Partnership with BWWMH first of its kind for UAB

For more than a year the Tombigbee Healthcare Authority board worked long hours to form a partnership with the University of Alabama at Birmingham Health System.

The hard work became official Oct. 1 when the two entities signed a Management and Affiliation Agreement.

At the Wednesday meeting of the Demopolis Rotary Club, Bryan W. Whitfield Memorial Hospital board vice chairman Alan Bishop explained the benefits of the partnership with the hospital and to the Demopolis area. He told local Rotarians that the process has been “quite a journey.”

“The time that has been spent has been unbelievable,” he said.

Cooperation started early with the formation of a transition team of representatives from the hospital, UAB, the city and the county. Former Robertson Banking Company President Al Garrett came out of retirement to chair the team.

While UAB has expanded its medical services to Montgomery and other larger communities, the partnership with BWWMH is the first venture into rural health care. The move was made possible because of legislation in 2016 opening the door for University Health Authorities to help rural systems. The collaboration brings with it the Birmingham-based hospital’s management and expertise, marketing, physician recruitment and purchasing, Bishop said.

Such affiliation also brings with it UAB’s reputation strength, he continued.

Already in place was a recently opened branch of the University Medical Center in the Outpatient Building of the hospital, joining UMC’s two other locations in Tuscaloosa and Northport.

Two UAB officials now serve on the BWWMH board. “I thought they’d send down a couple of middle managers,” said Bishop. Instead, the two are Don Lilly, senior vice president of network development and affiliate operations, and Sean Tenney, chief operations officer for the Medical West Hospital. The two sat in their first board meeting on Oct. 26.

UAB is very conscious of its brand. Within the next two to three months, an approved UAB sign will be erected on U.S. Hwy. 80 to let everyone know of the relationship between UAB and BWWMH.

While the link with the Demopolis hospital is the first venture into rural health care for UAB, Bishop said it probably won’t be the last. Lilly’s focus has been to expand UAB’s outreach.

Such a partnership is a win-win for both facilities. With BWWMH handling cases that normally would be transferred to UAB, beds will be freed in Birmingham for more acute medical needs.

“UAB is not here just to be a nice guy,” said Bishop. “UAB is here to make money.”

The new partner is studying the survey that BWWMH conducted to determine what services are needed in the area.

UMC Demopolis to hold open house Thursday

BWWMH, UAB exploring potential collaboration

The University of Alabama at Birmingham Health System and the Tombigbee Healthcare Authority, operator of Bryan W. Whitfield Memorial Hospital in Demopolis, Ala., have entered into a nonbinding memorandum of understanding to explore a possible relationship between the organizations. The action follows legislation passed in 2016 by the Alabama Legislature creating University Health Authorities to help Alabama hospitals.

“One of the main goals of this legislation was to help find ways to assist rural hospitals in remaining viable for the future,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “This will be one of the first opportunities to utilize this legislation and explore ways in which UAB and Bryan Whitfield Memorial can work together to improve health and wellness in Demopolis and the surrounding region.”

“We are excited at the prospect of potentially working with UAB for the future benefit of providing health care for the patients we serve,” said Art Evans, CEO of Bryan W. Whitfield Memorial Hospital. “We look forward to our continued progress and moving forward through this process.”

About UAB

Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham is an internationally renowned research university and academic medical center, as well as Alabama’s largest employer, with some 23,000 employees, and has an annual economic impact exceeding $5 billion on the state. The five pillars of UAB’s mission include education, research, patient care, community service and economic development. UAB is a two-time recipient of the prestigious Center for Translational Science Award. Learn more at UAB: Knowledge that will change your world.

Evans discusses BWWMH future with Demopolis Rotary

Art Evans speaks to the Demopolis Rotary Club on Wednesday, March 30. (Photo by Jan McDonald)

Art Evans speaks to the Demopolis Rotary Club on Wednesday, March 30. (Photo by Jan McDonald)

Demopolis’ hospital will “take a ‘selfie’” over the next three months as it conducts a Community Health Needs Assessment (CHNA).

Art Evans, CEO/administrator of Bryan W. Whitfield Memorial Hospital, told members of the Rotary Club Wednesday the assessment, being conducted by an independent agency, will cover demand for future services, where patients go if not to the local hospital, service time performance, core services, physicians’ needs and a SWOT analysis.

The last such CHNA occurred five years ago, Evans said. They are conducted on a regular basis to gauge how well the hospital is doing and how it can improve.

Part of the CHNA will be a survey of stakeholders in the five-county area the hospital covers, he continued. People such as health care professionals, elected officials and community leaders will be asked to give their opinion on improving hospital services.

Once the CHNA is complete, the hospital must set out an implementation strategy to address improvement issues as mandated by the IRS. The assessment helps the hospital recognize trends so that it can be proactive in preparing for the future.

Evans also talked about the issue of Medicaid funding in Alabama. Medicaid, he said, is limited to children, pregnant women, the elderly and disabled. Alabama has the most restrictive eligibility standards in the country since those requesting aid cannot make more than $2,867 a year.

For every 32 cents the state puts into Medicaid, the federal government adds 68 cents. Alabama has the third lowest cost per enrollee in the country.

The proposed legislation to add only $15 million to the Medicaid budget will fall far short of what is needed, Evans continued. “Level funding is going to force Medicaid to cut services,” he said.

The hospitals and medical professionals in the state have been working for the past two years on a Regional Care Organization plan which would start Oct. 1. Because it is done within the state and each RCO would manage its allocated funds, the usual 15 percent administrative fee would not have to be paid to an outside insurance company to oversee, saving costs for the state.

However, unless more money is added to the Medicaid budget, the RCOs are in jeopardy of not being able to begin and help keep down health care costs for those in need.

Evans stressed to the Rotarians that hospitals in the state get no money from the General Fund Budget. Hospitals themselves pay into a state fund that is matched at the federal level three-to-one. That money is returned to the hospitals after the state takes out 15 percent for the Medicaid agency.

The General Fund Budget, he explained, helps pay for physicians, pharmacies and nursing homes.

To help generate more funds for the hospital, Evans said BWWMH is taking advantage of the federal influx of $750 million to help jump-start the RCO program by submitting plans on how to save money in the long run. If approved, the hospital will be rewarded monetarily.

The hospital, said Evans, expected to submit three plans on Thursday. They include a more efficient admittance of patients to the Emergency Department, whether there for clinical ailments or more critical needs; group physicians to handle more Medicaid patients, and better use of the Health Care on Wheels van.

The hospital has received a $900,000 grant to extend the Health Care on Wheels for one year. It will equip the van and physicians’ offices, including technology to connect the van to doctors’ offices, and will pay for the doctors, nurses and nurse practitioners to man the van.

The van started last week and will have a rotating two-week schedule through the rural areas of the five counties the hospital serves.

The hospital on Tuesday received its audit report. While the auditors gave it a clean report, Evans said it showed that operating costs are 107 percent of the net patient service revenue.

The good news, he said, is that it is the lowest cost-to-revenue among the peer hospitals that the auditors used as comparisons.

Hospitals now have to rely on other sources of revenue besides patients paying their fee. The difference between BWWMH and the other hospitals it was compared to is that the others received millions of dollars in local government support.

The local hospital lost $650,000 in 2015. Thanks to cost-cutting measures and more efficient operations, the loss is considerably less that previous years. It is trending in the right direction, said Evans.

Hospital board discusses 340B program

“It’s a very complex program but of great benefit to the hospital,” Marty Brown, director of pharmacy at Bryan W. Whitfield Memorial Hospital, told the board at its meeting Thursday.

Because of its complexity, however, the 340B Contract Pharmacy Program still has glitches being worked out, she continued. Once it is fully implemented more eligible patients will be able to get the drugs they need. Brown has been working on the startup of the program for a year.

The hospital has been part of the 340B program since 2005. The program allows hospitals that have a disproportionate number of indigent patients to buy drugs at a discounted price. Only last fall did BWWMH enter into contracts with CVS and the Wal-Mart stores in Demopolis and Thomasville. Those stores benefit from lower drug replacement prices.

The hospital opted to contract with local pharmacies instead of setting up its own to keep from competing with them, said Brown.

Confusion has arisen because of the restrictions on who is eligible and the how to identify them so that Capture RX, the company that administers the program, can review prescriptions and reimburse the providers.

No Medicaid patients are included in the program, and no generic drugs are eligible for reimbursement, she went on.

Prescriptions “must be written for our patients by our physicians,” she said.

So far the reimbursement figures from prescription drug sales has been “disappointing,” but when the kinks are worked out, the benefits should be realized.  She told the board the program’s promise is worth continuing for the next few months. Then it can be reviewed.

Because of a law passed by Congress last November, the hospital no longer can consider using John Essex School as a facility for the Partial Hospitalization Program (PHP). It now is housed in the Holified Clinic but is rapidly outgrowing the facility.

The law, which went into effect Nov. 2, prohibits setting up off-campus programs in buildings more than 250 yards from the hospital.

The law, said PHP Committee chair Rob Fleming, “snatched John Essex out from under our feet.”

The board approved the hospital’s pension plan updates required by the IRS and other agencies.

It also approved the following reappointments:

  • Active staff: Dr. Keith Roberts
  • Special limited staff: Pat Moore,CRNA, and Gayla Culpepper, CRNP
  • Courtesy staff: Dr. James Geyer
  • Consulting staff: Drs. Amit Shah, James Proctor, Shelby Sanford, Dmitry Zak, Ronald Stanton and Robert Williams.
  • Emergency room: Dr. Mohamed Khalaf through February.

The board also heard the following reports:

  • Judy Travis said the medical staff is reviewing its bylaws and will vote on them at its next meeting.
  • Assistant administrator Derrick Morrison said the hospital was inspected by the insurance carrier which recommended a roof inspection.
  • Morrison also reported that the guidelines on active shooter response was resent to all departments.
  • Thomas Moore said the Public Partnership Committee will discuss a strategic plan once all stakeholders are present. The committee’s next meeting is Feb. 10.
  • Hospital administrator Arthur Evans said a photo display of the Employee of the Month will be set up in the hall next to Human Resources.