make decisions about when the should or, more importantly, when they shouldn't receive healthcare."

According to Donn Sorensen, the reasons the hospital and its clinics are seeing a decrease in volume are job losses in the area and people fearful of losing jobs who are putting off seeking medical care.At Cox Health Systems, volume has been choppy, according to Steve Edwards, Chief Operating Officer at Cox Health System. ER volume has flattened and gone down slightly as has clinic volume. But hospital volume was up. He says he believes ER and clinic volume are down because people are avoiding some care and they’ll unfortunately come back sicker…

"We have a seen a slight upward increase in the acuity of our patients. In the past three months it's gone up, so we think people are avoiding elective surgery, avoiding care and unfortunately for many that may mean they come back more sick."

Neither Cox Health nor St. John’s has had to lay off any employees. Edwards says they’re being cautious and reviewing every open position. He says they’re trying to take a measured response to the economy…

"By being well positioned but also knowing that our community is still growing and demand is still there, so we're trying to be very cautious. We have reduced some of our capital projects."

For example, the health system was in the conceptual stages of a 100,000 square foot business operations center and has decided to defer that. Instead, Cox is focusing its energies on clinical areas...

"Our area of greatest demand is our emergency departments. We're looking at urgent care expansions, which really matches up with the growth in our community and also the troubles we anticipate with patients who are losing insurance who will have nowhere to go but these other services, so we're trying to expand in those areas."

Edwards says they’re continuing to look at growing in critical areas such as orthopedics since they know that ultimately the economy will rebound, and the population is still aging. Cox is currently building an orthopedic hospital that will be connected to the Meyer Center and the Bone and Joint Center.Donald Babb, CEO of Citizens Memorial Hospital in Bolivar, also says growth is important despite the uncertain economic times. He says they’re being very cautious but they still want to continue to grow…

"We keep trying to move ahead and expand the programs we have to bring new people, new services, new dollars in, and I think in the healthcare environment that we're in, if we don't continue to grow, then the negative affect hits, and you don't want that, so it's just a matter of planning."

As people lose jobs and still need healthcare, Babb says they’re seeing an increase in uncompensated care. At St. John’s, too, uncompensated care is up, according to Jon Swope…both on the clinic and on the hospital side…

"We continue to see our patients with no insurance more frequently than we were in the past. We've run as high as one in every five of our emergency room patients don't have insurance, and that is as a result of the job loss and the reality of people simply not being able to afford their out of pocket expenses for those that even do have insurance."

Donn Sorensen says that’s had an adverse affect on their budget. But, despite that, he, too, believes growth must continue. He says they continue to review plans in critical areas such as the St. John’s Heart Hospital, Orthopedic Hospital and Women’s and Children’s Hospital and plans are ongoing for programmatic expansion and facility expansion in those areas though much of the major expense portion of that has had to be put off.This afternoon at 4:30, find out how the recession has impacted clinics that serve the uninsured and underinsured in Southwest Missouri.

This program is available on the web at ksmu.org. For KSMU News, I’m Michele Skalicky.