Cooper Farms;
Just a couple points about your statement re: AMH;
Medicare pays AMH on a cost basis. The Critical Access program which started in 1997 was created to keep small rural hospitals alive after it was determined that the regular DRG system did not pay these small volume facilities enough to survive. So the reimbursement is supposed to be 101% of "allowable costs" not submitted charges. Due to the Federal 2% sequester this is now actually 99%
Allowable costs exclude such costs as marketing, entertainment and provider salaries from reimbursement.
Mt. Family Care Center is owned and operated by AMH, sure shifting volume from the ED to the clinic frees up ED time and space for more urgent care needs, but the cost of providing service to non paying patients does not go away, they just don't pay in a different department of the hospital.
Once a patient enters the ED seeking service there are certain required services which must be provided under the Emergency Medical Treatment and Active Labor Act. There is no prohibition to telling folks they could have sought care in a less expensive location after the required services are provided.
It is not illegal to advertise ED services, happens all the time.
The only outsourcing of staff has been of the Providers, the nurses and everybody else still works for AMH.
Just a question, what is an acceptable wait time for a non-emergent condition? I'd suggest that a failed root canal is not an emergent condition, I've been there but it is still not an emergency, the ED won't be able to do anything for you, why didn't you go back to the dentist?
PointMan
There is no free enterprise in healthcare in NC. As long as the State uses the Certificate of Need laws to control the Medicaid budget, then you'll never have free market competition.
Not sure who made the comment regarding "let the hospital close" and someone else will reopen it with better management, that would not happen, If AMH is closed as a hospital the licensed beds would revert back to the state to be re-allocated in the bed need formula, at this point there is a surplus of beds in the state, with the exception of in-patient psych beds so those beds would be lost to Ashe County. AMH will lose it critical access status if a sale takes place, so even that is typically a non-starter in most cases.
For those who have advocated that the Hospital take steps to reduce costs, There have been wage freezes for the staff, hiring freezes and the like, benefits have been reduced such as contribution to the retirement system and increased costs the the employees for medical insurance and other benefits.
You suggest that the Board should cut their benefits, as a Non-Profit the Board Members are volunteers and receive no compensation, they are not paid benefits such as health insurance or the like. Board members are not even given a discount on their bills. The one benefit which is provided is a meal, in the cafeteria, prior to the regular Board meeting each month.
