QUINCY, Mass.-Competition has chipped away its maternity business. HCFA is chipping away its Medicare reimbursement. And Quincy (Mass.) Hospital has no partner to lean on.
The consequences-lower patient census and net losses in the millions-have forced Quincy to reduce its staff by 12%, or 130 positions, and phase out labor and delivery services at the end of October.
The hospital estimated that its once-thriving maternity department, which had 942 deliveries in fiscal 1995, will deliver 630 babies in fiscal 1998 ended Sept. 30 and lose $1.2 million. Deliveries were projected to tumble to 300 in 1999, and losses would have doubled to $2.5 million if the services had continued, said spokeswoman Renee Buisson.
That projection would have matched Quincy's $2.5 million loss from all services in fiscal 1997 on revenues of $74 million.
A healthy percentage of maternity referrals once came from a nurse-midwifery obstetrics practice Quincy established to meet needs of Medicaid patients who had trouble seeing physicians, Buisson said.
But with the state now gearing up to move Medicaid beneficiaries into managed care, providers have embraced the Medicaid caseload-and Quincy will shut down the obstetrics practice next month.
The Balanced Budget Act of 1997 also has hit Quincy hard, reducing Medicare payments in a hospital that derives 55% of its business from Medicare. Cutbacks are expected to reduce Medicare revenues by $3.7 million in 1998, Buisson said.
In fiscal 1998, medical-surgical discharges increased 4%, and inpatient surgical cases increased 12%. But the average length of stay dropped a full day during the past five months, lowering the average daily census. That means lower revenues from managed-care contracts, with many plans reimbursing on a per-day basis, Buisson said.
Operating losses are typical in Boston, but most hospitals have allied with larger systems that can better withstand year-to-year operating assaults (Sept. 14, p. 56).
However, Quincy is still alone two years after a planned merger with Carney Hospital in Boston was called off. The deal collapsed when Cardinal Bernard Law objected to the alliance of a Catholic facility with a municipal hospital that performed abortions and sterilizations.
A task force formed by Quincy's mayor is weighing offers from four regional organizations to buy the municipal hospital or form a joint venture. A recommendation on a suitor is scheduled for December.
STATEN ISLAND, N.Y.-Anthem, an Indianapolis-based insurer, is rolling out managed-care services in the New York metropolitan area. The company's local subsidiary, Anthem Health and Life Insurance Company of New York, recently obtained regulatory approval to offer a PPO backed by a network of some 30,000 primary-care physicians, specialists and other providers. Anthem Health of New York is part of the company's eastern operations.
DENVILLE, N.J.-Northwest Covenant Medical Center has unveiled a new name and a "strategic vision" that calls for a variety of service expansions. The northern New Jersey-based hospital, with three acute-care divisions and a behavioral health facility, is now Saint Clare's Hospital. Northwest's parent system, which includes housing and other healthcare services, is now called Saint Clare's Health Services. The name reconnects the system to the mission of the Sisters of the Sorrowful Mother, who founded a predecessor hospital as Saint Clare's in 1953. Kathryn McDonagh, who became the system's president and chief executive officer in 1997, has identified eight major service lines that will be the focus of future expansion. Plans include development of a pediatric emergency center, a women's cardiac disease program and a 20-bed inpatient unit for cancer care.