Of Hancock County’s three hospitals two financially are in good health while the third, Maine Coast Memorial Hospital in Ellsworth, continues to operate in the red.
Mount Desert Island Hospital in Bar Harbor won’t have a final tally until their fiscal year ends in April, but President and CEO Art Blank predicts the balance sheet will show a gain.
“I think we’ve had a strong year,” Blank said.
Blue Hill Memorial Hospital in Blue Hill posted a $950,000 gain for the fiscal year that ended in September. That was down slightly from $1.07 million in 2016.
Maine Coast Memorial Hospital, which is on the same fiscal year as Blue Hill Memorial, had an operating loss of $6.47 million for 2017. For 2016, the loss was $6.35 million.
The two hospitals are part of the Eastern Maine Healthcare System (EMHS). Blue Hill Memorial joined in 2005, Maine Coast in 2015. John Ronan has been president and CEO at Blue Hill since 2010. Ronan, in August, assumed those same positions at MCMH and now heads both hospitals. He had been acting president since late 2016.
Faced with a series of losses of more than $6 million at MCMH, Ronan and other administrators there have the Sisyphean task of financial turnaround. He said there is a plan.
“It’s really about building up your primary care,” he said, explaining that preventive care has replaced the filling-the-beds model of the past. “We have to find ways to see more patients on a given day.”
At the same time, in-patient care remains important, Ronan said. EMHS has what it calls a “hub strategy” that strives to keep patients at their local hospital instead of moving them to Eastern Maine Medical Center in Bangor.
“I think most people in Hancock County want to stay in Hancock County,” Ronan said.
In response, both Maine Coast and Blue Hill Memorial have been increasing local access to specialists. For example, Maine Coast recently added a cardiologist, Ronan noted.
One difference in the bottom line between the two hospitals comes down to the fact that Blue Hill is designated a critical access hospital by the Centers for Medicare and Medicaid Services. Maine Coast doesn’t benefit from the same level of Medicare and Medicaid reimbursement, Ronan said.
MDI Hospital remains independent but is a member of the Maine Rural Health Collective, a group of six hospitals that collaborate to respond to health care issues.
Blank attributes much of the success of the Bar Harbor hospital’s success to the financial support of the community.
“It’s really a community partnership,” he said.
Of course, that is only part of the equation.
“We’ve worked very hard to be as cost-effective as possible,” he said.
One big change at MDI Hospital is the decision to have hospitalists on duty around the clock. These physicians specialize in the care of patients who are hospitalized and work to coordinate their care. This “focus on implementing the integrative health care model” treats the patient’s full needs, medical and behavioral.
“We’re comfortable that we’re working hard to address the needs of our community,” Blank said.
Blank noted that the retirement of some long-term employees, particularly Dr. Edward Gilmore, who had been at the hospital for 46 years and was its chief medical officer. Finding physicians to replace these people is a challenge.
“There’s a shortage of physicians nationally, particularly in where we need them: primary care,” he said.
Ronan agreed that the pool of applicants for physician jobs is diminishing. He blames the problem on the high demand nationwide and fewer people going to medical school because the “prestige of being a doctor” is not what it once was. He said he also believes his hospitals have lost candidates because of concerns about relocating to “the second highest tax state in the country.”
Retaining the current staff also is another issue.
“One of our challenges is physician burnout,” Ronan said. “Doctors are being asked to do more and more.”
Maine Coast also has had to deal with other personnel issues in 2017. Several physicians left the hospital in a dispute that was the result of a contract change that arose from joining EMHC. Ronan acknowledged that some of those positions have not been filled.
More recently, a group of health care providers at Maine Coast voted to unionize under the Maine State Nurses Alliance/National Nurses Organizing Campaign. What impact this has on the hospital has yet to be seen.
“We don’t know; we haven’t negotiated a contract with them yet,” Ronan said.
Ronan said negotiations would take place in California, where the national campaign is located and not at the local level. This is a concern, he said.
“I always prefer to deal with my employees directly,” he explained.