Editorial Note: This issue of MD News was going to focus on the future of health care. As the magazine content was being prepared and readied for publication, Kansas hospitals and medical practices were focused on responding to a pandemic threat that likely will impact the future financial health and business operations of medical practices and hospitals in Kansas. Therefore, our focus had to also change. With the impact of COVID-19 changing almost daily, our bimonthly publication could refer to just a few of the changes that resulted within a short amount of time.
With the novel coronavirus and COVID-19 threats, medical facilities in Kansas and elsewhere started making changes to their services and procedures and dealing with financial pressure brought on by concerns.
Visitor guidelines to hospitals became more restrictive. Entry points at most facilities were reduced, with staff members screening every person, including employees, who entered the facilities. Hospitals canceled elective surgeries to free up resources for handling any potential patients resulting from the virus.
Many facilities canceled nonessential travel and large group activities, such as the Medical Group Management Association of Kansas spring conference. Wesley Medical Center assured pregnant women that it was taking extra precautions to ensure safe deliveries and care for them and their newborns, noting that its labor and delivery operating rooms in its birth care facilities are separate from the hospital’s main OR.
To reduce risks, some practices began providing different options for handling patient concerns and medical appointments. For example, Ascension Via Christi patients were provided the option to use its video service, Ascension Online Care, which allows patients to talk to a doctor from a video-enabled smartphone, tablet or computer. It also offered the service at a discounted rate. Some Wichita practices implemented curbside check-ins for appointments, asking patients to call when they arrived in the parking lot and remain in their car until a staff member could usher them directly into an open exam room.
With personal protective equipment supplies dwindling, some facilities also started asking for and accepting donations of unused equipment and supplies, such as hand sanitizers and disinfectant wipes, from temporarily closed business. In Wichita, for example, five parish schools within the Catholic Diocese of Wichita and some students from Newman University collected and donated to Ascension Via Christi hundreds of sanitizing and personal protective items that were no longer needed. Their schools had been shut down for the remainder of the school year by Kansas Gov. Laura Kelly.
Hospitals and medical practices are also dealing with financial strains brought about by the pandemic concerns. One report from McClatchy newspapers cited that hospitals were losing 40% to 50% of their revenue responding to COVID-19, as elective surgeries were canceled and hospitals prepared for hospitalizing COVID-19 patients.
“It’s really a triple whammy,” says Chip Kahn, President and CEO of the Federation of American Hospitals, in the April 1 McClatchy article. “They’ve lost the services that provide the resources to run the hospital, then they have to prepare for the surge, and then when the surge comes, many of them are elderly or on Medicare — the payments are not going to be sufficient.”
Robert Kenagy, MD
“While the pandemic threatens the health and lives of those in our communities, it is also greatly disrupting our organization’s financial foundation,” Robert Kenagy, MD, Stormont Vail Health President and CEO, said at the end of March. “This juxtaposition is an ongoing challenge for all of us.”
To handle the financial impact, the Topeka-based healthcare system announced salary reductions for its leadership and staff. The deepest cuts of 50% affected those who were on no-work requirement administrative leave. Dr. Kenagy’s base pay was cut by 35% with other administrators taking cuts of between 15% and 25%. The pay cuts were to take effect April 5 and would be reviewed every 30 days, according to a letter mailed to the system’s community partners.
With a growing number of patients opting out of seeking routine, preventive or nonemergency care, medical practices in Kansas were also dealing with financial pressure. Some news reports estimated practices were seeing drops of 50% to 80% in visits.
Some financial relief for medical facilities was expected through the $2 trillion relief package passed by Congress and signed by President Donald Trump, but specifics weren’t available in early April.