Carroll County Times
Carroll County

John Sernulka: New state hospital rules test-trialed at Carroll Hospital Center

Earlier this month, news from Annapolis and Washington, D.C., reported that Maryland was moving ahead with a new, updated system to ensure hospitals provide high quality health-care services through progressive cost controls that emphasize prevention and outcomes - not admissions.

This new approach to health-care delivery is possible because of a "Medicare waiver," a unique system among the 50 states that has a track record in Maryland of keeping costs down. However, our patients and area residents won't notice much of a change, because Carroll Hospital Center was a key participant in the state's pilot program, called Total Patient Revenue.

Over the next five years, Maryland will shift virtually all of its hospital payments to a fixed revenue model, giving hospitals incentives to work in partnership with other providers, like your physician or assisted living facility, to improve community health and prevent unnecessary hospitalizations. It is a major change in health care: Promote and work to keep people healthy and out of hospital beds rather than focus on admitting sick patients. Maryland hospitals will now be responsible for achieving quality outcomes designed to promote better care, better health and lower costs.

Carroll Hospital Center is in our fourth year of operating under the new rules as one of 10 Maryland hospitals in the pilot program, getting paid a set amount of money to care for patients each year, regardless of the number of patients.

While the hospital assumes some financial risk for caring for patients in the Carroll County service area, as we continue to improve quality and efficiency (benefiting both patients and the entities that pay for care), the hospital may achieve financial savings.

The hospital's staff and physicians are proud to work with the state to advance the new system. Since Maryland first adopted the initial Medicare waiver 35 years ago, the state's health-care costs have been significantly lower than the national average and saved patients and employers $45 billion.

Carroll Hospital Center has an advantage over many Maryland hospitals with the new system in that our focus, since our doors first opened in 1961, has been on our community and caring for our neighbors. In fact, for more than a half-century we have relied on civic engagement to expand the hospital's services and facilities, bring new technologies and advance essential health and wellness programs for our residents. We also are fortunate to collaborate closely with the Carroll County Health Department on key community health initiatives.

Today, Carroll Hospital Center is an energetic medical campus offering a growing range of specialized care. To serve every corner of the county, we've reached beyond the walls of the hospital with convenient satellite locations.

With advancements in medicine, we have stayed on the cutting edge to ensure our community has access to the latest diagnostic therapies, surgical procedures, imaging capabilities and medical treatments.

Our leadership team and community board of directors have devoted untold hours analyzing the needs of our region to formulate our Vision 2020 plan to outline how the hospital will continue delivering superior medical treatment and compassionate care in the coming years as the demographics shift and health-care reforms are fully implemented. We have developed a blueprint to ensure we will have the top-notch physicians, services, staff and facilities to continue to deliver unmatched care.

As evidenced by the community health needs assessment with The Partnership for a Healthier Carroll County, we know the top health imperatives include providing the tools and expertise to successfully help patients fight heart disease, cancer, substance abuse and obesity and maintain their mental health. By 2020, the number of Carroll County residents 65 years and older will grow an estimated 27 percent; this maturing population requires that we prepare to deal with the challenges of aging. To meet all these needs, we will need to attract more physicians while we expand and enhance our services and improve our hospital and outpatient facilities.

Fulfilling the Vision 2020 plan will require significant capital investments - in an environment when hospital payments will likely decrease from federal and state government.

As we focus on meeting the needs of Carroll County and the surrounding communities, funding the plan presents a financial challenge that Carroll Hospital Center is actively seeking to address. We are fortunate to begin this process on a firm financial footing and have opportunities and choices to carefully evaluate in order to fully develop and implement our plans.