SPRINGFIELD, Vt. – Recent changes to Springfield Hospital including elimination of the Birthing Center, and changes to contracted service providers have allowed the hospital to realize over $7 million in savings that they need to survive.
Now Springfield Hospital looks to work out the details of its Birthing Center partnership with Brattleboro Memorial Hospital. According to Interim CEO Mike Halstead, Springfield Hospital will continue providing pre- and postnatal care locally, even though expectant mothers will be delivering their babies in Brattleboro Memorial Hospital, a 42-minute drive from Springfield.
Part of that plan is having the Brattleboro Obstetrician group operating 2-3 days a week out of a Springfield location. Halstead and his administrative staff are looking for the location now where the Brattleboro obstetrics team and the Springfield gynecologists will be able to provide services side by side in the same location. Expectant mothers can then have all their prenatal and postnatal appointments, including testing, done locally while establishing a rapport with the staff that will be at BMH when they travel south to deliver their babies. Locations being considered are in the Ridgewood Office Building or in Springfield Hospital itself.
Halstead understands why the decision to close the Birthing Center initially caused uproar among locals. “This is a very emotional issue,” he said. Despite the initial reaction Halstead believes that “most of the people understand that it’s a decision that had to be made.”
The board thought long and hard before making their decision, according to Halstead, but realized they had no choice from a financial perspective. The Birthing Center only delivers approximately 150 babies each year but must be prepared for a C-section level of service around the clock. That amounted to losses each year that the hospital couldn’t sustain.
Even with the Birthing Center ending operation June 1, 2019, the hospital will still be prepared to deliver a baby in the emergency room. “If the decision by the emergency room doctor is you do not have the 42 minutes it takes to drive to Brattleboro, you will be delivered here,” said Halstead. Emergency room physicians are fully trained to do deliveries.
With the decision to close the Birthing Center, Halstead doesn’t anticipate eliminating any additional lines of service although they will continue to try to tweak services or look to and do them in a different way. Specifically, now with the elimination of the Birthing Center, they can restructure surgical services to be more cost effective since they will no longer need to have 24-hour coverage for certain services like anesthesiology.
Additional cost savings for Springfield Hospital are being realized in the upcoming switch to a new emergency services provider, BlueWater Emergency Partners, a contracted service provider that staffs fully-trained physicians and physician assistants in small hospitals around New England. They will provide a core group of providers assigned to the Springfield location but can also pull additional staff from other locations as needs change. According to Halstead, “That’s the benefit of having a service. They are responsible for scheduling and staffing. They are able to increase or decrease staffing based on need which helps to keep costs in check.”
BlueWater is replacing a previous contract provider, Emergency Services of New England, which had been operating within Springfield Hospital for over 40 years. As part of the process of reviewing all contractors, BlueWater was able to provide services for less than ESNE and included providing an M.D. on site at all times, an upgrade in service. BlueWater will take over staffing the emergency department April 9, 2019. Billing will be slightly different in that patients will receive two bills after they visit the emergency room, one from the hospital and one from the doctor provided by BlueWater. The total cost will be the same however.
Still, news from Springfield Hospital hasn’t been all about cuts. Recent reports showed that some hospital staffers received pay raises. Once initial staff salary reductions went into place in late February, the hospital saw approximately 50 additional people leave voluntarily. Some of the positions were direct patient caregivers such as R.N., LPN, and social workers. At that point, Halstead realized that the hospital “can’t operate the organization without those types of people.”
In looking to replace those positions, Springfield Hospital needed to be competitive in the marketplace and therefore needed to adjust the salaries accordingly, also raising the salaries of those that had stayed. Of those 50 that left, a number of those jobs would not be replaced however, so they were able to realize salary savings overall.
Still, the need to find additional savings and revenue continues. According to Halstead, “Overall, we are working to align revenues and expenses to bring our organization in balance. The recent expense reductions we’ve put in place are helping us achieve that goal; and we’ve identified over $7 million in expense reductions to date. There is, however, also a need to look to the revenue side of the equation to help cover the cost of care.”
Additional measures to increase patient revenue are being explored with Halstead asking the Green Mountain Care Board to approve measures that would allow Springfield Hospital to charge an additional 5% to the amount they can charge insurers throughout the remainder of the fiscal year. The board will meet with Springfield Hospital leaders and administrators during a public meeting before acting on that request.