Chicot Memorial Medical Center Utilizes SRHT Project to Prepare for the Future

April 2016
National Rural Health Resource Center (The Center)

Chicot Memorial Medical Center (CMMC) in Lake Village, Arkansas is a critical access facility that uses state-of-the-art procedures and equipment to care for their patients. The hospital offers extensive medical services and programs, from a 24/7 emergency room to home health care. They also have an onsite laboratory and specialized outpatient clinics, including cardiology and urology.<--break->" title=""> David Mantz, Chief Executive Officer (CEO), shares this message on the hospital website: “The ability to seek comprehensive medical services so close to home is essential for a healthy and growing community. We pride ourselves on being a place for quality care close to home. Our mission at CMMC is to be committed to providing extraordinary healthcare services and promoting healthy living in the communities we serve across Southeast Arkansas. Our quality scores rank at the top in the state.   We're proud of how far we have come in serving our community, but we will continue to strive to improve even more. Our physicians, clinical staff and all of our employees are committed to providing compassionate care for our patients. We also count it an honor to serve your needs.”

Eric Shell, Director, and Lindsay Corcoran, Consultant, with Stroudwater Associates, worked with CMMC in 2015, through the Small Rural Hospital Transition (SRHT) project, on a Financial Operational Assessment (FOA) project. RHI staff spoke with David Mantz concerning their progress with this project.

Q: What are some of your hospital's successes regarding implementation of Eric and Lindsay’s recommendations?   
A: Overall, the hospital is doing well. When Eric was onsite, he provided education to the board and physician group concerning the future of health care. This is very helpful in engaging them. CMMC just completed a Community Health Needs Assessment (CHNA) and will hold a strategic planning with the board and clinic physician recruiting side, pulling this project and the CHNA findings together to create a two-year strategy.

As a result of the FOA, actions were taken regarding services provided. While a difficult decision, CMMC chose to discontinue obstetric services. In the specialty clinic, a neurologist (urologist) started recently and discussion is ongoing with two orthopedists. There has been a focus on marketing radiology and the CHNA confirmed that people don’t know what services radiology offers. In addition, signage concerning MRI, CT scan and mammography was placed in front of the hospital to increase the visibility. Marketing has also been expanded for the home health services and the census has increased by 40%. Marketing, in general, has been revamped and more is done to promote inside quality, a Facebook strategy was completed and the hospital updated and reworked the website and billboards.

Information Technology (IT) created a 5-year strategic plan beyond meaningful use. CMMC replaced the network and new servers to enhance IT functioning and are looking at other upgrades to enhance quality and business. A clinic staff member now works half time as clinical informatics staff.

Concerning the business end of operations and revenue cycle management (RCM), a number of recommendations have been addressed. Issues with the cost report regarding bad debt and accounts being returned are addressed and monthly reconciliation is being done. An early out program was implemented and there is follow up with patients (within the next month) to talk about their bill and to discuss payment options. The hospital is working on point of service collection but this has been slow because of business office turnover. A new business office manager has started and CMMC is optimistic that this will gain momentum. The hospital is making progress on “from close to bill” in five days or less by looking at timely chart completions for physicians. Providers are now given a weekly report card on billing that is delayed because of lack of documentation. A changed policy about minimal payments on outstanding bills has been implemented and there is more focus on assisting patients to determine charity care at the front end so bills aren’t remaining in accounts receivable. The Chief Financial Officer (CFO) is working to create a process to communicate with directors about monthly variance and not wait for the annual budget.

CMMC is presently working to create a staff funded health plan. They are working with Blue Cross/Blue Shield and with an expert in wellness to pull staff biometrics in preparation.

Q: What are the expected next steps towards adopting your consultants' recommendations? 

A: The hospital will continue to focus on physician recruitment and on finalizing the strategic plan.

Q: What are some of the outcomes from this project, both measurable outcomes and those that aren’t measurable but demonstrate the impact of this project on your hospital and community?

A: Concerning measurable outcomes, net patient revenue increased and “days cash on hand” surpassed the goal set during the project. Regarding non-measurable goals, CMMC has seen:

  • Board and directors are more aware of strategy and need for changes
  • There is increased buy-in for the need to change because of the future of health care
  • There is better communication in general
  • Community awareness of services has improved

Q: How do you believe this project has helped you move forward in the newly emerging system of health care delivery and payment?

A: Board and leadership understand this issue better, creating a sense of urgency with the things we are working on and making the necessary changes to position our organization well for the future.