The Grant County Beat, on Wednesday, met with Gila Regional Medical Center Chief Financial Officer Elizabeth Allred and Chief Operations Officer Dan Otero to get some answers to clarify things for the community.

The first thing Allred told the Beat was that the hospital is in the black with about $80,000 net income in the first two months—July and August—of the current fiscal year 2014.

"We lost about $9 million last year," Allred said. "Most of it was related to the loss of the sole community provider funding, as well as from the dropping of other programs such as Medicare TOPs (transitional outpatient payments), which ended in mid-fiscal year on Dec. 31, 2012.

"The reality is that hospitals are going to get squeezed," she said. "The budget for this year was put together with a lot of assumptions, but we didn't have good numbers. There are too many unknowns. The Human Services Department still has not released numbers for next January. We are continuing cost-cutting measures trying to get the hospital fit and trim."

At the most recent GRMC board of trustees meeting, Allred said it is a possibility that a revised budget would be submitted to the state within the next few months, when better numbers are known.

"We are running the hospital like a business," Otero said.

"When reimbursements are cut so much, we are looking everywhere for efficiencies," Allred echoed.

"Our first responsibility is to the community and our caregivers," Otero said.

Allred said in response to what she had heard about the cutting of the Planetree program that "we have always been about patient-centered care, even before we chose to align with the Planetree program."

To a question about whether any price increases were expected at the hospital, Allred said GRMC had instituted price increases Aug. 1 of this year, and she did not anticipate any additional increases in the near future.

"We are having meetings to make sure that our prices are property aligned with our services," Otero said. "More public/private partnerships are happening in health care. We must ensure our pricing structures are competitive while simultaneously creating a reimbursement structure that facilitates a positive bottom line for long-term viability.”

Allred, in response to another question said GRMC still has substantial discounts for those who self-pay for services. "Anyone who pays up front gets 50 percent off. Those discount rates decrease over time. And if we have miscalculated the cost, we refund the money quickly."

Otero confirmed that the hospital is behind in sending out bills to patients, insurance companies, and other payers, such as Medicare and Medicaid, not because of the billing department, but because of a shortage of two coders. "Billing can't send anything out until it is coded. There is a national shortage of coders, so we are partnering with a company as a short-term strategy until we can hire full-time coders for the hospital."

Allred explained that the sole community provider funding was a subset of Medicaid. "There may be a potential increase in Medicaid rates, but it is not yet official, so we don't know the particulars."

"Our biggest opportunity is becoming more efficient in the hospital," Otero said. "For services that get a positive financial margin, we want to increase volumes."

"If things in the hospital are not efficient, we're looking at improving the process," Allred said.

"Aggressively," Otero said. "An inefficient process costs more money to operate."

Allred agreed and said that standardizing systems across various department and disciplines creates efficiencies.

"The regulatory stuff we have to abide by," Allred continued. "We are a government entity, so we have a fiduciary responsibility for taxpayers' money. It's not our money. We are taking care of assets that belong to the community. Regulatorially, it adds costs, but it's a safeguard for us and the community."

Otero said a special board meeting would be set to get the contracts going on the linear accelerator in the Cancer Center as soon as possible to lessen the impact to the community.

"It will be a several month process, but for patient impact, our goal is no more than 45 days," Otero said.

"We will work with patients to minimize the impact on them," Allred said.

"The new linear accelerator we are going to install is the best of the best," Otero said.

Allred said the funding comes to the hospital from the state cigarette stamp tax.

The next regular GRMC board of trustees meeting will take place at noon, Friday, Oct. 25, in the GRMC Board Room.